Cumulative childhood and adulthood adversity was associated with a 21% increased risk of incident cardiovascular disease compared to no adversity (HR 1.21; 95% CI 1.16-1.26; p<0.001).
Cohort (n=136,073)
Yes
Does exposure to childhood and adulthood adversities increase the risk of incident fatal and non-fatal CVD events in adults free of baseline CVD?
Childhood and adulthood adversities cumulatively increase the risk of incident cardiovascular disease, but this risk can be substantially mitigated by adopting a healthy lifestyle.
Hazard Ratio: 1.21 (95% CI 1.16–1.26)
p-value: p=<0.001
Background Much remains unknown regarding the associations of adversities in childhood and adulthood with incident cardiovascular diseases (CVD). We aimed to examine the independent and cumulative relations of adversities in childhood and adulthood with incident CVD and whether these associations can be mitigated by adopting a healthy lifestyle later in life. Methods We included 136,073 men and women 38–72 years at baseline free of diagnosed CVD at baseline who responded to surveys on adversities in childhood and adulthood in the United Kingdom Biobank prospective cohort. They were recruited between 2006 and 2010 and were followed-up until 28 January 2021. Adversities included physical abuse, emotional abuse, sexual abuse, emotional neglect, and physical neglect. Participants were categorised into four groups according to the exposure periods, which were no adversity, childhood adversity only, adulthood adversity only, and cumulative adversity (both childhood and adulthood). The primary outcomes included incident fatal and non-fatal CVD events. The modifiable lifestyle factors were smoking, physical activity, diet, sleeping, social or leisure activities, and friend or family visits. Findings We identified 16,415 (10.71/1000 person-year) incident CVD during a median follow-up of 11.8 years. Compared with participants with no adversity, CVD incidence increased by 11% in those with childhood adversity only (adjusted hazard ratio HR: 1.11 95% CI 1.06–1.17, p < 0.001), 4% in those with adulthood adversity only (1.04 1.00–1.09, p = 0.05), and 21% in those with cumulative adversity (1.21 1.16–1.26, p < 0.001). Analysis of interactions showed that adulthood adversity amplified the childhood adversity-CVD association ( p for interaction = 0.03). Compared with the participants with one or fewer ideal lifestyle factors, those with more than four ideal factors had a 25%–36% lower risk of CVD across the three adversity groups. Interpretation Our findings suggested that childhood adversities were associated with an increased risk of CVD which can be magnified by adulthood adversities and substantially mitigated by adopting a healthy lifestyle later in life. Funding The National Natural Science Foundation of China and Guangzhou Foundation for Basic and Applied Basic Research.
Zou et al. (Thu,) conducted a cohort in Incident cardiovascular diseases (n=136,073). Cumulative adversity (both childhood and adulthood) vs. No adversity was evaluated on Incident fatal and non-fatal CVD events (HR 1.21, 95% CI 1.16-1.26, p=<0.001). Cumulative childhood and adulthood adversity was associated with a 21% increased risk of incident cardiovascular disease compared to no adversity (HR 1.21; 95% CI 1.16-1.26; p<0.001).