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Health News

The Toll of Childhood Adversity

by Keng Lam, MD  

A new scientific statement from the American Heart Association (AHA) has added to the evidence that traumatic events in childhood can have a powerful effect not just on people’s future mental health, but on their physical health—specifically heart health.

Published in Circulation in December 2017, the statement summarizes the latest research on how childhood traumas—such as violence at home, sexual abuse, and bullying—can lead to negative cardiometabolic outcomes across the life course, such as hypertension, obesity, diabetes, and even heart attacks. One especially influential study, the Adverse Childhood Experiences (ACE) Study, actually showed that the greater number of specific childhood adverse experiences one has (up to a certain threshold), the greater the odds for heart disease later in life. This positive relationship persisted even after the ACE study investigators controlled for unhealthy lifestyle behaviors, such as heavy drinking or smoking, as well as socioeconomic status. Low socioeconomic status is independently associated with a host of health problems, including cardiovascular disease.

How might childhood trauma influence heart disease independent of other risk factors? The current proposed model is that childhood adversity can increase inflammation, cortisol, and other hormonal changes in the body that in turn contribute to hypertension, obesity, diabetes, and even clogging of blood vessels. Of course, childhood trauma can also have a profound negative effect on an individual’s mental health, which raises the risk of unhealthy lifestyle behaviors such as smoking, eating an unhealthy diet, and substance use—all of which then influence cardiovascular risk.

The AHA concludes that more research is still needed into the mechanisms of heart disease and what types of interventions in young people exposed to trauma might lead to better outcomes. But the statement sends an important message by acknowledging that traumas in a person’s early years can have literally heartbreaking consequences.

Also see How Stress Hurts Children's Health.