People with childhood adversity at elevated risk for CVD in young adulthood
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Children who experienced adversity from age 0 to 15 years were at elevated risk for developing CVD in young adulthood compared with those who did not, researchers reported in the European Heart Journal.
“Compared to young adults who experienced little adversity in childhood, we found an approximately 60% higher risk of developing cardiovascular disease among young adults who had experienced adversity,” Naja Hulvej Rod, MS, PhD, DMSc, head of epidemiology at the department of public health at the University of Copenhagen, Denmark, said in a press release. “This was especially true for those who had experienced serious illnesses, such as cancer, heart or lung diseases, or death in the family, and those who had experienced high and accelerating levels of adversity in childhood. In absolute numbers, this corresponds to 10 to 18 extra cases of CVD per 100,000 person-years. For comparison, the average incidence rate of CVD among a 30-year-old person is approximately 50 cases of CVD per 100,000 person-years.”
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Childhood adversity and CVD
Rod and colleagues analyzed 1,263,013 individuals born in Denmark between 1980 and 2001 who were not diagnosed with CVD or congenital heart disease before age 16 years. They stratified the cohort into five groups based on adversity experienced between birth and age 15 years.
Adversity was determined based on material deprivation (family poverty, parental long-term unemployment), loss or threat of loss in the family (parental and sibling somatic illness and death) and family dynamics (foster care placement, parental and sibling psychiatric illness, parental alcohol and drug abuse, maternal separation), the researchers wrote.
The five groups were low adversity, early deprivation, persistent deprivation, loss or threat of loss and high adversity.
During the study period, which ended at the end of 2018, 4,118 participants developed CVD from age 16 to 38 years.
Compared with those with low adversity, all other groups had elevated risk for CVD, Rod and colleagues found.
Excess CVD incidence
The highest risk was observed in the loss or threat of loss group (adjusted HR for men = 1.6; 95% CI, 1.4-1.8; aHR for women = 1.4; 95% CI, 1.2-1.6) and in the high adversity group (aHR for men and women = 1.6; 95% CI, 1.3-2).
Those risks translated into an extra 15.6 cases of CVD per 100,000 person-years for men in the loss or threat of loss group, 9.7 cases of CVD per 100,000 person-years for women in the loss or threat of loss group, 18 cases of CVD per 100,000 person-years for men in the high adversity group and 18.1 cases of CVD per 100,000 person-years for women in the high adversity group, the researchers wrote.
“The association we saw between childhood adversity and CVD in early adulthood may be explained partly by behaviors that can affect health, such as drinking alcohol, smoking and physical inactivity,” Rod said in the release. “Childhood is a sensitive period characterized by rapid cognitive and physical developments; the frequent and chronic exposure to adversity in childhood may influence the development of the physiological stress response, and this may provide an important explanation for the mechanisms underlying these findings. Targeting the social origins of such adversity and ensuring supportive structures for families who are, for example, struggling with disease in the family may potentially carry long-term protective effects.”
Reference:
- European Society of Cardiology. https://www.escardio.org/The-ESC/Press-Office/Press-releases/adversity-in-childhood-is-linked-to-increased-risk-of-heart-and-blood-vessel-dis. Published Nov. 15, 2022. Accessed Nov. 17, 2022.
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