Childhood adversity increases the risk of cardiovascular disease (CVD), according to a recent study.
CVD is currently the leading cause of death worldwide, with the incidence of CVD in young people increasing over time. Genetic factors are associated with CVD, but researchers hypothesized that environmental and behavioral factors also influence CVD risk.
Adversity has been associated with CVD in middle-aged and older adults, but few data have been collected on the effects of childhood adversity on CVD in young adults. Multiple internal systems develop during childhood, including a physiological response to stress. The development of this system can be influenced by frequent exposure to adversity.
Overeating, excessive alcohol consumption, and smoking are behaviors associated with cardiovascular disease, and childhood adversity is associated with a higher risk of these behaviors. However, the effects of childhood adversity on congenital etiology are still unclear.
To examine the impact of childhood adversity on CVD in individuals aged 16 to 38 years with a focus on ischemic heart disease (CHD) and cerebrovascular disease (CHD), researchers conducted a population-based cohort study. The data was collected from the DANish LIFE course group, containing information from multiple registries across the country.
For the study, information on childhood adversity, morbidity and mortality of children born between 1 January 1980 and 31 December 2001 was obtained. Participants were alive and residing in Denmark until their 16th birthday without a diagnosis of CVD or congenital heart disease. The final study population included 1,263,013 individuals.
Poverty was divided into 3 categories: loss or threat of loss in the family, family dynamics and material deprivation. Family poverty and long-term unemployment of parents are cases of material deprivation, while somatic illness of parents and siblings and death are loss or threat of loss in the family.
Family dynamics included: parental alcohol and drug abuse, foster care, parental and sibling mental illness, and maternal separation.
CVD such as CHD or CD events was the primary outcome. Covariates included year of birth, paternal age at birth, parental country of origin, and parental cardiometabolic disease. Adjustments were made for the effects of being small for gestational age at birth and parental education at birth.
The mean follow-up period for participants was 10.8 years after their 16th birthday. During this follow-up period, 4118 participants developed CVD, 966 of whom developed CHD and 3152 CD. There were 5,178 deaths from a cause other than CVD and 96,812 emigrations from the study before follow-up.
Participants were more likely to face difficulties if they were born to teenage mothers, with persistent risk of deprivation high among this group. Material deprivation is also common among children born to non-Western parents.
Parental cardiometabolic disease was seen in 24% of participants with material deprivation, 36% with loss or threat of loss, 39% with severe disadvantage and 21% with low disadvantage. Low parental education was seen in 8% of participants in the low disadvantage group and 54% of the high disadvantage group, and low for gestational age was seen in 11% of the low disadvantage group and 22% of the high disadvantage group unfavorable conditions.
Individuals with high distress had an increased risk of developing CVD, with 10 to 18 additional cases per 100,000 people. Men and women in the loss or threat of loss group had 15.6 and 9.7 more CVD events per 100,000, respectively. Individuals who are young or have experienced material deprivation are also more likely to develop CVD, but the risk is only slightly higher than average.
Because major childhood adversity leads to the greatest risk of cardiovascular disease, researchers recommend that efforts to provide support to affected families reduce the extent of long-term cardioprotective effects.
reference
Bengtsson J, Elsenburg LK, Stig Andersen G, Lytken Larsen M, Rieckmann A, Hulvej Rod N, Childhood adversity and cardiovascular disease in early adulthood: a Danish cohort study. European Heart Journal. 2022. doi:10.1093/eurheartj/ehac607
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