Why the study?
Adverse childhood experiences are associated with increased cardiovascular disease and altered acute stress reactivity, but their effect on hemodynamic and autonomic responses to orthostatic stress in young adults remained to be investigated.
Do ≥4 types of adverse childhood experiences alter cardiovascular reactivity to head-up tilt in healthy young adults?
Do ≥4 types of adverse childhood experiences alter cardiovascular reactivity to head-up tilt in healthy young adults?
Experiencing ≥4 types of adverse childhood experiences is associated with augmented blood pressure reactivity and blunted vagal response to orthostatic stress in young adults, potentially promoting autonomic dysfunction.
May link early adversity to altered orthostatic reactivity in youth; leaves open whether findings predict later CVD outcomes.
Adverse childhood experiences (ACEs) are associated with greater prevalence of cardiovascular disease and altered acute stress reactivity. The current study investigated the effect of ACEs on hemodynamic and autonomic responses to orthostatic stress imposed by 60° head-up tilt (HUT) in young adults. Two-hundred twenty-six healthy young adults (age = 22.6 ± 1.5 yr; n = 116 females) without cardiovascular disease participated and had complete data. Participants underwent supine blood pressure (BP), R-R interval (RRI), cardiac output (CO), total peripheral resistance (TPR), and cardiovagal baroreflex sensitivity (cvBRS) testing followed by a transition to 60° HUT where measures were reassessed. Childhood adversity exposures were assessed based on categorical exposure and nonexposure to childhood household dysfunction and maltreatment, and <4 and ≥4 types of ACEs. Significantly greater increases in SBP ( P < 0.05), DBP, MAP, and TPR ( P < 0.01; all) following 60° HUT were observed in individuals with ≥4 compared with those with <4 types of ACEs. Attenuated decreases in RRI and cvBRS were observed in those with ≥4 types of ACEs ( P < 0.05). Experiencing ≥4 types of ACEs was associated with augmented BP and TPR reactivity and a blunted decrease in cvBRS in response to 60° HUT in young adults. Results suggest that a reduced vagal response to orthostatic stress is present in those who have experienced ≥4 types of ACEs that may promote autonomic dysfunction. Future research examining the sympathetic and vagal baroreflex branches is warranted.
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Dempster et al. (2023) studied this question.
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