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In brief: Childhood trauma is taken to heart

In brief

Childhood trauma is taken to heart

Child abuse and traumatic experiences in early life raise the risk of heart disease many years later, according to a study reported in the American Heart Association journal Circulation. Kaiser Permanente, the largest health maintenance organization in the United States, collaborated with the Centers For Disease Control and Prevention on the research, in which more than 17,000 patients of both sexes answered questions about childhood physical and emotional abuse and neglect, family conflict and breakups, domestic violence, and parental drug abuse and alcoholism, as well as their own current or past problems with anger and depression. A typical question: "Did a parent or other adult in the household never, sometimes, often, or very often swear at you, insult you, or put you down?"

At an average age of 56, about 10% of the people responding had heart disease. After controls for ethnic origin and education, all the experiences mentioned in the questionnaire except marital discord strongly increased the risk of heart disease, with emotional abuse by parents raising the odds most. The more kinds of childhood trauma or abuse a person had experienced, the higher the likelihood of heart disease in middle age and later. With seven or more kinds, the odds more than tripled.

The study suggested one possible reason for the connection. The familiar heart disease risk factors — smoking, lack of exercise, obesity, and high blood pressure — were less highly correlated with heart disease than were current anger and depression. And people who recalled four or more kinds of early abuse or trauma had a two to three times higher rate of current anger and depression than those who reported no such childhood troubles.

Abuse, neglect, and disturbed family relations in childhood can cause stress with lasting effects on the developing brain and cardiovascular system, as well as depression and anger that may result in smoking, heavy drinking, or overeating. But even when these influences were statistically factored out, the effect of early experience persisted. For example, a person who emerged from a troubled childhood with low blood pressure and minimal depression was still at higher than average risk for heart disease later in life.

Dong, M, et al. "Insights into Causal Pathways for Ischemic Heart Disease: Adverse Childhood Experiences Study," Circulation (September 28, 2004): Vol. 110, No. 13, pp. 1761–66.

Last updated:	September 05, 2008