Adversities in childhood and young adulthood and incident cardiovascular diseases: a prospective cohort study

Figures

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  Fig. 1. Associations between adversities and risk of total CVD among 136,073 participants in the UKB. (A) Proportions of participants in each adversity group. (B) Crude incidence rate (per 1000 person-years) of total CVD in each adversity group. (C) Adjusted hazard ratios and their 95% CI of total cardiovascular diseases (CVD), which were derived from Cox proportional regression model with adjustment for age, sex, race/ethnicity, Townsend deprivation index, family history of heart disease, and stroke, and other types of adversity. Cumulative adversities denote adversities in both childhood and adulthood.

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  Fig. 2. Associations between adversities and specific cardiovascular conditions among 136,073 participants in the UKB. Hazard Ratios and 95% Cis were derived from Cox proportional regression models with adjustment for age, sex, race/ethnicity, Townsend deprivation index, and family history of heart diseases, and stroke. Cumulative adversities denote adversities in both childhood and adulthood. Abbreviations: CI, confidence interval; HR, hazard ratio; PY, person-years.

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  Fig. 3. Interactions between childhood and adulthood adversities on the risk of CVD among 136,073 participants in the UKB. (A) Cox proportional regression models with restricted cubic spline terms for adversity score were used to examine the associations between the scores and risk of CVD, with adjustment for age, sex, race/ethnicity, Townsend deprivation index, and family history of heart diseases and stroke. (B) Interaction surface plot on the linear predictor of the hazard function. The z-axis shows the predictor of the hazard function for varying scores of childhood adversities and adulthood adversities, illustrating their interacting effect on the risk of CVD. Cumulative adversities denote adversities in both childhood and adulthood.

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  Fig. 4. Risk of CVD according to adversities and number of ideal lifestyle factors among 136,073 participants in the UKB. Ideal lifestyle factors were defined as follows: no smoking, regular physical activity (≥150 min/week of moderate activity or ≥75 min/week of vigorous activity), a healthy diet (including at least 5 healthy foods such as fruits, vegetables, whole grains, (shell)fish, dairy, vegetable oils, and fewer refined grains, processed meats, unprocessed meats, and sugar-sweetened beverages), adequate sleep (7–9 h per day), engagement in social or leisure activities (like sports clubs or gyms, pubs or social clubs, religious groups, adult education classes, and other group activities), and participating in friend or family visits at least once a week. The Cox proportional hazard model was used for the analysis, with adjustment of age, sex, race/ethnicity, Townsend deprivation index, and family history of heart diseases and stroke. p values for interaction were calculated by including the product term of adversity and lifestyle in model. Cumulative adversities denote adversities in both childhood and adulthood.