A new study published in the Journal of the American Heart Association has found a link between exposure to childhood abuse and risk factors for heart disease and stroke as an adult. Results from the study varied by race and gender, however, those who described their family life as “well-managed” and who had family members involved in their lives during childhood were found to be less likely to have increased cardiovascular risk factors as adults.
Understanding High Cholesterol
Cholesterol is a waxy substance found in your blood. Your body needs cholesterol to build healthy cells, however, when your cholesterol levels become too high, it can increase your risk of heart disease.
Having high cholesterol causes fatty deposits to build up in your blood vessels. Eventually, these deposits will grow, making it harder for your blood to move through your arteries. In some instances, these deposits can become severe and break suddenly, forming a clot. This can cause a heart attack or stroke.
While cardiovascular disease, which includes heart disease and stroke, is often observed in older people, the risk factors typically begin much earlier in life. While the majority of cases of high cholesterol are the result of unhealthy lifestyle choices, such as poor diet and exercise, it can be inherited, or in some cases caused by your environment.
Previous research, conducted by the American Heart Association in 2018, has shown that physical and psychological abuse and other adverse experiences in childhood increase the risk of developing obesity, Type 2 diabetes, high blood pressure, and high cholesterol, which, in turn, increase the risk for cardiovascular diseases.
It also found that healthy childhood experiences, like having nurturing, loving relationships and a well-managed household, may increase the likelihood of heart-healthy behaviors that may decrease cardiovascular disease risks.
In this new study, researchers aimed to explore whether nurturing relationships and well-managed households may offset the likelihood of cardiovascular risk.
About the Study on the Link Between Childhood Abuse and High Cholesterol
Led by Liliana Aguayo, Ph.D., M.P.H., a social epidemiologist and research assistant professor at Emory University’s Rollins School of Public Health in Atlanta, researchers first examined information from the Coronary Artery Risk Development in Young Adults (CARDIA) Study, an ongoing, long-term study among 5,115 Black and white adults enrolled from 1985-1986 to 2015-2016.
The study’s enrollment consisted of participants from four cities in the United States: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. More than half of the participants were women, and nearly half were Black adults. At the start of the study, the average age of the participants was 25, and all that were involved in the study received an initial clinical examination. After the first exam, participants received eight follow-up examinations every few years to assess their cardiovascular risk over the next 30 years.
When the participants were between the ages of 33 and 45, they were asked to complete a survey that consisted of questions about their family life during childhood. This survey examined three specific areas:
- Abuse: How often a parent or adult in their home “pushed, grabbed, shoved or hit them so hard that they were injured;” and how often a parent or adult “swore at them, insulted them, or made them feel threatened.”
- Nurturing: How often a parent or adult made them “feel loved, cared for, or appreciated;” and how often a parent or adult in the family made “warm gestures of affection.”
- Household Organization: Did they [the participant] feel their household was “well-managed;” and did their parents “know they were and what they were doing most of the time.”
Understanding the Link Between Childhood Abuse and High Cholesterol as an Adult
About 30 percent of the study’s participants reported experiencing “occasional/frequent abuse,” which included those who responded, “occasionally or a moderate amount of time,” or “most or all of the time” to questions that pertained to abuse.
Nearly 20 percent of participants reported they experienced “some or little” amounts of abuse, which was categorized as “low abuse.”
The remaining participants, roughly 50 percent, reported no childhood abuse, and described their family life during childhood as “nurturing and well-managed.”
In the groups of adults who reported experiencing childhood abuse, the risk of Type 2 diabetes and high cholesterol was higher compared to adults who reported no abuse during childhood. The risk for obesity and high blood pressure was not higher in groups that reported experiencing childhood abuse. Furthermore, Aguayo and her colleagues noted that their results appeared to vary depending on gender and race.
They observed that the risk of high cholesterol was nearly 26 percent higher among white women, and almost 35% higher among white men who reported low levels of abuse in childhood. This was apparent even when compared to same-sex and race adults who reported no abuse in childhood.
They also found that the risk of Type 2 diabetes was 81% higher in white men who reported occasional or frequent abuse during childhood when compared with adults who reported no childhood abuse.
Black men and white women that reported experiencing childhood abuse, and who also reported living in a dysfunctional household were about three and a half times more likely to develop high cholesterol than those who reported no abuse. Conversely, those who reported no abuse during childhood and who reported growing up in a well-managed household had a nearly 34 percent decrease in their risk of developing high cholesterol.
“Our findings demonstrate how the negative and positive experiences we have in childhood can have long-term cardiovascular consequences in adulthood and define key heart disease risk disparities by race and sex,” said Aguayo.
Bottom Line on the Link Between Childhood Abuse and High Cholesterol
It’s important to note that several limitations may have affected the results of this study. First, the study was a retrospective analysis of data collected in the CARDIA study from 2015. This means that no new surveys were completed with the participants. Additionally, the surveys about childhood abuse and family environments may include some inaccuracies or incomplete recollections. These surveys also failed to define the words “well-managed,” which allowed for open interpretations which could skew the results.
Second, the body mass index (BMI) of the study participants was only measured in adulthood, with no childhood data to compare it to.
“Further research is needed to better understand the potential mechanisms linking childhood abuse and family environment to higher heart disease risk factors, as well as the impact of structural racism and social determinants of health, which likely influenced the differences we found by race and sex,” Aguayo said. “This information is critical to strengthening cardiovascular disease prevention interventions and policies, particularly those that focus on people who experienced abuse or other trauma during childhood.”
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