Abstract P222: Impact Of Adverse Childhood Experiences On Ambulatory Blood Pressure Profiles In Adolescence

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Cailin E Kellum ◽  
Paige Perry ◽  
Keri Kemp ◽  
Alan K Johnson ◽  
David M Pollock ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Adverse Childhood Experiences ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Cvd Risk ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Increased Risk ◽  
Physical Neglect

Adverse childhood experiences (ACEs) include exposure to abuse (verbal and physical), neglect, and household dysfunction during childhood. ACEs have long-lasting health impacts including increased risk for cardiovascular disease (CVD) and hypertension in adulthood. However, it is not clear how ACE exposure impacts CVD risk earlier in the life course, particularly in adolescence. To address this gap in knowledge, in this study we hypothesized that ACE exposure is associated with abnormal ambulatory blood pressure (ABP) profiles in adolescents, with an increased incidence of ambulatory hypertension phenotypes that have normal casual clinic BP [e.g., masked hypertension (MH) or blunted nocturnal dipping (BND)]. We utilized 24-h ambulatory BP monitoring (ABPM; Spacelabs) and casual clinic BP to construct a profile of adolescents with and without ACEs. Abnormal ABP profiles included the following categories: ambulatory hypertension (AH, elevated ABP and casual clinic BP ≥95 th percentile for age, sex, and height), white-coat hypertension (WCH, elevated casual clinic BP with normal ABP), MH (normal casual clinic BP with elevated ABP), or BND (drop in ABP < 10% during sleep). This study included 78 male and female adolescents (median age=16) recruited from Children’s of Alabama Pediatric Clinics. Exclusion criteria included known CVD and antihypertensive medication. Participants recorded wake and sleep times in a diary. Based on the ACE questionnaire, 51 (65%) of adolescents experienced at least 1 ACE. The prevalence of abnormal ABP profiles was similar between the group with ACE exposures vs. the group without ACE exposures (34% vs. 36%; P =0.87). In participants with ACE exposure (n=51), 9% had AH, 6% had MH, 19% had WCH, 43.1% had systolic BND and 22% had diastolic BND. In participants without ACEs (n=27), 4% had AH, 4% had MH, 29% had WCH, 37% had systolic BND and 15% had diastolic BND. Further analysis with covariates are necessary. These results suggest that adolescents with ACEs have similar prevalence of abnormal ABP overall, but higher prevalence of individual ABP phenotypes such as AH, MH, and BND compared to adolescents without ACEs.

Abstract MP37: Adverse Childhood Experiences Impact Blood Pressure And Pulse Wave Velocity In Adolescence

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Cailin E Kellum ◽  
Keri M Kemp ◽  
Paige Perry ◽  
Sylvie Mrug ◽  
Jennifer Pollock ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Adverse Childhood Experiences ◽  
Pulse Wave ◽  
Linear Regression Models ◽  
Childhood Experiences ◽  
Race And Gender ◽  
Adverse Childhood ◽  
Increased Risk

Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, have been associated with increased risk of cardiovascular disease (CVD) in adulthood. Understanding how ACEs affects blood pressure during early life is key for the development of early interventions that may reduce the risk of future CVD. We hypothesized that exposure to ACEs is associated with detrimental hemodynamic parameters during adolescence. This study included 78 male and female adolescents (median age=16, range=13-18) recruited from Children’s of Alabama hospital. Exclusion criteria included cardiovascular or renal disease and antihypertensive medication. An oscillometric blood pressure (BP) monitor was used to measure 24-h ambulatory BP. ACE exposure was measured with the Adolescent Life Change Event (ALCES) questionnaire and was prevalent, with 65% (51 of 78) of participants experiencing 1 ACEs. The mean cumulative ACE score was 1.4±0.2. ACE exposure was not correlated with gender, race, age, or body mass index (BMI). Linear regression models were utilized to link ACE exposure (0 versus 1 ACEs) with 24-h mean arterial pressure (MAP), systolic BP (SBP), diastolic BP (DBP), and pulse wave velocity (PWV). Race and gender were included as covariates. Mean 24-h DBP was significantly (p=0.04) higher in participants with ACE exposure (65.9±0.7 mmHg, n=51) compared to those with no ACE exposure (64.1±0.9 mmHg, n=27); this association was independent of covariates. Since BMI was significantly correlated with SBP, PWV, and MAP, additional models included BMI as a covariate. Both ACE exposure (p= 0.02) and BMI (p<0.001) were associated with increased PWV, while the interaction between ACE exposure and BMI was negatively associated with PWV (p=0.02). Mean 24-h SBP and MAP were not significantly associated with ACE exposure. The finding that ACE exposure is associated with elevated DBP and PWV and not with SBP is in accordance with previously reported results in young adults and suggests that ACEs may alter autonomic pathways leading to CVD and hypertension. Interventions targeted at individuals with ACE exposure early in life could lower the risk of arterial stiffness and in turn the cascade of events leading to CVD.

scholarly journals Maternal history of adverse childhood experiences and ambulatory blood pressure in pregnancy

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Margaret H. Bublitz ◽  
Laura G. Ward ◽  
Meera Simoes ◽  
Laura R. Stroud ◽  
Myriam Salameh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Adverse Childhood Experiences ◽  
Maternal History ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
History Of ◽  
In Pregnancy

scholarly journals Adverse Childhood Experiences on Reproductive Plans and Adolescent Pregnancy in the Gulf Resilience on Women’s Health Cohort

2020 ◽  
Vol 18 (1) ◽  
pp. 165
Author(s):  
Megan Flaviano ◽  
Emily W. Harville
Keyword(s):  
Logistic Regression ◽  
Educational Attainment ◽  
Women’S Health ◽  
Women's Health ◽  
Adolescent Pregnancy ◽  
Adverse Childhood Experiences ◽  
Odds Ratios ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Increased Risk

We investigated if adverse childhood experiences (ACEs) and ACE sub-types were associated with increased odds of planning to have children and adolescent pregnancy. The Gulf Resilience on Women’s Health (GROWH) is a diverse cohort of reproductive-age women living in southeastern Louisiana during the 2010 Deepwater Horizon oil spill. In our sample of 1482 women, we used multinomial logistic regression to model odds ratios of wanting future children and assessed effect measure modification by educational attainment. We also estimated odds ratios of adolescent pregnancy with binomial logistic regression. Exposure to ACEs increased odds of wanting future children across all ACE sub-types. Among women with lower educational attainment, three or more ACEs (overall, childhood, and adolescence) had over two times the odds of wanting future children. History of ACE and the various sub-types, except for emotional abuse, were associated with increased risk of adolescent pregnancy. ACEs may be linked to adolescent pregnancy and reproductive plans, and variations by educational status highlighted social discrepancies and importance of social context in evaluation and intervention.

scholarly journals Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents

2018 ◽  
Vol 214 (3) ◽  
pp. 146-152 ◽  
Author(s):  
Yuhui Wan ◽  
Ruoling Chen ◽  
Shuangshuang Ma ◽  
Danielle McFeeters ◽  
Ying Sun ◽  
...  
Keyword(s):  
Social Support ◽  
Gender Differences ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Adverse Childhood Experiences ◽  
Interaction Effects ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Increased Risk ◽  
The Individual

BackgroundThere is little investigation on the interaction effects of adverse childhood experiences (ACEs) and social support on non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt in community adolescent populations, or gender differences in these effects.AimsTo examine the individual and interaction effects of ACEs and social support on NSSI, suicidal ideation and suicide attempt in adolescents, and explore gender differences.MethodA school-based health survey was conducted in three provinces in China between 2013–2014. A total of 14 820 students aged 10–20 years completed standard questionnaires, to record details of ACEs, social support, NSSI, suicidal ideation and suicide attempt.ResultsOf included participants, 89.4% reported one or more category of ACEs. The 12-month prevalence of NSSI, suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively; all were significantly associated with increased ACEs and lower social support. The multiple adjusted odds ratio of NSSI in low versus high social support was 2.27 (95% CI 1.85–2.67) for girls and 1.81 (95% CI 1.53–2.14) for boys, and their ratio (Ratio of two odds ratios, ROR) was 1.25 (P = 0.037). Girls with high ACEs scores (5–6) and moderate or low social support also had a higher risk of suicide attempt than boys (RORs: 2.34, 1.84 and 2.02, respectively; all P < 0.05).ConclusionsACEs and low social support are associated with increased risk of NSSI and suicidality in Chinese adolescents. Strategies to improve social support, particularly among female adolescents with a high number of ACEs, should be an integral component of targeted mental health interventions.Declaration of interestNone.

scholarly journals Impact of adverse childhood experiences and fruit and vegetable intake in adulthood

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Masako Horino ◽  
Wei Yang
Keyword(s):  
Adverse Childhood Experiences ◽  
Vegetable Intake ◽  
Parental Divorce ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Increased Risk

Abstract Objective: To assess the association between adverse childhood experiences (ACE) and behaviours of fruit and vegetable consumption among adults. Design: Cross-sectional analysis. Weighted χ2 and weighted multiple logistic regression analyses were conducted to determine the association between ACE and low fruit and vegetable consumption. Setting: The 2017 Nevada Behavioral Risk Factor Surveillance System. Participants: The sample consisted of 2939 adults. Results: After controlling for potential confounders, exposure to three or more ACE (adjusted OR (AOR) 1·42, 95 % CI 1·02, 2·00) and experiencing parental divorce/separation (AOR 1·50, 95 % CI 1·13, 1·98) were significantly associated with low fruit and vegetable consumption. The study did not find a dose–response relationship between the number of ACE and fruit and vegetable consumption. Conclusions: The study suggests that participants who experienced three or more ACE or parental divorce/separation were at increased risk for low fruit and vegetable consumption. The findings highlight the continuing need for public health interventions and policies that decrease exposure to ACE and increase fruit and vegetable intake among the populations with ACE.

scholarly journals Adverse childhood experiences and their relationship to gender and depression among young adults in Iraq: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ameel F. Al Shawi ◽  
Yassen T. Sarhan ◽  
Mahasin A. Altaha
Keyword(s):  
Young Adults ◽  
Physical Abuse ◽  
Adverse Childhood Experiences ◽  
Emotional Abuse ◽  
Statistical Tests ◽  
Emotional Neglect ◽  
Convenience Sample ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Physical Neglect

Abstract Background Adverse childhood experiences (ACEs) are considered as universal public health problem that associate with mental disorders and risky behaviors during adulthood. The aims of the paper are to estimate the prevalence of Adverse childhood experiences (ACEs) among young adults in Iraq as well as to estimate the association between ACEs and depression. Methods A convenience sample of young adults of 18–20 years was chosen from centre and west of Iraq, mainly from universities. The adverse childhood experiences were measured by Adverse Childhood Experiences Questionnaire. A depression scale was derived from the Depression, Anxiety and Stress Scales (DASS). Statistical tests: chi square was used to measure the association between adverse childhood experiences and other variables like gender and depression. Odds ratios were computed to estimate the risk for depression. A P value of less than 0.05 was considered statistically significant. Results The total number of participants was 401, 38.9% of the subjects were men, while 61.1% were women. The mean age of the participants was 18.88 ± 0.745. The results revealed that the most common forms of ACEs among the subjects were physical neglect (19.8%) and emotional neglect (19.2%) followed by physical abuse (17.21%) while sexual abuse was 7.52%. There was statistically significant association between most forms of adverse childhood experiences especially emotional abuse, emotional neglect, physical abuse and physical neglect with depression. Conclusion ACEs are not uncommon among young adults in Iraq and are associated with depression in adulthood. National programmes to support mental health rehabilitation might be necessary to reduce the effect of ACEs among Iraqi people, especially for adolescents and young adults.

scholarly journals Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): a systematic review

2019 ◽  
Vol 73 (12) ◽  
pp. 1087-1093 ◽  
Author(s):  
David Walsh ◽  
Gerry McCartney ◽  
Michael Smith ◽  
Gillian Armour
Keyword(s):  
Systematic Review ◽  
Socioeconomic Position ◽  
Adverse Childhood Experiences ◽  
Later Life ◽  
Cochrane Library ◽  
High Quality ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Increased Risk ◽  
The Relationship

Background‘Adverse childhood experiences’ (ACEs) are associated with increased risk of negative outcomes in later life: ACEs have consequently become a policy priority in many countries. Despite ACEs being highly socially patterned, there has been very little discussion in the political discourse regarding the role of childhood socioeconomic position (SEP) in understanding and addressing them. The aim here was to undertake a systematic review of the literature on the relationship between childhood SEP and ACEs.MethodsMEDLINE, PsycINFO, ProQuest and Cochrane Library databases were searched. Inclusion criteria were: (1) measurement of SEP in childhood; (2) measurement of multiple ACEs; (3) ACEs were the outcome; and (4) statistical quantification of the relationship between childhood SEP and ACEs. Search terms included ACEs, SEP and synonyms; a second search additionally included ‘maltreatment’. Overall study quality/risk of bias was calculated using a modified version of the Hamilton Tool.ResultsIn the ACEs-based search, only 6 out of 2825 screened papers were eligible for qualitative synthesis. The second search (including maltreatment) increased numbers to: 4562 papers screened and 35 included for synthesis. Eighteen papers were deemed ‘high’ quality, five ‘medium’ and the rest ‘low’. Meaningful statistical associations were observed between childhood SEP and ACEs/maltreatment in the vast majority of studies, including all except one of those deemed to be high quality.ConclusionLower childhood SEP is associated with a greater risk of ACEs/maltreatment. With UK child poverty levels predicted to increase markedly, any policy approach that ignores the socioeconomic context to ACEs is therefore flawed.PROSPERO registration numberCRD42017064781.

Adverse childhood experiences and bullying behaviours at work among workers in Japan

2019 ◽  
Vol 77 (1) ◽  
pp. 9-14
Author(s):  
Masashi Kizuki ◽  
Takeo Fujiwara ◽  
Tomohiro Shinozaki
Keyword(s):  
Direct Effect ◽  
Adverse Childhood Experiences ◽  
Workplace Bullying ◽  
Structural Model ◽  
Marginal Structural Model ◽  
Childhood Experiences ◽  
Total N ◽  
Adverse Childhood ◽  
Increased Risk ◽  
Bullying Victimisation

ObjectivesTo examine the relationship between adverse childhood experiences (ACEs), workplace bullying victimisation and bullying behaviours to subordinates among Japanese workers.MethodsWe conducted an internet-based cross-sectional survey among workers who had enacted 0, 1 and ≥2 types of bullying behaviours that had been directed towards subordinates in the past 3 years (n=309 for each group, total N=927). We assessed ACEs with questionnaires about adverse experiences at home and bullying victimisation at school. The total and controlled direct effects of ACEs on the number of bullying behaviours to subordinates were estimated from a baseline-adjusted and a direct-effect marginal structural ordinal logistic model, respectively.ResultsThere was a positive dose–response association between the level of ACEs and the frequency of workplace bullying victimisation, as well as the number of bullying behaviours enacted at work after adjustment for sex, age and childhood socioeconomic status (both p<0.001). Workers in the highest tertile of ACEs compared with the lowest tertile had 3.15 (95% CI 2.20 to 4.50) times higher odds of having perpetrated more bullying behaviours at work. The magnitude of the effect was 2.57 (95% CI 1.70 to 3.90) via pathways not mediated by workplace bullying victimisation in a direct-effect marginal structural model.ConclusionsPeople who had ACEs were at increased risk later in life of enacting bullying behaviours at work. Current findings may be useful to prevent bullying behaviours at work.

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