Key result
Childhood maltreatment is linked to ~13% lower odds of hypertension in females, but not males.
Why the study?
Previous studies on the relationship between childhood maltreatment and adult blood pressure did not sufficiently account for age- and sex-dependent variability in blood pressure.
Does childhood maltreatment influence adult blood pressure-based outcomes and hypertension risk in a general population?
Cross-Sectional (n=150,983)
Does childhood maltreatment influence adult blood pressure-based outcomes and hypertension risk in a general population?
Odds Ratio: 0.87 (95% CI 0.8–0.94)
Childhood maltreatment demonstrates unexpected, age- and sex-dependent inverse associations with adult blood pressure markers and hypertension, particularly in women.
Inverse CM-BP associations emerged in females; cross-sectional design leaves open confounding and precludes causal inference for hypertension risk.
Background Childhood maltreatment (CM) is associated with adult cardiovascular disease (CVD) risk. Systolic (SBP) and diastolic (DBP) blood pressure (BP), key markers of CVD risk, exhibit age- and sex-dependent variability, which was insufficiently accounted for in previous studies on the CM-BP relationship. This study therefore aimed to assess ageand sex-specific associations between CM and adult BP-based outcomes and hypertension using cross-sectional data from the population based German National Cohort (NAKO). Methods Complete data were available for 150,983 participants (49.3% female), who took part in the baseline assessment between 2014 and 2019. CM was assessed via the Childhood Trauma Screener (CTS). Resting BP was assessed using a standardized procedure. Hypertension was defined as either SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or intake of antihypertensive medication. Age- and sex-stratified multivariable regression models estimated ageand sex-specific associations between CM and BP-based markers and sex-stratified logistic regression models were calculated for hypertension as the outcome. Results A pattern of inverse associations between CTS sum score (CTSSUM) and BP markers emerged. Compared to their non-exposed counterparts, females (OR = 0.87, 95%-CI: 0.80; 0.94) but not males (OR = 1.01, 95%-CI: 0.91; 1.13) with high cumulative CM exposure (i.e., ≥ 3 CM categories) had lower odds of hypertension. Age-dependent inverse associations between CTSSUM and BP markers revealed sex-specific patterns. The age- and sex-dependent inverse associations of CM with BP markers were more consistent for the abuse vs. neglect subscales. Conclusions The association between CM and BP revealed age- and sex-dependent patterns, highlighting the complexity of physical consequences in adulthood associated with CM.
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Thielcke et al. (2026) conducted a cross-sectional in Hypertension (n=150,983). Childhood maltreatment vs. Non-exposed counterparts was evaluated on Hypertension (SBP ≥ 140 mmHg, DBP ≥ 90 mmHg, or antihypertensive medication intake) (OR 0.87, 95% CI 0.80-0.94). High cumulative childhood maltreatment exposure was associated with lower odds of hypertension in females (OR 0.87; 95% CI 0.80-0.94), whereas no such association was found in males.
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