1
|
DeAndrade S, Pelletier A, Grossman S, Lewis-O'Connor A, Dutton C, Royce CS, Bartz D. Trauma-Informed Care Training in U.S. and Canadian Ob/Gyn Residencies. Violence Against Women 2024:10778012241230328. [PMID: 38356282 DOI: 10.1177/10778012241230328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
This is a cross-sectional study investigating the prevalence and nature of trauma-informed care (TIC) training in obstetrics and gynecology residency programs. In our sample, 20% of programs had annual TIC training, 53% had less than annual training, and 27% had no training at all. Only 25.3% of respondents were satisfied with their current training in interpersonal trauma and TIC. A lack of facilitators to conduct such training was the primary barrier to implementing TIC. Significant opportunity exists to improve TIC education for Ob/Gyn trainees.
Collapse
Affiliation(s)
- Samantha DeAndrade
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham & Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andrea Pelletier
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham & Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Samara Grossman
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, USA
| | - Annie Lewis-O'Connor
- Harvard Medical School, Boston, MA, USA
- Division of Women's Health and Internal Medicine, Brigham & Women's Hospital, Boston, MA, USA
| | - Caryn Dutton
- Harvard Medical School, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Celeste S Royce
- Harvard Medical School, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Deborah Bartz
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham & Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
Brown MJ, Amoatika D, Addo PNO, Kaur A, Haider MR, Merrell MA, Crouch E. Childhood Sexual Trauma and Subjective Cognitive Decline: An Assessment of Racial/Ethnic and Sexual Orientation Disparities. J Appl Gerontol 2023; 42:2129-2138. [PMID: 37218145 PMCID: PMC10523896 DOI: 10.1177/07334648231175299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Prior studies examining the association between childhood sexual abuse (CSA) and subjective cognitive decline (SCD) are limited. The aim of this study was to examine the racial/ethnic and sexual orientation disparities in the association between CSA and SCD. Using data from the 2019 Behavioral Risk Factor Surveillance System Survey, crude and multivariable logistic regression models were used to determine the association between CSA and SCD adjusting for sociodemographic characteristics, diabetes, hypertension, and depression. There were statistically significant differences in CSA status by age, gender, income, education, employment, and health status (depression). Black and Hispanic/Latine respondents had a stronger relationship between CSA and SCD compared to White populations. Also, sexual minority populations had a stronger relationship between CSA and SCD compared to heterosexual populations. Health disparities exist in the association between CSA and SCD. Trauma-informed interventions should be implemented among affected populations.
Collapse
Affiliation(s)
- Monique J. Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Daniel Amoatika
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Prince Nii Ossah Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Melinda A. Merrell
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
3
|
Kellum CE, Kemp KM, Mrug S, Pollock JS, Seifert ME, Feig DI. Adverse childhood experiences are associated with vascular changes in adolescents that are risk factors for future cardiovascular disease. Pediatr Nephrol 2023; 38:2155-2163. [PMID: 36622441 PMCID: PMC10234926 DOI: 10.1007/s00467-022-05853-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, are associated with a higher risk of cardiovascular disease (CVD) and indicators of future CVD risk in adulthood, such as greater vascular stiffness. The impact of ACEs in adolescence is unclear, and understanding how ACEs relate to blood pressure (BP) and vascular function during early life is key for the development of prevention strategies to reduce CVD risk. We hypothesized that exposure to ACEs would be associated with changes in central hemodynamics such as increased vascular stiffness and higher BP during adolescence. METHODS This pilot study enrolled 86 adolescents recruited from the Children's of Alabama. A validated ACE questionnaire was employed, and ACEs were modeled both as a continuous variable and a categorical variable (ACE ≥ 1 vs. ACE = 0). The primary outcomes used are considered to be indicators of future cardio-renal disease risk: aortic augmentation index normalized to 75 bpm (Alx75, a surrogate for vascular stiffness), carotid-femoral PWV (m/s), and ambulatory BP patterns. RESULTS Adolescents with ACE ≥ 1 had significantly higher Alx75 (ACE: 5.2% ± 2.2 compared to no ACE: - 1.4% ± 3.0; p = 0.043). PWV only reflected this trend when adjustments were made for the body mass index. Adolescents with ACEs showed no differences in ambulatory BP patterns during the 24-h, wake, or sleep periods compared to adolescents with no ACEs. CONCLUSIONS ACEs were associated with higher AIx75 in adolescence, which is a risk factor for future CVD. Adolescence could present an opportunity for early detections/interventions to mitigate adverse cardiovascular outcomes in adulthood. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Cailin E Kellum
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Keri M Kemp
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Jennifer S Pollock
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA.
| | - Michael E Seifert
- Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Daniel I Feig
- Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| |
Collapse
|
4
|
Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Thomas EBK, Taylor A, Teague TK, Jenkins NDM. Progressive exercise training improves cardiovascular psychophysiological outcomes in young adult women with a history of adverse childhood experiences. J Appl Physiol (1985) 2023; 134:742-752. [PMID: 36727632 PMCID: PMC10027078 DOI: 10.1152/japplphysiol.00524.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
Adverse childhood experiences (ACEs) are early-life psychosocial stressors that are associated with poorer mental health and increased cardiovascular disease (CVD) risk in a dose-dependent manner. We examined the feasibility of an 8-wk combined aerobic and resistance exercise training program to improve systolic (SBP) and diastolic blood pressure (DBP), serum endothelin-1 (ET-1), resilience, hope agency, and hope pathways in young women with ACEs. Forty-two healthy women (21 ± 3 yr) with ≥4 (ACE+; n = 28) or 0 ACEs (ACE-; n = 14) participated in this study. Women with ACEs were randomly assigned to an exercise (ACE+EXT; n = 14) or nonexercise control (ACE+CON; n = 14) group, whereas all ACE- participants were assigned to a nonexercise control (n = 14) group. Hope agency and DBP did not change in any group (P ≥ 0.43), but hope pathways improved only in ACE+EXT (means ± SE change; +1.6 ± 0.74 au, P = 0.032, Hedges' g = 0.53). ET-1 decreased in ACE+EXT only (-0.31 ± 0.15 pg/mL, P = 0.043, g = 0.46). Although the interactions for resilience and SBP did not reach significance (P = 0.05-0.06), forced post hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, P = 0.012, g = 0.64) and SBP tended to improve (-4.0 ± 2.0 mmHg, P = 0.053, g = 0.51) in ACE+EXT only. There were significant associations between changes in hope pathways and SBP (ρ = -0.43, P = 0.023) and ET-1 (ρ = -0.53, P = 0.005), and between changes in SBP and ET-1 (ρ = 0.49; P = 0.012) in the ACE+ group. In summary, structured exercise training reduces serum ET-1 levels, improves positive psychological coping, and may improve SBP in young women with ACEs. The relationships among the changes in hope pathways, SBP, and ET-1 suggest a cardiovascular psychophysiological relationship in young women with ACEs.NEW & NOTEWORTHY This randomized controlled pilot trial shows, for the first time, that 8 wk of structured, progressive exercise training lowers serum endothelin-1 (ET-1) and improves positive psychological coping in young women with significant early-life psychosocial stress. Furthermore, the observed associations among changes in psychological attributes, ET-1, and systolic blood pressure signify a potential interplay between positive psychology and cardiovascular disease risk among women with adverse childhood experiences.
Collapse
Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio, United States
| | | | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, Oklahoma, United States
| | - Emily B K Thomas
- Department of Psychology and Brain Sciences, University of Iowa, Iowa City, Iowa, United States
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Science, Tulsa, Oklahoma, United States
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa, United States
| |
Collapse
|
5
|
Liveri K, Dagla M, Sarantaki A, Orovou E, Antoniou E. Abuse of Girls During Childhood and Its Impacts on the Health of Their Adult Lives: A Systematic Review. Cureus 2023; 15:e34981. [PMID: 36938260 PMCID: PMC10019939 DOI: 10.7759/cureus.34981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
Child abuse is a global problem for public health as it negatively affects people and society. The US Centers for Disease Control and Prevention (CDC) associates the adverse experience during childhood with a series of long-term impacts on health. The aim of this study is to explore the impact of child abuse on females' health, including physical, mental, and social health. The methodology used in this specific review is to carry out a systematic search in electronic databases (Google Scholar, Scopus, PubMed, and Crossref) in published articles between 2004 and 2021. The exclusion criteria were all review papers, such as literature reviews, systematic reviews, and meta-analyses. We also excluded papers that were not written in the English language. Consequently, the inclusion criteria were written in English, original articles, and prospective, case-control, cross-sectional studies that investigated childhood abuse of girls and the health effects in adulthood. Initially, from a total of 796 papers returned by the search, 415 were rejected due to duplicate articles, systematic reviews, and meta-analyses. In addition, 316 articles were rejected due to nonrelevance to the study's subject. However, from the first 796 papers, 18 met the conditions to be included in the review. We found that females exposed to childhood abuse were more likely to suffer from eating disorders, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, anxiety, phobias, paranoid ideation and psychoticism, early menarche, sleep disorders, metabolism disorders, cardiovascular diseases, asthma, chronic pain, and early mortality, which are physical and mental conditions in females' adulthood related to child abuse. The conclusions of this work show that it is a primary need to give emphasis on combating child abuse and timely management when this is a fact.
Collapse
Affiliation(s)
- Kyriaki Liveri
- Department of Midwifery, University of West Attica, Athens, GRC
| | - Maria Dagla
- Department of Midwifery, University of West Attica, Athens, GRC
| | | | - Eirini Orovou
- Department of Midwifery, University of Western Macedonia, Ptolemaida, GRC
| | | |
Collapse
|
6
|
Caceres BA, Huang Y, Barcelona V, Wang Z, Newhall KP, Cerdeña JP, Crusto CA, Sun YV, Taylor JY. The Interaction of Trauma Exposure and DNA Methylation on Blood Pressure Among Black Women in the InterGEN Study. Epigenet Insights 2022; 15:25168657221138510. [PMID: 36466626 PMCID: PMC9716582 DOI: 10.1177/25168657221138510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/21/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Despite evidence that trauma exposure is linked to higher risk of hypertension, epigenetic mechanisms (such as DNA methylation) by which trauma potentially influences hypertension risk among Black adults remain understudied. Methods Data from a longitudinal study of Black mothers were used to test the hypothesis that direct childhood trauma (ie, personal exposure) and vicarious trauma (ie, childhood trauma experienced by their children) would interact with DNA methylation to increase blood pressure (BP). Separate linear mixed effects models were fitted at each CpG site with the DNA methylation beta-value and direct and vicarious trauma as predictors and systolic and diastolic BP modeled as dependent variables adjusted for age, cigarette smoking, and body mass index. Interaction terms between DNA methylation beta-values with direct and vicarious trauma were added. Results The sample included 244 Black mothers with a mean age of 31.2 years (SD = ±5.8). Approximately 45% of participants reported at least one form of direct childhood trauma and 49% reported at least one form of vicarious trauma. Epigenome-wide interaction analyses found that no CpG sites passed the epigenome-wide significance level indicating the interaction between direct or vicarious trauma with DNAm did not influence systolic or diastolic BP. Conclusions This is one of the first studies to simultaneously examine whether direct or vicarious exposure to trauma interact with DNAm to influence BP. Although findings were null, this study highlights directions for future research that investigates epigenetic mechanisms that may link trauma exposure with hypertension risk in Black women.
Collapse
Affiliation(s)
| | | | | | - Zeyuan Wang
- Rollins School of Public Health, Department of Epidemiology and Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Kevin P Newhall
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Cindy A Crusto
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yan V Sun
- Rollins School of Public Health, Department of Epidemiology and Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Jacquelyn Y Taylor
- Columbia University School of Nursing, New York, NY, USA,Jacquelyn Y Taylor, Columbia University School of Nursing, 560 West 168th Street, New York, NY 10032, USA.
| |
Collapse
|
7
|
Gaffey AE, Rosman L, Sico JJ, Haskell SG, Brandt CA, Bathulapalli H, Han L, Dziura J, Skanderson M, Burg MM. Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women. J Hypertens 2022; 40:2307-2315. [PMID: 35983872 DOI: 10.1097/hjh.0000000000003267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Veterans, especially women, are three times more to experience sexual harassment and assault [military sexual trauma (MST)] than civilians. As trauma is associated with elevated cardiovascular risk, we investigated whether MST independently contributes to risk for incident hypertension and whether the effects are distinct among women. METHODS We assessed 788 161 post-9/11 Veterans ( Mage = 32.14 years, 13% women) who were free of hypertension at baseline, using nationwide Veterans Health Administration data collected 2001-2017. Time-varying, multivariate Cox proportional hazard models were used to examine the independent contribution of MST to new cases of hypertension while sequentially adjusting for demographics, lifestyle and cardiovascular risk factors, including baseline blood pressure, and psychiatric disorders including posttraumatic stress disorder. We then tested for effect modification by sex. RESULTS Over 16 years [mean = 10.23 (SD: 3.69)], 35 284 Veterans screened positive for MST (67% were women). In the fully adjusted model, MST was associated with a 15% greater risk of hypertension [95% confidence interval (95% CI) 1.11-1.19]. In sex-specific analyses, men and women with a history of MST showed a 6% (95% CI, 1.00-1.12, P = 0.042) and 20% greater risk of hypertension (95% CI, 1.15-1.26, P < 0.001), respectively. CONCLUSION In this large prospective cohort of young and middle-aged Veterans, MST was associated with incident hypertension after controlling for established risk factors, including trauma-related psychiatric disorders. Although MST is disproportionately experienced by women, and the negative cardiovascular impact of MST is demonstrated for both sexes, the association with hypertension may be greater for women. Subsequent research should determine if early MST assessment and treatment attenuates this risk.
Collapse
Affiliation(s)
- Allison E Gaffey
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, Connecticut
| | - Lindsey Rosman
- Division of Cardiology, Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Jason J Sico
- VA Connecticut Healthcare System, West Haven
- Department of Neurology and Center for NeuroEpidemiological and Clinical Neurological Research
| | - Sally G Haskell
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (General Medicine)
| | - Cynthia A Brandt
- VA Connecticut Healthcare System, West Haven
- Department of Emergency Medicine
- Yale Center for Medical Informatics
| | - Harini Bathulapalli
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (General Medicine)
| | - Ling Han
- Department of Internal Medicine, Program on Aging
| | - James Dziura
- VA Connecticut Healthcare System, West Haven
- Department of Emergency Medicine
| | | | - Matthew M Burg
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, Connecticut
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
8
|
Nguyen KA, Kengne AP, Abrahams N, Jewkes R, Mhlongo S, Peer N. Associations of childhood maltreatment with hypertension in South African women: a cross-sectional study. BMJ Open 2022; 12:e057436. [PMID: 36123062 PMCID: PMC9486236 DOI: 10.1136/bmjopen-2021-057436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To examine the associations of childhood maltreatment (CM) with hypertension, and the mediating effects of hypertension risk factors on the associations in South African women, using baseline data of the Rape Impact Cohort Evaluation longitudinal study. DESIGN Cross-sectional SETTING AND PARTICIPANTS: Self-reported data on CM exposure and its severity in 18-40-year-old women living in KwaZulu-Natal province were assessed. Logistic regression models, adjusted for traditional hypertension risk factors, rape exposure, HIV-infection, other traumatic exposures, depression scores and acute stress reactions (ASR) scores were used to examine the CM-hypertension associations. RESULTS Among 1797 women, 220 (12.2%) had hypertension; CM prevalence was higher in women with hypertension than without hypertension overall (70.9% vs 57.2%) and for each abuse type: sexual abuse (20.9% vs 12.4%), physical abuse (51.8% vs 41.5%), emotional abuse (40% vs 27.6%) and parental neglect (35% vs 25.7%). Exposures to 1-2 types and 3-4 types of CM were 46.4% and 24.5%, respectively, in women with hypertension, and lower in women without (42.9% and 14.3%, respectively). Exposures to any CM (adjusted OR: 1.62; 95% CI: 1.19 to 2.25), sexual abuse (1.64; 95% CI: 1.12 to 2.37), emotional abuse (1.57; 95% CI: 1.16 to 2.13), physical abuse (1.43; 95% CI: 1.07 to 1.92) and parental neglect (1.37; 95% CI: 1.00 to 1.86) were associated with hypertension. Exposures to an increasing number of abuse types and cumulative severity of CM overall (1.13; 95% CI: 1.05 to 1.21) and for each CM type were associated with increased odds of hypertension. Alcohol use, other trauma experienced, depression and ASR partially mediated these associations. CONCLUSION CM was associated with hypertension; the effects were greater with multiple abuse types and severe abuse, and were partially mediated by alcohol use, depression, ASR and other traumatic exposures. While CM must be prevented, effective mental health interventions to curb the uptake of unhealthy behaviours and the development of hypertension in women exposed to CM are key.
Collapse
Affiliation(s)
- Kim Anh Nguyen
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
- Department of Medicine, University of Cape Town, Observatory, Western Cape, South Africa
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Cape Town, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
- Department of Medicine, University of Cape Town, Observatory, Western Cape, South Africa
| |
Collapse
|
9
|
Kapur G, Stenson AF, Chiodo LM, Delaney-Black V, Hannigan JH, Janisse J, Ratner HH. Childhood Violence Exposure Predicts High Blood Pressure in Black American Young Adults. J Pediatr 2022; 248:21-29.e1. [PMID: 35660017 DOI: 10.1016/j.jpeds.2022.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the impact of childhood adversity, including community violence exposure, on hypertension risk in Black American young adults to understand what risk factors (eg, prenatal factors, later exposures) and ages of adversity exposure increased hypertension risk. STUDY DESIGN The study included 396 Black American participants with data from prenatal, birth, and age 7-, 14-, and 19-year visits. At age 19 years, individuals with blood pressure (BP) measures >120 mmHg systolic and/or >80 mmHg diastolic were classified as having high blood pressure (HBP), and those with BP <120/80 mmHg were classified as normal. Associations between prenatal and birth risk factors; childhood adversity at age 7, 14, and 19 years; age 19 body mass index (BMI); and both systolic and diastolic BP at age 19 were tested using logistic regression models. RESULTS Age 19 BMI was positively associated with systolic and diastolic HBP status at age 19. Controlling for all covariates, community violence exposure at age 7 and 19 years was associated with 2.2-fold (95% CI, 1.242-3.859) and 2.0-fold (95% CI, 1.052-3.664) greater odds of systolic HBP, respectively, at age 19 years. Prenatal risk, birth risk, and other dimensions of childhood adversity were not associated with HBP in this cohort. CONCLUSION Childhood community violence exposure is a significant risk factor for HBP in young adults. As Black American children typically experience more community violence exposure than other American children, our results suggest that racial disparities in childhood community violence exposure may contribute to racial disparities in adult hypertension burden.
Collapse
Affiliation(s)
- Gaurav Kapur
- Department of Pediatrics, Wayne State University, Detroit, MI; Department of Pediatrics, Central Michigan University, Mount Pleasant, MI
| | - Anaïs F Stenson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI.
| | - Lisa M Chiodo
- College of Nursing, University of Massachusetts-Amherst, Amherst, MA
| | | | - John H Hannigan
- Department of Obstetrics & Gynecology, Wayne State University, Detroit, MI; C.S. Mott Center for Human Growth & Development, Wayne State University, Detroit, MI; Merrill-Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI; Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, MI; Department of Psychology, Wayne State University, Detroit, MI
| | - James Janisse
- Department of Family Medicine & Public Health Sciences, Wayne State University, Detroit, MI
| | - Hilary H Ratner
- Merrill-Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI; Department of Psychology, Wayne State University, Detroit, MI
| |
Collapse
|
10
|
Carbone JT, Kremer KP, Holzer KJ, Kondis JS, Vaughn MG. Emergency Department Admissions for Physical Child Abuse: Evidence from the 2006-2017 Nationwide Emergency Department Sample. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP12768-NP12793. [PMID: 33715483 DOI: 10.1177/08862605211001479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Physical child abuse continues to be a serious public health issue in the United States. This study expands on previous research by exploring trends in physical child abuse diagnoses among children admitted to emergency departments (EDs) across the United States. The analysis aimed to explicate the association between physical child abuse and both sociodemographic and behavioral health covariates to better inform and identify risk factors associated with ED admissions for abuse. The study also explicated differences between confirmed and suspected physical child abuse cases. The study utilized a nationally representative sample of hospital-owned EDs that included 319,676,625 ED admissions between 2006 and 2017 for children under 18-years-old. The analysis included a trend analysis, bivariate descriptive statistics, and multivariate logistic regression models were employed. Children with a physical child abuse diagnosis were less likely to be from higher income communities (aOR = 0.61, 95% CI [0.53, 0.71]), less likely to be female (aOR = 0.93, 95% CI [0.90, 0.96]), and more likely to be uninsured (aOR = 1.65, 95% CI [1.48, 1.84]). Children with attention-deficit hyperactivity disorder (aOR = 1.36, 95% CI [1.14, 1.62]) and a conduct disorder (aOR = 1.28, 95% CI [1.04, 1.58]) were more likely to have a physical abuse diagnosis. The sex-stratified analyses found that the higher rates of physical abuse among children with attention-deficit hyperactivity disorder were driven by the male subsample, while higher rates of abuse for those with conduct disorders were the result of the female subsample. A supplemental analysis of suspected versus confirmed physical child abuse for the fourth quarter of 2015 through 2017 also revealed sociodemographic and behavioral health differences. This study supports the need to consider sociodemographic and behavioral risk factors associated with physical child abuse to inform treatment and potential reoccurrence of abuse.
Collapse
Affiliation(s)
| | | | | | - Jamie S Kondis
- Washington University School of Medicine, St. Louis, MO, USA
| | - Michael G Vaughn
- Saint Louis University, St. Louis, MO, USA
- Yonsei University, Seodaemun-gu, Seoul, South Korea
| |
Collapse
|
11
|
Huang T, Zeleznik OA, Roberts AL, Balasubramanian R, Clish CB, Eliassen AH, Rexrode KM, Tworoger SS, Hankinson SE, Koenen KC, Kubzansky LD. Plasma Metabolomic Signature of Early Abuse in Middle-Aged Women. Psychosom Med 2022; 84:536-546. [PMID: 35471987 PMCID: PMC9167800 DOI: 10.1097/psy.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Metabolomic profiling may provide insights into biological mechanisms underlying the strong epidemiologic links observed between early abuse and cardiometabolic disorders in later life. METHODS We examined the associations between early abuse and midlife plasma metabolites in two nonoverlapping subsamples from the Nurses' Health Study II, comprising 803 (mean age = 40 years) and 211 women (mean age = 61 years). Liquid chromatography-tandem mass spectrometry assays were used to measure metabolomic profiles, with 283 metabolites consistently measured in both subsamples. Physical and sexual abuse before age 18 years was retrospectively assessed by validated questions integrating type/frequency of abuse. Analyses were conducted in each sample and pooled using meta-analysis, with multiple testing adjustment using the q value approach for controlling the positive false discovery rate. RESULTS After adjusting for age, race, menopausal status, body size at age 5 years, and childhood socioeconomic indicators, more severe early abuse was consistently associated with five metabolites at midlife (q value < 0.20 in both samples), including lower levels of serotonin and C38:3 phosphatidylethanolamine plasmalogen and higher levels of alanine, proline, and C40:6 phosphatidylethanolamine. Other metabolites potentially associated with early abuse (q value < 0.05 in the meta-analysis) included triglycerides, phosphatidylcholine plasmalogens, bile acids, tyrosine, glutamate, and cotinine. The association between early abuse and midlife metabolomic profiles was partly mediated by adulthood body mass index (32% mediated) and psychosocial distress (13%-26% mediated), but not by other life-style factors. CONCLUSIONS Early abuse was associated with distinct metabolomic profiles of multiple amino acids and lipids in middle-aged women. Body mass index and psychosocial factors in adulthood may be important intermediates for the observed association.
Collapse
Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Oana A. Zeleznik
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Raji Balasubramanian
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA
| | | | - A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Kathryn M. Rexrode
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Shelley S. Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Susan E. Hankinson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
12
|
Rodriguez-Miguelez P, Looney J, Blackburn M, Thomas J, Pollock JS, Harris RA. The Link Between Childhood Adversity and Cardiovascular Disease Risk: Role of Cerebral and Systemic Vasculature. FUNCTION (OXFORD, ENGLAND) 2022; 3:zqac029. [PMID: 35774591 PMCID: PMC9228651 DOI: 10.1093/function/zqac029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 01/07/2023]
Abstract
Adverse childhood experiences (ACEs) are traumatic events during the first years of life that are associated with a higher risk of developing cardiovascular disease (CVD) during adulthood. The medial prefrontal cortex (mPFC) is a core region in the brain that modulates emotions and is directly involved in the cardiovascular response to stress by increasing vascular resistance. In the present study we examined the relationship between ACEs, mPFC and peripheral vascular function. Forty-five, adults (33±5 yrs.) participated in the present study to evaluate cerebral hemodynamics and peripheral vascular function. The impact of adverse experiences was evaluated through the ACE questionnaire. Among those that experienced ACEs (ACE group, n = 22), there was a significantly (P < 0.001) reduced activation of the mPFC as well as greater peripheral vascular resistance observed in the small (P ≤ 0.035), conduit (P ≤ 0.042) and large (P ≤ 0.001) blood vessels, when compared to those that did not report ACEs (Control group, n = 23). In addition, relationships between the number of ACEs and mPFC activation (rs = -0.428; P = 0.003) and peripheral vascular function (rs ≤ -0.373; P ≤ 0.009) were observed. Findings from the present study support that adults who experienced ACEs exhibit a reduced activation of the mPFC along with systemic vascular dysfunction. In addition, individuals exposed to more childhood traumatic events exhibited a progressively greater inactivation of the mPFC and an increased peripheral vasoconstriction in a dose-dependent manner. These findings provide novel insights into the potential role that the brain and the peripheral vasculature may have in connecting adverse childhood events to the increased risk of CVD.
Collapse
Affiliation(s)
| | - Jacob Looney
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA
| | - Marsha Blackburn
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA
| | - Jeffrey Thomas
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA
| | - Jennifer S Pollock
- School of Medicine, University of Alabama at Birmingham, Birmingham 35294, Alabama, USA
| | - Ryan A Harris
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA,Sport and Exercise Science Research Institute, University of Ulster, Jordanstown BT37 0QB, Northern Ireland, UK
| |
Collapse
|
13
|
Salt sensitivity of blood pressure in childhood and adolescence. Pediatr Nephrol 2022; 37:993-1005. [PMID: 34327584 DOI: 10.1007/s00467-021-05178-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/07/2021] [Accepted: 06/12/2021] [Indexed: 10/20/2022]
Abstract
Although moderation of sodium intake is recommended population-wide, it remains uncertain who benefits from salt restriction. Salt sensitivity refers to changes in blood pressure in response to sodium intake and may occur with or without hypertension. Unfortunately, there is no practical way to assess salt sensitivity in daily practice. Assessment of salt sensitivity even in research studies is challenging with varying protocols utilized which may contribute to differing results. Building on studies in animals and adults, risk factors and conditions associated with salt sensitivity have been identified in the pediatric and young adult populations. This review presents the limited evidence linking obesity, low birth weight, diabetes, chronic kidney disease, and race/ethnicity with salt sensitivity in children, adolescents, and young adults. The impact of stress on sodium handling is also reviewed. The influence of age on the timing of introduction of dietary salt restriction and the long-term influence of salt sensitivity on risk for hypertension are considered. Lastly, interventions other than salt restriction that may improve salt sensitivity and may inform recommendations to families are reviewed.
Collapse
|
14
|
Aguayo L, Chirinos DA, Heard-Garris N, Wong M, Davis MM, Merkin SS, Seeman T, Kershaw KN. Association of Exposure to Abuse, Nurture, and Household Organization in Childhood With 4 Cardiovascular Disease Risks Factors Among Participants in the CARDIA Study. J Am Heart Assoc 2022; 11:e023244. [PMID: 35475340 PMCID: PMC9238582 DOI: 10.1161/jaha.121.023244] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background We investigated associations of childhood abuse with 4 cardiovascular disease risk factors in adulthood, and whether exposure to nurturing and household organization in childhood mitigated these associations. Methods and Results The CARDIA (Coronary Artery Risk Development in Young Adults) study (baseline examination, 1985–1986) was used to examine associations of childhood exposures (measured retrospectively at the year 15 examination) with incident obesity, type 2 diabetes, hypertension, and hyperlipidemia (assessed from baseline to year 30). Race‐ and sex‐stratified Cox proportional hazards models were used to examine associations of exposure to childhood abuse with incident cardiovascular disease risk factors. Interaction terms between exposure to abuse and exposure to nurturing relationship and household organization were included to test for effect modifications. Exposure to occasional/frequent abuse (versus no abuse) was associated with incident type 2 diabetes among White men (hazard ratio [HR], 1.81; 95% CI, 1.06–3.08). Exposure to low versus no abuse was associated with incident hyperlipidemia among White men (HR, 1.35; 95% CI, 1.09–1.67) and White women (HR, 1.26; 95% CI, 1.01–1.56). Risks of incident hyperlipidemia were higher for White women who experienced abuse and lived in dysfunctional households (HR, 3.61; 95% CI, 1.62–8.05) or households with low levels of organization (HR, 2.05; 95% CI, 1.25–3.36) compared with White women who experienced abuse but lived in well‐organized households (HR, 0.66; 95% CI, 0.41–1.06). Similar patterns were seen for Black men who lived in dysfunctional households (HR, 3.62; 95% CI, 1.29–10.12) or households with low organization (HR, 2.01; 95% CI, 1.08–3.72). Conclusions We identified race‐ and sex‐specific associations of childhood exposures with incident cardiovascular disease risk factors. The associations of household organization and dysfunction with cardiovascular disease risks merits further investigation.
Collapse
Affiliation(s)
- Liliana Aguayo
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation CenterStanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital Chicago IL.,Hubert Department of Global Health Rollins School of Public Health Emory University Atlanta GA
| | - Diana A Chirinos
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Nia Heard-Garris
- Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation CenterStanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital Chicago IL.,Division of Advanced General Pediatrics and Primary Care Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL.,Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago IL
| | - Mandy Wong
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Matthew M Davis
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation CenterStanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital Chicago IL.,Division of Advanced General Pediatrics and Primary Care Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL.,Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago IL.,Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Department of Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago IL
| | - Sharon Stein Merkin
- Division of Geriatrics Los Angeles Geffen School of MedicineUniversity of California Los Angeles CA
| | - Teresa Seeman
- Division of Geriatrics Los Angeles Geffen School of MedicineUniversity of California Los Angeles CA
| | - Kiarri N Kershaw
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| |
Collapse
|
15
|
Sinko L, Hughesdon K, Grotts JH, Giordano N, Choi KR. A Systematic Review of Research on Trauma and Women's Health in the Nurses' Health Study II. Nurs Womens Health 2022; 26:116-127. [PMID: 35240108 DOI: 10.1016/j.nwh.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/13/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To synthesize research on interpersonal trauma and women's health from the Nurses' Health Study II (NHS II) and to analyze conceptualization of interpersonal trauma across studies. DATA SOURCES A literature review was conducted in PubMed using a systematic search strategy. STUDY SELECTION Articles were included in the review if they used data from the NHS II and involved investigations of interpersonal trauma. Theoretical articles, methodologic articles, and other literature reviews involving the NHS II were excluded. Initially, the search returned 61 articles. After exclusions, 45 articles met the criteria for inclusion in the review and data extraction. DATA EXTRACTION Information was extracted and consolidated in an evidence table. Data included study time frame, sample, definition of trauma, outcomes studied, and journal of publication. DATA SYNTHESIS Trauma was not operationalized consistently across studies, even though the NHS II assessed trauma experiences in childhood, adolescence, and adulthood. Most investigations focused on childhood abuse, with investigations of childhood sexual abuse overrepresented in comparison to other abuse experiences. Authors conducting studies of trauma at any time in the life course consistently found a negative association with physical and mental health outcomes, which were increased by the presence of posttraumatic stress symptoms. Results from a small number of studies suggested a negative intergenerational impact of trauma on the children of women in the NHS II. CONCLUSION Interpersonal trauma across the life course was strongly associated with many leading causes of morbidity and mortality among female nurses. Trauma conceptualization and operationalization varied across studies, and future investigations should leverage the full range of trauma measures available in the NHS II data set.
Collapse
|
16
|
Roberts AL, Zafonte R, Chibnik LB, Baggish A, Taylor H, Baker J, Whittington AJ, Weisskopf MG. Association of Adverse Childhood Experiences With Poor Neuropsychiatric Health and Dementia Among Former Professional US Football Players. JAMA Netw Open 2022; 5:e223299. [PMID: 35315919 PMCID: PMC8941347 DOI: 10.1001/jamanetworkopen.2022.3299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Childhood adversities, including neglect, abuse, and other indicators of family dysfunction, are associated in adulthood with risk factors for poor cognitive and mental health. However, the extent to which these experiences are associated with adulthood cognition-related quality of life and risk for dementia is unknown. OBJECTIVE To determine the association of 10 adverse childhood experiences (ACEs) with neuropsychiatric outcomes among former National Football League (NFL) players. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis used data from the Football Player's Health Study at Harvard University, an ongoing longitudinal cohort study from January 30, 2015, to November 19, 2021, of former NFL players. EXPOSURES Ten ACEs were assessed using the Adverse Childhood Experiences Questionnaire. MAIN OUTCOMES AND MEASURES Dementia symptoms were assessed using the AD8: The Washington University Dementia Screening Test; cognition-related quality of life was assessed with the short form of the Quality of Life in Neurological Disorders; depression was assessed with the Patient Health Questionnaire-9; anxiety was assessed with the Generalized Anxiety Disorder-7; and pain intensity and pain interference in daily life were assessed with the Brief Pain Inventory. Risk ratios (RRs) assessing the association between ACEs and neuropsychiatric outcomes were estimated using generalized estimating equations, adjusted for age, race, and childhood socioeconomic status, and further adjusted for playing position, concussions incurred during football play, and number of seasons played in the NFL. RESULTS A total of 1755 men (mean [SD] age, 57.2 [13.5] years) who were former professional football players were included in the analysis. Five hundred twenty players (29.6%) identified as Black, 1160 (66.1%) identified as White, and 75 (4.3%) identified as other race or ethnicity. Players with 4 or more ACEs were at 48% greater risk of a positive screen for dementia (RR, 1.48 [95% CI, 1.22-1.79]), and at significantly greater risk of every other neuropsychiatric outcome except anxiety (RR range, 1.62 [95% CI, 1.09-2.39] to 1.74 [95% CI, 1.27-2.40]) compared with players with no ACEs. Further adjustment for concussions incurred during playing years attenuated these associations, although some were still significant (adjusted RR range, 1.32 [95% CI, 1.10-1.58] to 1.56 [95% CI, 1.15-2.11]). ACEs were also associated with concussion symptoms; players with 4 or more ACEs had a 60% increased risk of being in the top quartile of concussion symptoms (RR, 1.60; 95% CI, 1.12-2.28) compared with players with no ACEs. CONCLUSIONS AND RELEVANCE These findings suggest that ACEs may be associated with dementia symptoms among former NFL players. Moreover, ACEs should be investigated among professional football players and other populations as a prospective indicator of persons at high risk of concussion. These findings further suggest that treatment of psychological trauma in addition to treatment of physical injury may improve neuropsychiatric health in former NFL players.
Collapse
Affiliation(s)
- Andrea L. Roberts
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Ross Zafonte
- Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts
| | - Lori B. Chibnik
- Department of Neurology, Massachusetts General Hospital, Boston
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Aaron Baggish
- Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts
| | - Herman Taylor
- Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts
| | - Jillian Baker
- Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts
| | - Alicia J. Whittington
- Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts
| | - Marc G. Weisskopf
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
17
|
Lawn RB, Nishimi KM, Sumner JA, Chibnik LB, Roberts AL, Kubzansky LD, Rich‐Edwards JW, Koenen KC, Thurston RC. Sexual Violence and Risk of Hypertension in Women in the Nurses' Health Study II: A 7-Year Prospective Analysis. J Am Heart Assoc 2022; 11:e023015. [PMID: 35189695 PMCID: PMC9075082 DOI: 10.1161/jaha.121.023015] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/09/2021] [Indexed: 01/22/2023]
Abstract
Background Hypertension is a prevalent condition in women and an important modifiable risk factor for cardiovascular disease. Despite women's experiences of sexual violence being common, no prospective studies have examined lifetime sexual assault and workplace sexual harassment in relationship to hypertension in large civilian samples with extended follow-up. Here, we examined whether these experiences were prospectively associated with greater risk of developing hypertension over 7 years. Methods and Results Data are from a substudy of the Nurses' Health Study II and include women free of hypertension at the time of sexual assault and workplace sexual harassment assessment in 2008 (n=33 127). Hypertension was defined as self-reported doctor diagnosis or initiating antihypertensive medication use, assessed biennially through 2015. We performed Cox proportional hazards regression models to predict time to developing hypertension associated with sexual violence exposure, adjusting for relevant covariates. Over follow-up, 7096 women developed hypertension. Sexual assault and workplace sexual harassment were prevalent (23% and 12%, respectively; 6% of women experienced both). Compared with women with no exposure, women who experienced both sexual assault and workplace sexual harassment had the highest risk of developing hypertension (hazard ratio [HR], 1.21; 95% CI, 1.09-1.35), followed by women who experienced workplace sexual harassment (HR, 1.15; 95% CI, 1.05-1.25) and then by women who experienced sexual assault (HR, 1.11; 95% CI, 1.03-1.19), after adjusting for relevant covariates. Conclusions Sexual assault and workplace sexual harassment are prospectively associated with greater risk of hypertension. Reducing such violence is important in its own right and may also improve women's cardiovascular health.
Collapse
Affiliation(s)
- Rebecca B. Lawn
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
| | - Kristen M. Nishimi
- Mental Health ServiceSan Francisco Veterans Affairs Medical CenterSan FranciscoCA
- Department of Psychiatry and Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCA
| | | | - Lori B. Chibnik
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Department of NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA
| | - Andrea L. Roberts
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Laura D. Kubzansky
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA
| | - Janet W. Rich‐Edwards
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Division of Women’s HealthDepartment of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonMA
| | - Karestan C. Koenen
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA
- Psychiatric and Neurodevelopmental Genetics UnitDepartment of PsychiatryMassachusetts General HospitalBostonMA
| | - Rebecca C. Thurston
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
- Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghPA
| |
Collapse
|
18
|
Roberts AL, Sumner JA, Koenen KC, Kubzansky LD, Grodstein F, Rich-Edwards J, Weisskopf MG. Childhood Abuse and Cognitive Function in a Large Cohort of Middle-Aged Women. CHILD MALTREATMENT 2022; 27:100-113. [PMID: 33161764 PMCID: PMC10281011 DOI: 10.1177/1077559520970647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Cognitive function at middle age is of particular public health interest, as it strongly predicts later dementia. Children who have experienced abuse subsequently have worse cognitive function than those who have not. However, it remains unclear whether the association of abuse with cognitive function persists into middle age. In 2014-2016, 14,151 women ages 49-69 years who had previously responded to a childhood abuse questionnaire completed a cognitive battery. In models adjusted for childhood socioeconomic status and head trauma, combined physical, emotional, and sexual abuse was associated with lower scores on both Learning/Working Memory (severe abuse, lower scores similar to that observed in women 4.8 years older in our data) and Psychomotor Speed/Attention (severe abuse, lower scores similar to that observed in women to 2.9 years older in our data). Adjustment for adulthood socioeconomic status and health factors (e.g., smoking, hypertension) slightly attenuated associations. In exploratory analyses further adjusted for psychological distress, associations were attenuated. Women exposed versus unexposed to childhood abuse had poorer cognitive function at mid-life. Associations were particularly strong for learning and working memory and were not accounted for by adulthood health factors. Childhood abuse should be investigated as a potential risk factor for cognitive decline and dementia in old age.
Collapse
Affiliation(s)
- Andrea L Roberts
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Karestan C Koenen
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Laura D Kubzansky
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Francine Grodstein
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Janet Rich-Edwards
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Marc G Weisskopf
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| |
Collapse
|
19
|
Finegood ED, Miller GE. Childhood Violence Exposure, Inflammation, and Cardiometabolic Health. Curr Top Behav Neurosci 2022; 54:439-459. [PMID: 34935115 DOI: 10.1007/7854_2021_283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Exposure to interpersonal violence during childhood, a severe and often traumatic form of social stress, is an enduring problem that an emerging body of work suggests may be relevant to cardiometabolic health and the progression of cardiovascular disease (CVD) across the life course. Less is known about this association causally, and consequently, the biological mechanisms that may confer risk for, and resilience to, poor health outcomes in the aftermath of violence are not well understood. Drawing on recent theoretical insights and empirical research in both humans and non-human animal models, the current paper articulates a hypothesis for one way that childhood violence could get "under the skin" to influence CVD. Based on this emerging literature, one plausible way that childhood violence exposure could increase susceptibility to CVD in later life is by sensitizing stress-response neurobiology and immune processes that regulate and promote inflammation, which is a key pathogenic mechanism in CVD. This is inherently a developmental process that begins in early life and that unfolds across the life course, although less is known about the specific mechanisms through which this occurs. The goal of this paper is to articulate some of these plausible mechanisms and to suggest areas for future research that aims to reduce the burden of disease among individuals who are exposed to violence.
Collapse
Affiliation(s)
- Eric D Finegood
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, IL, USA.
| | - Gregory E Miller
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, IL, USA
| |
Collapse
|
20
|
Lifetime Trauma and Cardiovascular Health in Latinas. Nurs Res 2022; 71:66-74. [PMID: 34644271 PMCID: PMC8732306 DOI: 10.1097/nnr.0000000000000560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Potentially traumatic experiences throughout the life course are associated with poor cardiovascular health among women. However, research on the associations of trauma with cardiovascular health among Latino populations is limited. Understanding the impact of trauma on cardiovascular health within marginalized populations may provide guidance on developing interventions with a particular focus on preventative care. OBJECTIVE The purpose of this descriptive cross-sectional study was to examine the associations of lifetime trauma with cardiovascular health among middle-aged and older Latina women. METHODS Participants were recruited from an existing study in New York City. All participants completed a structured questionnaire to assess lifetime trauma, demographic characteristics (such as age and education), financial resource strain, and emotional support. The Trauma History Questionnaire was used to assess lifetime exposure to potentially traumatic experiences (range 0-24). Cardiovascular health was measured with a validated measure of cardiovascular health from the American Heart Association (Life's Simple 7). We used self-reported and objective data to calculate cardiovascular health scores (range 0-14). Multiple linear regression was used to examine the associations of lifetime trauma with cardiovascular health, adjusted for age, education, financial resource strain, and emotional support. RESULTS The sample included 50 Latina women with a mean age of 63.1 years, 88% were Dominican, and only 6% had completed a college degree. Women reported an average of 4.8 traumatic experiences. Mean cardiovascular health score was 6.5 (SD = 1.6, range 3-10). Linear regression models found that, after adjusting for age, education, financial resource strain, and emotional support, a higher count of lifetime trauma was associated with worse cardiovascular health. However, this association did not reach statistical significance. DISCUSSION Women with a higher count of lifetime trauma had worse cardiovascular health scores; this association was not statistically significant. Future studies should investigate associations of lifetime trauma and cardiovascular health in larger and more diverse samples of Latinas. Nurses and other clinicians should incorporate trauma-informed approaches to cardiovascular disease risk reduction to improve the cardiovascular health of Latina women who are survivors of trauma.
Collapse
|
21
|
Suglia SF, Appleton AA, Bleil ME, Campo RA, Dube SR, Fagundes CP, Heard-Garris NJ, Johnson SB, Slopen N, Stoney CM, Watamura SE. Timing, duration, and differential susceptibility to early life adversities and cardiovascular disease risk across the lifespan: Implications for future research. Prev Med 2021; 153:106736. [PMID: 34293381 PMCID: PMC8595689 DOI: 10.1016/j.ypmed.2021.106736] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Early life adversities (ELA), include experiences such as child maltreatment, household dysfunction, bullying, exposure to crime, discrimination, bias, and victimization, and are recognized as social determinants of cardiovascular disease (CVD). Strong evidence shows exposure to ELA directly impacts cardiometabolic risk in adulthood and emerging evidence suggests there may be continuity in ELA's prediction of cardiometabolic risk over the life course. Extant research has primarily relied on a cumulative risk framework to evaluate the relationship between ELA and CVD. In this framework, risk is considered a function of the number of risk factors or adversities that an individual was exposed to across developmental periods. The cumulative risk exposure approach treats developmental periods and types of risk as equivalent and interchangeable. Moreover, cumulative risk models do not lend themselves to investigating the chronicity of adverse exposures or consider individual variation in susceptibility, differential contexts, or adaptive resilience processes, which may modify the impact of ELA on CVD risk. To date, however, alternative models have received comparatively little consideration. Overall, this paper will highlight existing gaps and offer recommendations to address these gaps that would extend our knowledge of the relationship between ELA and CVD development. We focus specifically on the roles of: 1) susceptibility and resilience, 2) timing and developmental context; and 3) variation in risk exposure. We propose to expand current conceptual models to incorporate these factors to better guide research that examines ELA and CVD risk across the life course.
Collapse
Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Emory University, Atlanta, GA, United States of America.
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Albany, NY, United States of America
| | - Maria E Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States of America
| | - Rebecca A Campo
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Shanta R Dube
- Public Health Program, Levine College of Health Sciences, Wingate University, Wingate, NC, United States of America
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
| | - Nia J Heard-Garris
- Division of Advanced General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Sara B Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Catherine M Stoney
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Sarah E Watamura
- Department of Psychology, University of Denver, Denver, CO, United States of America
| |
Collapse
|
22
|
Jakubowski KP, Murray V, Stokes N, Thurston RC. Sexual violence and cardiovascular disease risk: A systematic review and meta-analysis. Maturitas 2021; 153:48-60. [PMID: 34654528 DOI: 10.1016/j.maturitas.2021.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/22/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of death among adults. Over 35% of women worldwide report lifetime exposure to sexual violence. While psychosocial factors broadly have been linked to CVD risk, it is unclear if a history of sexual violence is associated with increased risk for CVD. This study employed quantitative meta-analysis to investigate the association between sexual violence and CVD risk. METHODS PubMed and PsycINFO databases were searched through March 1, 2021. Included articles had a measure of sexual violence and at least one cardiovascular outcome (i.e., clinical CVD, subclinical CVD, select CVD risk factors) in women and men aged 18 years or older. Data were expressed as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI) extracted from fully-adjusted models. OR and HR effects were pooled separately, given the inability to statistically harmonize these effects and differences in interpretation, using random effects meta-analysis. Heterogeneity of effects was tested using Cochran's Q test. RESULTS Overall, 45 articles based on 830,579 adults (77.1% women) were included (113 individual effects expressed as OR and 9 individual effects expressed as HR). Results indicated that sexual violence was related to adult CVD risk (OR [95%CI] = 1.25 [1.11-1.40]; HR [95%CI] = 1.17 [1.05-1.31]). Results varied by outcome type and measurement, and timing of violence. CONCLUSIONS Adults with a history of sexual violence demonstrate greater CVD risk relative to those without this history. The results highlight the importance of addressing sexual violence in CVD risk reduction efforts.
Collapse
Affiliation(s)
- Karen P Jakubowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Vanessa Murray
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Natalie Stokes
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
23
|
Kameg B, Mitchell A. Associations Between Adverse Childhood Experiences and Substance Use in Nursing Students. J Psychosoc Nurs Ment Health Serv 2021; 59:43-47. [PMID: 34228574 DOI: 10.3928/02793695-20210219-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adverse childhood experiences (ACEs) are a public health problem, and exposure to ACEs can lead to negative health consequences, including substance use. Little is known about ACEs and substance use in the nursing student population. The purpose of the current study was to describe the types of ACEs encountered by nursing students and the rate at which they occur; and examine associations between individual ACEs and alcohol and drug use. This study uses a cross-sectional, descriptive design. Measurements were used to assess and quantify ACEs and alcohol and drug use. There were small to medium associations between alcohol use and ACE items, and more modest associations found between drug use and ACE items (p < 0.001). Findings highlight the need for a trauma-informed approach to nursing education. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 43-47.].
Collapse
|
24
|
Caceres BA, Wardecker BM, Anderson J, Hughes TL. Revictimization Is Associated With Higher Cardiometabolic Risk in Sexual Minority Women. Womens Health Issues 2021; 31:341-352. [PMID: 33766475 PMCID: PMC8260453 DOI: 10.1016/j.whi.2021.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Although there is evidence that interpersonal trauma is associated with cardiometabolic risk in women, previous studies have not assessed the potential role of revictimization (victimization in both childhood and adulthood) among sexual minority women. METHODS We used data from the Chicago Health and Life Experiences of Women study to examine the associations of revictimization (including physical, sexual, and any revictimization) with self-reported psychosocial factors, health behaviors, and cardiometabolic risk factors (e.g., obesity, hypertension, and diabetes). We tested multiple logistic regression models, adjusted for covariates, to estimate odds ratios of the associations between revictimization and cardiometabolic risk. RESULTS The sample included 615 sexual minority women with a mean age of 40.0 years; 38.7% White. Eighty-three (13.5%) and 101 (16.4%) participants reported experiencing sexual revictimization and physical revictimization, respectively. Each form of revictimization was associated with higher odds of reporting lifetime depression and recent binge eating, but lower odds of having high social support. Physical revictimization was associated with higher odds of obesity (adjusted odds ratio [AOR], 2.38; 95% confidence interval [CI], 1.38-4.10) and hypertension (AOR, 3.31; 95% CI, 1.70-6.46). Similarly, participants who reported any revictimization were more likely to have obesity (AOR, 2.36; 95% CI, 1.42-3.92) and hypertension (AOR, 2.60; 95% CI, 1.31-5.26). No form of revictimization was associated with a higher odds of diabetes. CONCLUSIONS The higher odds of obesity and hypertension observed among sexual minority women who reported revictimization reinforce the need for early interventions to reduce cardiometabolic risk in this vulnerable population.
Collapse
Affiliation(s)
- Billy A Caceres
- Program for the Study of LGBT Health, Columbia University School of Nursing, New York, New York.
| | | | - Jocelyn Anderson
- Pennsylvania State College of Nursing, University Park, Pennsylvania
| | - Tonda L Hughes
- Program for the Study of LGBT Health, Columbia University School of Nursing, New York, New York
| |
Collapse
|
25
|
Scott J, McMillian-Bohler J, Johnson R, Simmons LA. Adverse Childhood Experiences and Blood Pressure in Women in the United States: A Systematic Review. J Midwifery Womens Health 2021; 66:78-87. [PMID: 33576175 DOI: 10.1111/jmwh.13213] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Elevated blood pressure is a leading contributor to adverse cardiovascular outcomes. Some studies suggest there is an association between adverse childhood experiences (ACEs) and subsequent elevated blood pressure in adulthood. The literature specific to ACEs and blood pressure in women has not been synthesized; thus the purpose of this systematic review was to examine what is known about the association between ACEs and blood pressure in women living in the United States. METHODS In collaboration with a medical librarian, a systematic search of the literature published between January 1998 and December 2019 was conducted. Original, peer-reviewed publications were identified from PubMed, CINAHL, and PsycINFO databases. Studies were excluded if they (1) were conducted outside the United States, (2) measured acute stress or adult stressors, or (3) measured childhood- or pregnancy-related outcomes. RESULTS Of 1740 articles, 12 publications met criteria for inclusion in this study, 8 of which were from cohort studies. Racial and ethnic diversity was limited, with half of the articles in this review consisting of samples that were majority white. Of the studies that used a self-reported history of hypertension, 60% obtained significant associations with ACEs, compared with only 30% of the studies that had objective blood pressure data. ACEs were associated with lower blood pressure in 3 studies. DISCUSSION More research is needed to elucidate the relationship between ACEs and elevated blood pressure. Inconsistencies in the findings may be related to the measurement of blood pressure, assessment of ACEs, and population characteristics. Future studies should incorporate diverse population-representative samples with consideration for sex- or race-specific stressors such as pregnancy or racism and their potential influence on blood pressure. Health care providers may consider the history of ACEs as part of screening for cardiovascular risk factors among female patients, especially younger women presenting with elevated blood pressure.
Collapse
Affiliation(s)
- Jewel Scott
- Duke University School of Nursing, Durham, North Carolina
| | - Jacquelyn McMillian-Bohler
- Division of Health of Women, Children, and Families, Duke University School of Nursing, Durham, North Carolina
| | - Ragan Johnson
- Division of Healthcare in Adult Populations, Duke University School of Nursing, Durham, North Carolina
| | - Leigh Ann Simmons
- Department of Human Ecology, University of California, Davis, California
| |
Collapse
|
26
|
Godoy LC, Frankfurter C, Cooper M, Lay C, Maunder R, Farkouh ME. Association of Adverse Childhood Experiences With Cardiovascular Disease Later in Life: A Review. JAMA Cardiol 2021; 6:228-235. [PMID: 33263716 DOI: 10.1001/jamacardio.2020.6050] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Adverse childhood experiences (ACEs) are potentially harmful events that occur during childhood, spanning neglect, physical or sexual abuse, parental separation, or death, among others. At least 50% of the US adult population has experienced 1 or more ACEs before the age of 18 years, but in clinical practice, ACEs remain underrecognized. Adults who have experienced ACEs are at increased risk of developing health risk behaviors and, ultimately, cardiovascular disease (CVD). This review summarizes the evidence regarding the association of ACEs with CVD and the accompanying diagnostic and therapeutic approaches in the adult population. Observations ACEs are commonly classified into 3 domains: abuse (psychological, physical, or sexual), household dysfunction (eg, substance use by household members, mental illness, parental separation), and neglect. These experiences elicit chronic activation of the stress response system, leading to autonomic, neuroendocrine, and inflammatory dysfunction. The subsequent development of traditional risk factors, such as diabetes, hypertension, smoking, and obesity, results in the onset of CVD and premature mortality. Adults with 4 or more ACEs compared with those with none have a more than 2-fold higher risk of developing CVD and an almost 2-fold higher risk of premature mortality. Conclusions and Relevance Identifying methods of mitigating the health consequences of ACEs may lead to better cardiovascular outcomes. Inquiry into ACE exposure during clinical encounters and subsequent referral to psychological services when appropriate may be helpful, but strategies aimed at CVD prevention via management of ACEs in adults continue to lack adequate evidence.
Collapse
Affiliation(s)
- Lucas C Godoy
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada.,Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Claudia Frankfurter
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Matthew Cooper
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Christine Lay
- Centre for Headache, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Robert Maunder
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Michael E Farkouh
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
27
|
Leachman JR, Rea MD, Cohn DM, Xu X, Fondufe-Mittendorf YN, Loria AS. Exacerbated obesogenic response in female mice exposed to early life stress is linked to fat depot-specific upregulation of leptin protein expression. Am J Physiol Endocrinol Metab 2020; 319:E852-E862. [PMID: 32830551 PMCID: PMC7790118 DOI: 10.1152/ajpendo.00243.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Early life stress (ELS) is an independent risk factor for increased BMI and cardiometabolic disease risk later in life. We have previously shown that a mouse model of ELS, maternal separation and early weaning (MSEW), exacerbates high-fat diet (HF)-induced obesity only in adult female mice. Therefore, the aim of this study was to investigate 1) whether the short- and long-term effects of HF on leptin expression are influenced by MSEW in a sex-specific manner and 2) the potential epigenetic mechanisms underlying the MSEW-induced changes in leptin expression. After 1 wk of HF, both MSEW male and female mice displayed increased fat mass compared with controls (P < 0.05). However, only MSEW female mice showed elevated leptin mRNA expression in gonadal white adipose tissue (gWAT; P < 0.05). After 12 wk of HF, fat mass remained increased only in female mice (P < 0.05). Moreover, plasma leptin and both leptin mRNA and protein expression in gWAT were augmented in MSEW female mice compered to controls (P < 0.05), but not in MSEW male mice. This association was not present in subcutaneous WAT. Furthermore, among 16 CpG sites in the leptin promoter, we identified three hypomethylated sites in tissue from HF-fed MSEW female mice compared with controls (3, 15, and 16, P < 0.05). These hypomethylated sites showed greater binding of key adipogenic factors such as PPARγ (P < 0.05). Taken together, our study reveals that MSEW superimposed to HF increases leptin protein expression in a sex- and fat depot-specific fashion. Our data suggest that the mechanism by which MSEW increases leptin expression could be epigenetic.
Collapse
Affiliation(s)
- Jacqueline R Leachman
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky
| | - Mathew D Rea
- Department of Molecular and Cellular Biochemistry, University of Kentucky, Lexington, Kentucky
| | - Dianne M Cohn
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky
| | - Xiu Xu
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky
| | | | - Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky
| |
Collapse
|
28
|
Liu M, Li Y, Tian Z, Zhu C. Correlations of MMP-1 and MMP-2 gene polymorphisms with essential hypertension. Minerva Med 2020; 111:501-504. [DOI: 10.23736/s0026-4806.19.06116-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
29
|
Spence ND, Farvid MS, Warner ET, VanderWeele TJ, Tworoger SS, Argentieri MA, Shields AE. Religious Service Attendance, Religious Coping, and Risk of Hypertension in Women Participating in the Nurses' Health Study II. Am J Epidemiol 2020; 189:193-203. [PMID: 31595952 DOI: 10.1093/aje/kwz222] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 12/30/2022] Open
Abstract
The association between religious service attendance, religious coping, and hypertension is unclear. Prospective research and assessment of potential mediators is needed to understand this relationship. From 2001-2013, we prospectively followed 44,281 nonhypertensive women who provided information on religious service attendance and religious coping in the Nurses' Health Study II. Cox regression and mediation analyses were conducted to assess associations between religion and hypertension. There were 453,706 person-years of follow-up and 11,773 incident hypertension cases. Women who attended religious services were less likely to develop hypertension. In the fully adjusting model, compared with women who never or almost never attend religious meetings or services, women attending less than once per month (hazard ratio (HR) = 0.97, 95% confidence interval (CI): 0.91, 1.03), 1-3 times per month (HR = 0.94, 95% CI: 0.88, 1.00), once per week (HR = 0.93, 95% CI: 0.88, 0.98), or more than once per week (HR = 0.91, 95% CI: 0.86, 0.97) showed a decreased risk of hypertension (P for trend = 0.001). Body mass index was an important mediator (11.5%; P < 0.001). Religious coping had a marginal association with hypertension. In conclusion, religious service attendance was modestly associated with hypertension in an inverse dose-response manner and partially mediated through body mass index. Future research is needed on biological or social reasons for the lower risk of hypertension.
Collapse
Affiliation(s)
- Nicholas D Spence
- Department of Sociology, University of Toronto, Toronto, Ontario
- Interdisciplinary Center for Health and Society, University of Toronto, Toronto, Ontario
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital, Boston, Massachusetts
| | - Maryam S Farvid
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erica T Warner
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shelley S Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - M Austin Argentieri
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital, Boston, Massachusetts
- School of Anthropology and Museum Ethnography, University of Oxford, Oxford, United Kingdom
| | - Alexandra E Shields
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
30
|
Schreier HMC, Kuras YI, McInnis CM, Thoma MV, St Pierre DG, Hanlin L, Chen X, Wang D, Goldblatt D, Rohleder N. Childhood Physical Neglect Is Associated With Exaggerated Systemic and Intracellular Inflammatory Responses to Repeated Psychosocial Stress in Adulthood. Front Psychiatry 2020; 11:504. [PMID: 32581878 PMCID: PMC7290130 DOI: 10.3389/fpsyt.2020.00504] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 05/18/2020] [Indexed: 11/29/2022] Open
Abstract
Experiences of child maltreatment are associated with a host of adverse mental and physical health outcomes in adulthood. Altered reactivity to psychosocial stress exposure may partially explain known associations between early experiences of maltreatment and later life health. The present study focuses on examining whether experiences of child maltreatment are associated with physiological reactions to initial and repeated psychosocial stress in adulthood. To this end, 44 healthy adults (52% male, aged 18-65) completed the Childhood Trauma Questionnaire to provide information about exposure to child maltreatment and completed the Trier Social Stress Test (TSST) on 2 consecutive days. Peripheral blood was collected prior to as well as 30 and 120 min following the TSST on each day. Plasma Interleukin-6 (IL-6) and gene expression of IL-6, IL-1β, nuclear factor-kB (NF-kB), and inhibitor of kB (IkB) were measured from each blood sample. Total CTQ scores were unrelated to plasma IL-6 and gene expression (ps > .10) but a history of childhood physical neglect was associated with increased interleukin-1β (β =.35; p =.02; R2 =.19) and nuclear factor-kB (β =.30; p =.046; R2 =.13) expression following initial stress. Following repeated exposure to the TSST, childhood physical neglect was associated with increased plasma IL-6 reactivity (β =.34; p =.02; R2 =.16) and increased expression of nuclear factor-kB (β =.31; p =.04; R2 =.08). Finally, childhood physical neglect was associated with decreased habituation following repeated exposure to the TSST. Other CTQ subscales were not related to plasma IL-6 and gene expression when considered individually. Results from this study are suggestive of a unique effect of childhood physical neglect on the physiological stress response following initial and repeated exposure to a common psychosocial stressor. This provides important directions for future research because the effect of childhood physical neglect on long-term neglect are not well understood and in need of further investigation.
Collapse
Affiliation(s)
- Hannah M C Schreier
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
| | - Yuliya I Kuras
- Department of Psychology, Brandeis University, Waltham, MA, United States.,Precision Neurology Program, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States
| | | | - Myriam V Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Luke Hanlin
- Department of Psychology, Brandeis University, Waltham, MA, United States
| | - Xuejie Chen
- Department of Psychology, Brandeis University, Waltham, MA, United States
| | - Diana Wang
- Center for Economic and Social Research, Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Dena Goldblatt
- Center for Neural Science, New York University, New York, NY, United States.,Department of Otolaryngology, Neuroscience and Physiology, and the Neuroscience Institute, NYU School of Medicine, New York, NY, United States
| | - Nicolas Rohleder
- Department of Psychology, Brandeis University, Waltham, MA, United States.,Chair of Health Psychology, Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
31
|
Sumner JA, Kubzansky LD, Roberts AL, Chen Q, Rimm EB, Koenen KC. Not all posttraumatic stress disorder symptoms are equal: fear, dysphoria, and risk of developing hypertension in trauma-exposed women. Psychol Med 2020; 50:38-47. [PMID: 30606272 PMCID: PMC6609506 DOI: 10.1017/s0033291718003914] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with higher risk of incident hypertension, but it is unclear whether specific aspects of PTSD are particularly cardiotoxic. PTSD is a heterogeneous disorder, comprising dimensions of fear and dysphoria. Because elevated fear after trauma may promote autonomic nervous system dysregulation, we hypothesized fear would predict hypertension onset, and associations with hypertension would be stronger with fear than dysphoria. METHODS We examined fear and dysphoria symptom dimensions in relation to incident hypertension over 24 years in 2709 trauma-exposed women in the Nurses' Health Study II. Posttraumatic fear and dysphoria symptom scores were derived from a PTSD diagnostic interview. We used proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each symptom dimension (quintiles) with new-onset hypertension events (N = 925), using separate models. We also considered lower-order symptom dimensions of fear and dysphoria. RESULTS Higher levels of fear (P-trend = 0.02), but not dysphoria (P-trend = 0.22), symptoms were significantly associated with increased hypertension risk after adjusting for socio-demographics and family history of hypertension. Women in the highest v. lowest fear quintile had a 26% higher rate of developing hypertension [HR = 1.26 (95% CI 1.02-1.57)]; the increased incidence associated with greater fear was similar when further adjusted for biomedical and health behavior covariates (P-trend = 0.04) and dysphoria symptoms (P-trend = 0.04). Lower-order symptom dimension analyses provided preliminary evidence that the re-experiencing and avoidance components of fear were particularly associated with hypertension. CONCLUSIONS Fear symptoms associated with PTSD may be a critical driver of elevated cardiovascular risk in trauma-exposed individuals.
Collapse
Affiliation(s)
- Jennifer A. Sumner
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Qixuan Chen
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | - Eric B. Rimm
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Psychiatric and Neurodevelopmental Genetics Unit and Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| |
Collapse
|
32
|
Bellizzi S, Nivoli A, Salaris P, Ronzoni AR, Pichierri G, Palestra F, Wazwaz O, Luque-Fernandez MA. Sexual violence and eclampsia: analysis of data from Demographic and Health Surveys from seven low- and middle-income countries. J Glob Health 2019; 9:020434. [PMID: 31777658 PMCID: PMC6858987 DOI: 10.7189/jogh.09.020434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Scientific literature has provided clear evidence of the profound impact of sexual violence on women’s health, such as somatic disorders and mental adverse outcomes. However, consequences related to obstetric complications are not yet completely clarified. This study aimed to assess the association of lifetime exposure to intimate partner sexual violence with eclampsia. Methods We considered all the seven Demographic and Health Surveys (DHS) that included data on sexual violence and on signs and symptoms suggestive of eclampsia for women of reproductive age (15-49 years). We computed unadjusted and adjusted odds ratios (OR) to evaluate the risk of suggestive eclampsia by ever subjected to sexual violence. A sensitivity analysis was conducted restricting the study population to women who had their last live birth over the 12 months before the interview. Results Self-reported experience of sexual violence ranged from 3.7% in Mali to 9.2% in India while prevalence of women reporting signs and symptoms compatible with eclampsia ranged from 14.3% in Afghanistan to 0.7% in the Philippines. Reported sexual violence was associated with a 2-fold increased odd of signs and symptoms suggestive of eclampsia in the pooled analysis. The sensitivity analysis confirmed the strength of the association between sexual violence and eclampsia in Afghanistan and in India. Conclusions Women and girls in low-and-middle-income countries are at high risk of sexual violence, which may represent a risk factor for hypertensive obstetric complication. Accurate counseling by health care providers during antenatal care consultations may represent an important opportunity to prevent adverse outcomes during pregnancy.
Collapse
Affiliation(s)
- Saverio Bellizzi
- Partnership for Maternal, Newborn & Child Health, Geneva, Switzerland
| | - Alessandra Nivoli
- Department of Neuroscience, Institute of Psychiatry, University of Sassari, Sassari, Italy
| | - Paola Salaris
- Department of Endocrinology, Mater Olbia Hospital, Olbia, Italy
| | | | - Giuseppe Pichierri
- Kingston Hospital NHS Foundation Trust, Galsworthy Road, Kingston upon Thames, UK
| | | | - Ola Wazwaz
- Partnership for Maternal, Newborn & Child Health, Geneva, Switzerland
| | - Miguel Angel Luque-Fernandez
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Biomedical Research Institute of Granada, Non-Communicable and Cancer Epidemiology Group (ibs.Granada), Andalusian School of Public Health, Granada, University of Granada, Spain
| |
Collapse
|
33
|
State-of-the-Science Review of Non-Chemical Stressors Found in a Child's Social Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224417. [PMID: 31718056 PMCID: PMC6888402 DOI: 10.3390/ijerph16224417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 12/14/2022]
Abstract
Background: Children are exposed to chemical and non-chemical stressors from their built, natural, and social environments. Research is needed to advance our scientific understanding of non-chemical stressors, evaluate how they alter the biological response to a chemical stressor, and determine how they impact children’s health and well-being. To do this, we conducted a state-of-the-science review of non-chemical stressors found in a child’s social environment. Methods: Studies eligible for inclusion in this review were identified through a search of the peer-reviewed literature using PubMed and PsycINFO. Combinations of words associated with non-chemical stressors and children were used to form search strings. Filters were used to limit the search to studies published in peer-reviewed journals from 2000–2016 and written in English. Publications found using the search strings and filters went through two rounds of screening. Results: A total of 146 studies met the inclusion criteria. From these studies, 245 non-chemical stressors were evaluated. The non-chemical stressors were then organized into 13 general topic areas: acculturation, adverse childhood experiences, economic, education, family dynamics, food, greenspace, neighborhood, social, stress, urbanicity, violence, and other. Additional information on health outcomes, studies evaluating both chemical and non-chemical stressors, and animal studies are provided. This review provides evidence that non-chemical stressors found in a child’s social environment do influence their health and well-being in both beneficial (e.g., salutatory effects of greenspace and social support) and adverse (e.g., poor relationships between health and selected non-chemical stressors such as economics, educational attainment, exposure to violence, stress) ways. Conclusions: This literature review identified a paucity of studies addressing the combined effects of chemical and non-chemical stressors and children’s health and well-being. This literature review was further complicated by inconsistencies in terminology, methodologies, and the value of non-chemical stressor research in different scientific disciplines. Despite these limitations, this review showed the importance of considering non-chemical stressors from a child’s social environment when addressing children’s environmental health considerations.
Collapse
|
34
|
Morris G, Berk M, Maes M, Carvalho AF, Puri BK. Socioeconomic Deprivation, Adverse Childhood Experiences and Medical Disorders in Adulthood: Mechanisms and Associations. Mol Neurobiol 2019; 56:5866-5890. [PMID: 30685844 PMCID: PMC6614134 DOI: 10.1007/s12035-019-1498-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 01/15/2019] [Indexed: 12/30/2022]
Abstract
Severe socioeconomic deprivation (SED) and adverse childhood experiences (ACE) are significantly associated with the development in adulthood of (i) enhanced inflammatory status and/or hypothalamic-pituitary-adrenal (HPA) axis dysfunction and (ii) neurological, neuroprogressive, inflammatory and autoimmune diseases. The mechanisms by which these associations take place are detailed. The two sets of consequences are themselves strongly associated, with the first set likely contributing to the second. Mechanisms enabling bidirectional communication between the immune system and the brain are described, including complex signalling pathways facilitated by factors at the level of immune cells. Also detailed are mechanisms underpinning the association between SED, ACE and the genesis of peripheral inflammation, including epigenetic changes to immune system-related gene expression. The duration and magnitude of inflammatory responses can be influenced by genetic factors, including single nucleotide polymorphisms, and by epigenetic factors, whereby pro-inflammatory cytokines, reactive oxygen species, reactive nitrogen species and nuclear factor-κB affect gene DNA methylation and histone acetylation and also induce several microRNAs including miR-155, miR-181b-1 and miR-146a. Adult HPA axis activity is regulated by (i) genetic factors, such as glucocorticoid receptor polymorphisms; (ii) epigenetic factors affecting glucocorticoid receptor function or expression, including the methylation status of alternative promoter regions of NR3C1 and the methylation of FKBP5 and HSD11β2; (iii) chronic inflammation and chronic nitrosative and oxidative stress. Finally, it is shown how severe psychological stress adversely affects mitochondrial structure and functioning and is associated with changes in brain mitochondrial DNA copy number and transcription; mitochondria can act as couriers of childhood stress into adulthood.
Collapse
Affiliation(s)
- Gerwyn Morris
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
| | - André F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - Basant K Puri
- Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
| |
Collapse
|
35
|
Caceres BA, Veldhuis CB, Hughes TL. Racial/Ethnic Differences in Cardiometabolic Risk in a Community Sample of Sexual Minority Women. Health Equity 2019; 3:350-359. [PMID: 31312782 PMCID: PMC6626969 DOI: 10.1089/heq.2019.0024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: To examine the intersection of sexual identity and race/ethnicity on self-reported cardiometabolic risk in sexual minority women (SMW). Methods: Data from the Chicago Health and Life Experiences of Women study were analyzed. Logistic regression models examined racial/ethnic differences in cardiometabolic risk (including obesity, hypertension, and diabetes) in SMW, accounting for psychosocial and behavioral factors. A variable accounting for the intersection of sexual identity and race/ethnicity was added to regression models (White lesbian women were the reference group). Results: The analytic sample included 601 SMW (237 White, 219 Black, 145 Latina). Black (adjusted odds ratio [AOR] 2.96, 95% confidence interval [CI]=1.48-5.94) and Latina (AOR 2.30, 95% CI=1.18-4.48) SMW had higher rates of lifetime trauma than White SMW. Black SMW reported higher rates of obesity (AOR 3.05, 95% CI=1.91-4.88), hypertension (AOR 1.99, 95% CI=1.08-3.66), and diabetes (AOR 3.77, 95% CI=1.46-9.74) relative to White SMW. Intersectional analyses revealed that Black lesbian (AOR 2.94, 95% CI=1.74-4.97) and Black bisexual (AOR 3.43, 95% CI=1.69-6.96) women were more likely to be obese than White lesbian women. Black lesbian women also reported higher rates of hypertension (AOR 2.09, 95% CI=1.08-4.04) and diabetes (AOR 3.31, 95% CI=1.26-8.67) than White lesbian women. No differences in cardiometabolic risk were found between Latina and White SMW. Conclusion: This study extends previous research on racial/ethnic differences in cardiometabolic risk among SMW. Prevention strategies are needed to reduce cardiometabolic risk in Black SMW. Findings highlight the need for cardiovascular disease research in SMW that incorporates longitudinal designs and objective measures.
Collapse
|
36
|
Obi IE, McPherson KC, Pollock JS. Childhood adversity and mechanistic links to hypertension risk in adulthood. Br J Pharmacol 2019; 176:1932-1950. [PMID: 30656638 PMCID: PMC6534788 DOI: 10.1111/bph.14576] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/17/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023] Open
Abstract
Adverse childhood experiences (ACEs), defined as traumatic events in childhood that range from various forms of abuse to household challenges and dysfunction, have devastating consequences on adult health. Epidemiological studies in humans and animal models of early life stress (ELS) have revealed a strong association and insight into the mechanistic link between ACEs and increased risk of cardiovascular disease (CVD). This review focuses on the mechanistic links of ACEs in humans and ELS in mice and rats to vasoactive factors and immune mediators associated with CVD and hypertension risk, as well as sex differences in these phenomena. Major topics of discussion in this review are as follows: (a) epidemiological associations between ACEs and CVD risk focusing on hypertension, (b) evidence for association of ACE exposures to immune-mediated and/or vasoactive pathways, (c) rodent models of ELS-induced hypertension risk, (d) proinflammatory mediators and vasoactive factors as mechanisms of ELS-induced hypertension risk. We also provide some overall conclusions and directions of further research. LINKED ARTICLES: This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc.
Collapse
Affiliation(s)
- Ijeoma E. Obi
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| | - Kasi C. McPherson
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| | - Jennifer S. Pollock
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| |
Collapse
|
37
|
Berger I, Werdermann M, Bornstein SR, Steenblock C. The adrenal gland in stress - Adaptation on a cellular level. J Steroid Biochem Mol Biol 2019; 190:198-206. [PMID: 30959152 DOI: 10.1016/j.jsbmb.2019.04.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 03/15/2019] [Accepted: 04/05/2019] [Indexed: 01/29/2023]
Abstract
Human individuals are constantly confronted to various kinds of stressors and the body's response and adaptation is essential for human health. The adrenal gland as the main producer of stress hormones plays a major role in the response to physiological challenges and is able to adapt to these physiological needs. Proper adaptation is of particular importance since dysregulation of the stress system is the cause of various human diseases including obesity, depression, Parkinson's disease, and post-traumatic stress disorder. Therefore, it is fundamental to understand the physiological, cellular, and molecular underpinnings of the stress adaptation in humans. Because of ethical reasons it is problematic to study the plasticity of the human gland in stress. Hence, various experimental models have been established for the analysis of the functional and cellular role of the adrenal gland adaptation on a translational approach. Here, we summarize the insights of stress-induced adrenal plasticity gained from these models and discuss their relevance to clinical observations.
Collapse
Affiliation(s)
- Ilona Berger
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Martin Werdermann
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Stefan R Bornstein
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; Diabetes and Nutritional Sciences Division, King's College London, London WC2R 2LS, UK
| | - Charlotte Steenblock
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany.
| |
Collapse
|
38
|
Caceres BA, Veldhuis CB, Hickey KT, Hughes TL. Lifetime Trauma and Cardiometabolic Risk in Sexual Minority Women. J Womens Health (Larchmt) 2019; 28:1200-1217. [PMID: 31099702 DOI: 10.1089/jwh.2018.7381] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Sexual minority women (SMW; such as lesbian, bisexual, and mostly lesbian) exhibit excess cardiometabolic risk, yet factors that contribute to cardiometabolic risk in this population are poorly understood. Trauma exposure has been posited as a contributor to cardiometabolic risk in SMW. Materials and Methods: An analysis of data from Wave 3 of the Chicago Health and Life Experiences of Women Study was conducted. Multinomial logistic regression was used to examine correlates of trauma. Next, multiple logistic regression was used to examine the associations of different forms of trauma throughout the life course (childhood, adulthood, and lifetime), with psychosocial and behavioral risk factors and self-reported cardiometabolic risk (obesity, hypertension, and diabetes) in SMW adjusted for relevant covariates. Results: A total of 547 participants were included. Older age was associated with higher rates of childhood and adulthood trauma. SMW of color reported higher rates of childhood trauma than white participants. Higher education was associated with lower rates of adulthood trauma. All forms of trauma were associated with probable diagnosis of post-traumatic stress disorder and lower perceived social support. Adult trauma was associated with anxiety, whereas childhood and lifetime trauma were associated with higher odds of depression. No significant associations between forms of trauma and behavioral risk factors were noted, except that childhood trauma was associated with higher odds of past-3-month overeating. Logistic regression models examining the association of trauma and cardiometabolic risk revealed that childhood trauma was an independent risk factor for diabetes. Adulthood and lifetime trauma were significantly associated with obesity and hypertension. Conclusions: Trauma emerged as an independent risk factor for cardiometabolic risk in SMW. These findings suggest that clinicians should screen for trauma as a cardiovascular risk factor in SMW, with special attention to SMW most at risk.
Collapse
Affiliation(s)
| | | | | | - Tonda L Hughes
- Columbia University School of Nursing, New York, New York
| |
Collapse
|
39
|
Li L, Pinto Pereira SM, Power C. Childhood maltreatment and biomarkers for cardiometabolic disease in mid-adulthood in a prospective British birth cohort: associations and potential explanations. BMJ Open 2019; 9:e024079. [PMID: 30904846 PMCID: PMC6475361 DOI: 10.1136/bmjopen-2018-024079] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/31/2018] [Accepted: 01/28/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Research on associations between childhood maltreatment and adult cardiometabolic disease risk is sparse. We aimed to investigate associations between different forms of child maltreatment and mid-adult cardiometabolic markers and whether potential intermediaries could account for the associations observed. SETTING 1958 British birth cohort. PARTICIPANTS Approximately 9000 cohort members with data on cardiometabolic markers. OUTCOMES Adult (45y) cardiometabolic markers (blood pressure, lipids and glycated haemoglobin [HbA1c]). RESULTS Seventeen per cent of participants were identified as neglected; 6.1%, 1.6% and 10.0% were identified as experiencing physical, sexual and psychological abuse, respectively. Childhood neglect and physical abuse were associated with high body mass index (BMI) and large waist circumference when adjusting for early-life covariates. For neglect, the adjusted odds ratio (AOR) was 1.16 (95% CI: 1.02 to 1.32) and 1.15 (1.02 to 1.30) for general and central obesity, respectively, and for physical abuse, the respective AOR was 1.36 (1.13 to 1.64) and 1.38 (1.16 to 1.65). Neglect was also associated with raised triglycerides by 3.9 (0.3 to 7.5)% and HbA1c by 1.2 (0.4 to 2.0)%, and among females, lower high-density lipoprotein cholesterol (HDL-c) by 0.05 (0.01 to 0.08)mmol/L after adjustment. For physical abuse, the AOR was 1.25 (1.00 to 1.56) for high low-density lipoprotein cholesterol, HbA1c was raised by 2.5 (0.7 to 4.3)% (in males) and HDL-c was lower by 0.06 (0.01 to 0.12)mmol/L (in females). Associations for sexual abuse were similar to those for physical abuse but 95% CIs were wide. For psychological abuse, the AOR for elevated triglycerides was 1.21 (1.02 to 1.44) and HDL-c was lower by 0.04 (0.01 to 0.07)mmol/L. Maltreatments were not associated with raised blood pressure. In analyses of potential intermediary factors, several associations attenuated after adjustment for adult lifestyles (mainly smoking and alcohol consumption rather than physical activity) and child-to-adult BMI. CONCLUSIONS Childhood maltreatments, particularly neglect and physical abuse, were associated with greater adiposity and poorer lipid and HbA1c profiles decades later in adulthood. Associations were modest but independent of early-life factors linked to these outcomes. Findings implicate adult lifestyles as an important intermediary between child maltreatment and outcomes.
Collapse
Affiliation(s)
- Leah Li
- Population, Policy and Practice Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Snehal M Pinto Pereira
- Population, Policy and Practice Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Christine Power
- Population, Policy and Practice Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| |
Collapse
|
40
|
Mocayar Marón FJ, Ferder L, Saraví FD, Manucha W. Hypertension linked to allostatic load: from psychosocial stress to inflammation and mitochondrial dysfunction. Stress 2019; 22:169-181. [PMID: 30547701 DOI: 10.1080/10253890.2018.1542683] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Although a large number of available treatments and strategies, the prevalence of cardiovascular diseases continues to grow worldwide. Emerging evidence supports the notion of counteracting stress as a critical component of a comprehensive therapeutic strategy for cardiovascular disease. Indeed, an unhealthy lifestyle is a burden to biological variables such as plasma glucose, lipid profile, and blood pressure control. Recent findings identify allostatic load as a new paradigm for an integrated understanding of the importance of psychosocial stress and its impact on the development and maintenance of cardiovascular disease. Allostasis complement homeostasis and integrates behavioral and physiological mechanisms by which genes, early experiences, environment, lifestyle, diet, sleep, and physical exercise can modulate and adapt biological responses at the cellular level. For example, variability is a physiological characteristic of blood pressure necessary for survival and the allostatic load in hypertension can contribute to its related cardiovascular morbidity and mortality. Therefore, the current review will focus on the mechanisms that link hypertension to allostatic load, which includes psychosocial stress, inflammation, and mitochondrial dysfunction. We will describe and discuss new insights on neuroendocrine-immune effects linked to allostatic load and its impact on the cellular and molecular responses; the links between allostatic load, inflammation, and endothelial dysfunction; the epidemiological evidence supporting the pathophysiological origins of hypertension; and the biological embedding of allostatic load and hypertension with an emphasis on mitochondrial dysfunction.
Collapse
Affiliation(s)
- Feres José Mocayar Marón
- a Área de Química Biológica, Departamento de Morfofisiología, Facultad de Ciencias Médicas , Universidad Nacional de Cuyo , Mendoza , Argentina
| | - León Ferder
- b Department of Pediatrics , Nephrology Division, Miller School of Medicine, University of Miami , FL , USA
| | - Fernando Daniel Saraví
- c Instituto de Fisiología, Departamento de Morfofisiología, Facultad de Ciencias Médicas , Universidad Nacional de Cuyo , Mendoza , Argentina
| | - Walter Manucha
- d Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas , Universidad Nacional de Cuyo , Mendoza , Argentina
- e Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET) , Mendoza , Argentina
| |
Collapse
|
41
|
Ports KA, Holman DM, Guinn AS, Pampati S, Dyer KE, Merrick MT, Lunsford NB, Metzler M. Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015. J Pediatr Nurs 2019; 44:81-96. [PMID: 30683285 PMCID: PMC6355255 DOI: 10.1016/j.pedn.2018.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 02/07/2023]
Abstract
Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.
Collapse
Affiliation(s)
- Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Angie S Guinn
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sanjana Pampati
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Karen E Dyer
- Virginia Commonwealth University, School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
| | - Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| |
Collapse
|
42
|
Mitro SD, Sanchez SE, Palomino H, Gelaye B, Williams MA. Childhood abuse, intimate partner violence, and placental abruption among Peruvian women. Ann Epidemiol 2018; 31:26-31. [PMID: 30606468 DOI: 10.1016/j.annepidem.2018.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/08/2018] [Accepted: 12/15/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Experiencing childhood abuse (CA) or intimate partner violence (IPV) has been linked to adverse pregnancy outcomes. We examined whether CA history and current IPV are independently and jointly associated with placental abruption (PA). METHODS We recruited 662 PA cases and 665 controls in Lima, Peru. We used multivariate logistic regression to calculate odds ratios (OR), adjusting for age, education, and parity. RESULTS Approximately 42% of cases and controls reported CA; 50% of cases and 49% of controls reported IPV. History of any CA was not associated with PA, but history of severe CA was associated with 38% increased odds of PA (adjusted OR [aOR], 1.38; 95% confidence interval (CI), 1.07-1.80), adjusting for IPV. There was a statistically nonsignificant association between severe IPV and odds of PA (aOR, 1.22; 95% CI, 0.92-1.62), adjusting for CA. Women who experienced severe CA and severe IPV had 2.06-fold (95% CI, 1.25-3.40) increased odds of PA compared with women who did not experience severe abuse. The joint effect of CA and IPV was positive but statistically nonsignificant on the multiplicative (aOR, 1.48; 95% CI, 0.79-2.80) and additive scale (relative excess risk due to interaction, 0.70; 95% CI, -0.39 to 1.78). CONCLUSIONS Preventing exposure to violence may improve maternal outcomes.
Collapse
Affiliation(s)
- Susanna D Mitro
- Population Health Sciences Program, Harvard University, Boston, MA.
| | - Sixto E Sanchez
- Asociación Civil PROESA, Lima, Peru; Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Henry Palomino
- Facultad de Medicina Humana, Universidad San Martin de Porres, Lima, Peru
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
43
|
Harris HR, Wieser F, Vitonis AF, Rich-Edwards J, Boynton-Jarrett R, Bertone-Johnson ER, Missmer SA. Early life abuse and risk of endometriosis. Hum Reprod 2018; 33:1657-1668. [PMID: 30016439 PMCID: PMC6112577 DOI: 10.1093/humrep/dey248] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/11/2018] [Accepted: 06/20/2018] [Indexed: 02/07/2023] Open
Abstract
STUDY QUESTION Is there an association between physical and sexual abuse occurring in childhood or adolescence and risk of laparoscopically-confirmed endometriosis? SUMMARY ANSWER Early life sexual and physical abuse was associated with an increased risk of endometriosis. WHAT IS KNOWN ALREADY Previous studies have reported that physical and sexual abuse are associated with chronic pelvic pain (CPP). However, only one study has examined the association between childhood physical abuse and laparoscopically-confirmed endometriosis, and did not observe an association with endometriosis risk. STUDY DESIGN, SIZE, DURATION Prospective cohort study using data collected from 60 595 premenopausal women from 1989 to 2013 as part of the Nurses' Health Study II cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants completed an exposure to violence victimization questionnaire in 2001. Cases were restricted to laparoscopically-confirmed endometriosis. Cox proportional hazards models were used to calculate rate ratios (RR) and 95% confidence intervals (CI). MAIN RESULTS AND THE ROLE OF CHANCE Three thousand three hundred and ninety-four cases of laparoscopically-confirmed endometriosis were diagnosed during 24 years of follow-up. Compared to those reporting no physical or sexual abuse, the risk of endometriosis was greater among those who experienced severe physical abuse (RR = 1.20; 95% CI = 1.06, 1.37) or severe sexual abuse (RR = 1.49; 95% CI = 1.24, 1.79). There was a 79% increased risk of laparoscopically-confirmed endometriosis for women reporting severe-chronic abuse of multiple types (95% CI = 1.44, 2.22). The associations between abuse and endometriosis were stronger among women presenting without infertility, a group that was more likely to have been symptomatic with respect to pain. LIMITATIONS, REASONS FOR CAUTION The violence exposure was recalled by the study participants and thus is subject to misclassification as well as recall bias for the cases who were diagnosed prior to 2001. However, our results were similar in a sensitivity analysis including only endometriosis cases incident after their violence history report. In addition, residual or unmeasured confounding is a possibility; however, we were able to adjust for a variety of potential early life confounders. Finally, selection bias is also a possibility if those who chose to return the violence questionnaire did so based jointly on abuse history and endometriosis risk. WIDER IMPLICATIONS OF THE FINDINGS Early life sexual and physical abuse was associated with an increased risk of endometriosis. Severity, chronicity and accumulation of types of abuse were associated with greater risk. Understanding the mechanisms underlying these relations may better define the biologic impacts of abuse and the related pathophysiology of endometriosis. STUDY FUNDING/COMPETING INTEREST(s) This work was supported by National Institute of Child Health and Human Development [Grant numbers HD48544, HD52473, HD57210 and CA50385] and the Atlanta Clinical and Translational Science Institute [Grant number ULRR025008]. The Nurses' Health Study II is supported by the National Institutes of Health grant UM1 CA176726 from the National Cancer Institute. H.R.H. is supported by the National Cancer Institute, National Institutes of Health [Grant number K22 CA193860]. Authors report no conflict of interest.
Collapse
Affiliation(s)
- Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-859, Seattle, WA, USA
| | - Friedrich Wieser
- Gynecology and Obstetrics, Emory University School of Medicine, WMB 4217, 1639 Pierce Drive, Atlanta, GA, USA
| | - Allison F Vitonis
- Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, USA
| | - Janet Rich-Edwards
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital and Harvard Medical School, 1620 Tremont Street Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
| | - Renée Boynton-Jarrett
- Department of General Pediatrics, Boston University School of Medicine/Boston Medical Center, 88 East Newton Street, Boston, MA, USA
| | - Elizabeth R Bertone-Johnson
- Division of Biostatistics and Epidemiology, University of Massachusetts, 715 North Pleasant Street, Amherst, MA, USA
| | - Stacey A Missmer
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
- Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, 333 Longwood Avenue, Boston, MA, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 15 Michigan Street NE, Grand Rapids, MI, USA
| |
Collapse
|
44
|
Non-pharmacological management of hypertension: in the light of current research. Ir J Med Sci 2018; 188:437-452. [DOI: 10.1007/s11845-018-1889-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/16/2018] [Indexed: 02/07/2023]
|
45
|
Mason SM, Santaularia NJ, Berge JM, Larson N, Neumark-Sztainer D. Is the childhood home food environment a confounder of the association between child maltreatment exposure and adult body mass index? Prev Med 2018; 110:86-92. [PMID: 29454080 PMCID: PMC5851654 DOI: 10.1016/j.ypmed.2018.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/05/2018] [Accepted: 02/12/2018] [Indexed: 01/10/2023]
Abstract
Childhood maltreatment is consistently associated with adult obesity, leading to calls for tailored weight interventions for people with maltreatment histories. However, it is possible that the maltreatment-obesity association is spurious and driven by unmeasured confounding, in which case such interventions would be misplaced. The home food environment in childhood is a potential confounder, but its role in the association of maltreatment with obesity has not been examined. We used a longitudinal dataset (Project EAT) to examine the association of adult retrospective reports of maltreatment history in childhood (1+ types of maltreatment before age 18 years) with previously-collected prospective childhood reports of home food environment characteristics (availability of healthy foods, availability of sweet/salty snack food, family meal frequency, and food insufficiency). We then estimated the association between maltreatment and adult body mass index (BMI, kg/m2) with and without adjustment for these home food environment factors. After adjustment for sociodemographics, maltreatment had a 0.84 kg/m2 (95% CI: 0.28, 1.41) higher BMI at age 24-39 years, compared to those with no maltreatment, after adjustment for sociodemographics, parenting style, and BMI in childhood. Additional adjustment for home food environment factors had little effect on this association (β = 0.78 kg/m2; 95% CI: 0.21,1.35), suggesting limited confounding influence of the home food environment factors. Findings provide additional robust evidence that childhood maltreatment is a risk factor for obesity that may warrant tailored interventions.
Collapse
Affiliation(s)
- S M Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States.
| | - N J Santaularia
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - J M Berge
- Department of Family Medicine and Community Health, University of Minnesota School of Medicine, Minneapolis, MN, United States
| | - N Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - D Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
| |
Collapse
|
46
|
Suglia SF, Koenen KC, Boynton-Jarrett R, Chan PS, Clark CJ, Danese A, Faith MS, Goldstein BI, Hayman LL, Isasi CR, Pratt CA, Slopen N, Sumner JA, Turer A, Turer CB, Zachariah JP. Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association. Circulation 2017; 137:e15-e28. [PMID: 29254928 DOI: 10.1161/cir.0000000000000536] [Citation(s) in RCA: 273] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Adverse experiences in childhood and adolescence, defined as subjectively perceived threats to the safety or security of the child's bodily integrity, family, or social structures, are known to be associated with cardiometabolic outcomes over the life course into adulthood. This American Heart Association scientific statement reviews the scientific literature on the influence of childhood adversity on cardiometabolic outcomes that constitute the greatest public health burden in the United States, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. This statement also conceptually outlines pathways linking adversity to cardiometabolic health, identifies evidence gaps, and provides suggestions for future research to inform practice and policy. We note that, despite a lack of objective agreement on what subjectively qualifies as exposure to childhood adversity and a dearth of prospective studies, substantial evidence documents an association between childhood adversity and cardiometabolic outcomes across the life course. Future studies that focus on mechanisms, resiliency, and vulnerability factors would further strengthen the evidence and provide much-needed information on targets for effective interventions. Given that childhood adversities affect cardiometabolic health and multiple health domains across the life course, interventions that ameliorate these initial upstream exposures may be more appropriate than interventions remediating downstream cardiovascular disease risk factor effects later in life.
Collapse
|
47
|
Miller GE, Culhane J, Grobman W, Simhan H, Williamson D, Adam EK, Buss C, Entringer S, Kim KY, Garcia-Espana JF, Keenan-Devlin L, McDade TW, Wadhwa PD, Borders A. Mothers' childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways. Brain Behav Immun 2017; 65:11-19. [PMID: 28450221 PMCID: PMC5537016 DOI: 10.1016/j.bbi.2017.04.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/28/2017] [Accepted: 04/23/2017] [Indexed: 12/23/2022] Open
Abstract
Research suggests the health consequences of economic hardship can be transmitted across generations. Some of these disparities are thought to be passed to offspring during gestation. But this hypothesis has not been tested in contemporary American samples, and the mechanisms of transmission have not been characterized. Accordingly, this study had two goals: first, to determine if women exposed to economic hardship during childhood showed higher rates of adverse birth outcomes; and second, to evaluate the contribution of inflammation, psychosocial, lifestyle, and obstetric characteristics to this phenomenon. This prospective study enrolled 744 women with singleton pregnancies (59.1% White; 16.3% Black; 18.7% Latina; 5.9% Other). Childhood economic hardship was measured by self-report. Birth outcomes included length of gestation and incidence of preterm birth; birth weight percentile and small for gestational age; length of hospital stay and admission to Special Care Nursery. Analyses revealed that mothers' childhood economic hardship was independently associated with multiple adverse birth outcomes, even following adjustment for demographics, maternal education, and obstetrical confounders. Women raised in economically disadvantaged conditions had shorter gestation length and higher preterm delivery rates. Their babies had lower birth weights, were more likely to be small for gestational age, stayed in the hospital longer, and had more Special Care Nursery admissions. Mediation analyses suggested these associations arose through multiple pathways, and highlighted roles for inflammation, education, adiposity, and obstetric complications. Collectively, these findings suggest that childhood economic hardship predisposes women to adverse birth outcomes, and highlights likely behavioral and biological mechanisms.
Collapse
Affiliation(s)
- Gregory E. Miller
- Department of Psychology, Northwestern University,Institute for Policy Research, Northwestern University
| | - Jennifer Culhane
- Children’s Hospital of Philadelphia, Division of Adolescent Medicine,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
| | - William Grobman
- Center for Healthcare Studies, Northwestern University Feinberg School of Medicine,Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine
| | - Hyagriv Simhan
- Division of Maternal-Fetal Medicine, University of Pittsburgh School of Medicine,Division of Obstetrical Services, Magee Women’s Hospital
| | | | - Emma K. Adam
- Institute for Policy Research, Northwestern University,School of Education and Social Policy, Northwestern University
| | - Claudia Buss
- Development, Health and Disease Research Program, University of California, Irvine,Institute of Medical Psychology, Charite University of Medicine, Berlin, Germany
| | - Sonja Entringer
- Development, Health and Disease Research Program, University of California, Irvine,Institute of Medical Psychology, Charite University of Medicine, Berlin, Germany
| | - Kwang-Youn Kim
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | | | - Lauren Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University Health System, University of Chicago Pritzker School of Medicine
| | - Thomas W. McDade
- Institute for Policy Research, Northwestern University,Department of Anthropology, Northwestern University
| | - Pathik D. Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine
| | - Ann Borders
- Center for Healthcare Studies, Northwestern University Feinberg School of Medicine,Department of Obstetrics and Gynecology, NorthShore University Health System, University of Chicago Pritzker School of Medicine,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| |
Collapse
|
48
|
Bleil ME, Booth-LaForce C, Benner AD. Race disparities in pubertal timing: Implications for cardiovascular disease risk among African American women. POPULATION RESEARCH AND POLICY REVIEW 2017; 36:717-738. [PMID: 30127541 PMCID: PMC6097246 DOI: 10.1007/s11113-017-9441-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Compared to white girls, sexual maturation is accelerated in African American girls as measured by indicators of pubertal development, including age at first menses. Increasing epidemiological evidence suggests that the timing of pubertal development may have strong implications for cardio-metabolic health in adolescence and adulthood. In fact, younger menarcheal age has been related prospectively to poorer cardiovascular risk factor profiles, a worsening of these profiles over time, and an increase in risk for cardiovascular events, including non-fatal incident cardiovascular disease and cardiovascular-specific and all-cause mortality. Yet, because this literature has been limited almost exclusively to white girls/women, whether this same association is present among African American girls/women has not been clarified. In the current narrative review, the well-established vulnerability of African American girls to experience earlier pubertal onset is discussed as are findings from literatures examining the health outcomes of earlier pubertal timing and its antecedents, including early life adversity exposures often experienced disproportionately in African American girls. Gaps in these literatures are highlighted especially with respect to the paucity of research among minority girls/women, and a conceptual framework is posited suggesting disparities in pubertal timing between African American and white girls may partially contribute to well-established disparities in adulthood risk for cardio-metabolic disease between African American and white women. Future research in these areas may point to novel areas for intervention in preventing or lessening the heightened cardio-metabolic risk among African American women, an important public health objective.
Collapse
Affiliation(s)
- Maria E. Bleil
- Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195, USA
| | - Cathryn Booth-LaForce
- Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195, USA
| | - Aprile D. Benner
- Human Development and Family Sciences, University of Texas at Austin, Box G1800, Austin, TX 78712, USA
| |
Collapse
|
49
|
Lee C, Coe CL, Ryff CD. Social Disadvantage, Severe Child Abuse, and Biological Profiles in Adulthood. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2017; 58:371-386. [PMID: 29353512 PMCID: PMC5783196 DOI: 10.1177/0022146516685370] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Guided by the stress process model and the life course perspective, we hypothesize: (1) that childhood abuse is concentrated, in terms of type and intensity, among socially disadvantaged individuals, and (2) that experiencing serious abuse contributes to poor biological profiles in multiple body systems in adulthood. Data came from the Biomarker subsample of Midlife in the United States (2004-2006). We used latent class analysis to identify distinct profiles of childhood abuse, each reflecting a combination of type and severity. Results indicate that disadvantaged groups, women, and those from disadvantaged families are at greater risk of experiencing more severe and multiple types of abuse. Those with more severe and multifaceted childhood abuse show greater physiological dysregulation. Childhood abuse experiences partially accounted for the social status differences in physiological profiles. Our findings underscore that differential exposure to serious childhood stressors plays a significant role in gender and class inequalities in adult health.
Collapse
Affiliation(s)
- Chioun Lee
- 1 University of Wisconsin-Madison, Madison, WI, USA
| | | | - Carol D Ryff
- 1 University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
50
|
Rihmer Z, Gonda X, Döme P. Is Mania the Hypertension of the Mood? Discussion of A Hypothesis. Curr Neuropharmacol 2017; 15:424-433. [PMID: 28503115 PMCID: PMC5405605 DOI: 10.2174/1570159x14666160902145635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 01/17/2023] Open
Abstract
Beyond both being biphasic/bidirectional disorders (hypo)mania and essential hypertension share a surprising number of similarities and an overlap between their genetics, biological background, underlying personality and temperamental factors, precipitating factors, comorbidity and response to treatment, indicating a possibly partially shared biological background. Based on theoretical knowledge, similarities related to characteristics, manifestation and course, and the results of pharmacological studies related to the effects and side effects of pharmacotherapies used in the treatment of these two distinct disorders, the authors outline a hypothesis discussing the similar origins of these two phenomena and thus mania being the hypertension of mood in memory of Athanasios Koukopoulos, one of the greatest researchers and theoreticists of mania of all time.
Collapse
Affiliation(s)
- Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Xénia Gonda
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Péter Döme
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
| |
Collapse
|