Adults who reported experiencing abuse during childhood could have a higher risk of Type 2 diabetes and high cholesterol, according to new research that found risk varied by gender and race.
The new study, published Wednesday in the Journal of the American Heart Association, showed the risk lessened for white women and Black men if they also grew up in "well-organized households" in which family members were engaged in their lives.
"Our findings demonstrate how the negative and positive experiences we have in childhood can have long-term cardiovascular consequences in adulthood and may also explain key heart disease risk disparities by race and sex," said the study's lead author Liliana Aguayo. She is a social epidemiologist and research assistant professor at Emory University's Rollins School of Public Health in Atlanta.
The risks for heart disease and stroke develop over a lifetime and can begin as early as childhood. A 2018 scientific statement from the American Heart Association outlined research showing physical and psychological abuse, along with other negative childhood experiences, could increase the risk for numerous cardiovascular risk factors, including obesity, Type 2 diabetes, high blood pressure and high cholesterol.
Other studies show positive childhood experiences, such as having nurturing relationships with family members who are involved and engaged in a child's life, can encourage heart-healthy behaviors that reduce cardiovascular risks. This new study looked at whether positive relationships during childhood could offset the higher cardiovascular risks associated with abuse.
Researchers used data from 5,115 adults who were 18 to 30 years old and living in Chicago; Minneapolis; Birmingham, Alabama; or Oakland, California, in the mid-1980s.
Abuse and childhood environment were measured using surveys that asked participants to recall how often a parent or adult in the home pushed, grabbed, shoved or hit them hard enough to injure them; how often a parent or adult in the home swore at them, insulted them or made them feel threatened; how often a parent or adult made them feel loved, supported or cared for; how often they were hugged or shown physical affection; whether their childhood household was well-organized; and whether family knew where they were and what they were doing most of the time.
Cardiovascular risks were assessed during an initial clinical examination and eight additional exams over 30 years of follow-up. Roughly 30% of those in the study said they experienced occasional or frequent abuse and 20% said they were sometimes abused. Among those who reported childhood abuse, the risk for Type 2 diabetes and high cholesterol – but not for obesity and high blood pressure – increased. Yet it varied by gender and race.
The risk of high cholesterol was 26% higher in white women and 35% higher in white men who reported low levels of childhood abuse compared to their peers who were not abused. White men also were 81% more likely to develop Type 2 diabetes if they experienced occasional or frequent abuse.
However, positive engagement with family members appeared to offset the cardiovascular risks associated with childhood abuse. Black men and white women who experienced abuse and lacked that engagement were 3.5 times more likely to develop high cholesterol. But that risk diminished as family engagement increased.
Black women who experienced childhood abuse did not see any corresponding increase in cholesterol risk.
"Further research is needed to better understand the potential mechanisms linking childhood abuse to higher heart disease risk factors, and the race and sex differences that may also play a role," Aguayo said. "This information could help inform cardiovascular disease prevention interventions and policies, particularly those that focus on children who experienced abuse or other trauma during childhood."
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