Childhood abuse affects the heart

By Piriya Mahendra

Severe child abuse is a risk factor for cardiovascular disease (CVD) in early adulthood, report researchers in Circulation.

Janet Rich-Edwards (Brigham and Women's Hospital, Boston, Massachusetts, USA) and team's study showed that women who experienced moderate physical abuse in childhood (defined as being hit with something more than once, or physically attacked once) was associated with a 46% increased risk for CVD events (myocardial infarction, angina, stroke).

Compared with women who did not experience childhood sexual abuse, those who experienced unwanted sexual touching in childhood were at a 10% increased risk for CVD events later in life, and those who experienced forced sex were at a 56% increased risk.

After adjusting for adult lifestyle and medical risk factors, women who underwent severe physical childhood abuse (physically attacked more than once or ever choked or burned) were at a 13% increased risk for CVD events in adulthood. Those who experienced forced sex were at a 25% increased risk.

Overall, 513 CVD events occurred including 262 MIs and 251 strokes. Of these, severe physical abuse occurred in 68 cases per 97,860 person-years. Sexual touching occurred in 119 cases per 254,752 person-years and forced sex occurred in 88 cases per 128,066 person-years.

The study included 66,798 women aged 25-42 years at baseline from the Nurses' Health Study II. Overall, 65% of women reported some abuse, predominantly mild physical abuse or unwanted sexual touching.

Moreover, 9% reported severe physical abuse and 11% reported forced sex; 17% experienced severe physical or sexual abuse.

Adult risk factors known to be associated with early abuse, including adult experiences of intimate partner violence, smoking, high body mass index, hypertension, diabetes, and depression accounted for 60-80% of the association between severe early abuse and CVD risk.

"This suggests that a large portion of the association of childhood abuse with adult CVD risk could be eliminated or reduced by targeted prevention efforts that have been successful in reducing CVD incidence among US women," say the authors.

They conclude: "We need to understand the complex physiological and behavioral pathways through which abuse leads to true CVD events, so that interventions that aim to alter CVD risk trajectories from childhood to adulthood can be maximally effective."

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