Adversities in childhood and young adulthood and incident cardiovascular diseases: a prospective cohort study

被引:6
作者
Zou, Xia [1 ]
Zhao, Junfei [7 ]
Feng, Anping [1 ]
Chan, Kei Hang Katie [4 ,5 ,8 ]
Wu, Wen-Chih [4 ,5 ,9 ,10 ]
Manson, JoAnn E. [5 ,11 ,12 ]
Liu, Simin [1 ,4 ,6 ,14 ,15 ]
Li, Jie [1 ,2 ,3 ,4 ,5 ,13 ]
机构
[1] Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Global Hlth Res Ctr, Guangzhou, Peoples R China
[2] Southern Med Univ, Sch Publ Hlth, Guangzhou, Peoples R China
[3] South China Univ Technol, Sch Med, Guangzhou, Peoples R China
[4] Brown Univ, Dept Epidemiol, Providence, RI USA
[5] Brown Univ, Ctr Global Cardiometab Hlth, Sch Publ Hlth, Providence, RI USA
[6] Brown Univ, Warren Alpert Med Sch, Dept Med & Surg, Providence, RI USA
[7] Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci,Dept Cardiovasc Surg, Guangzhou, Peoples R China
[8] City Univ Hong Kong, Dept Biomed Sci & Elect Engn, Hong Kong, Peoples R China
[9] Brown Univ, Providence VA Med Ctr, Dept Med, Div Cardiol, Providence, RI USA
[10] Brown Univ, Warren Alpert Med Sch, Providence, RI USA
[11] Harvard Med Sch, Harvard THChan Sch Publ Hlth, Brigham & Womens Hosp, Dept Med, Boston, MA USA
[12] Harvard THChan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
[13] Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Global Hlth Res Ctr, Guangzhou 510080, Peoples R China
[14] Brown Univ, Dept Epidemiol, Providence, RI 02906 USA
[15] Brown Univ, Ctr Global Cardiometab Hlth, Providence, RI 02906 USA
基金
中国国家自然科学基金;
关键词
Cardiovascular diseases; Adverse experience; Childhood; Adulthood; Lifestyle; INTIMATE PARTNER VIOLENCE; HEART-DISEASE; LIFE-STYLE; HEALTH; RISK; EXPERIENCES; WOMEN;
D O I
10.1016/j.eclinm.2024.102458
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Much remains unknown regarding the associations of adversities in childhood and adulthood with incident cardiovascular diseases (CVD). We aimed to examine the independent and cumulative relations of adversities in childhood and adulthood with incident CVD and whether these associations can be mitigated by adopting a healthy lifestyle later in life. Methods We included 136,073 men and women [38-72 years at baseline] free of diagnosed CVD at baseline who responded to surveys on adversities in childhood and adulthood in the United Kingdom Biobank prospective cohort. They were recruited between 2006 and 2010 and were followed -up until 28 January 2021. Adversities included physical abuse, emotional abuse, sexual abuse, emotional neglect, and physical neglect. Participants were categorised into four groups according to the exposure periods, which were no adversity, childhood adversity only, adulthood adversity only, and cumulative adversity (both childhood and adulthood). The primary outcomes included incident fatal and non -fatal CVD events. The modifiable lifestyle factors were smoking, physical activity, diet, sleeping, social or leisure activities, and friend or family visits. Findings We identified 16,415 (10.71/1000 person -year) incident CVD during a median follow-up of 11.8 years. Compared with participants with no adversity, CVD incidence increased by 11% in those with childhood adversity only (adjusted hazard ratio [HR]: 1.11 [95% CI 1.06-1.17], p < 0.001), 4% in those with adulthood adversity only (1.04 [1.00-1.09], p = 0.05), and 21% in those with cumulative adversity (1.21 [1.16-1.26], p < 0.001). Analysis of interactions showed that adulthood adversity amplified the childhood adversity-CVD association (p for interaction = 0.03). Compared with the participants with one or fewer ideal lifestyle factors, those with more than four ideal factors had a 25%-36% lower risk of CVD across the three adversity groups. Interpretation Our findings suggested that childhood adversities were associated with an increased risk of CVD which can be magnified by adulthood adversities and substantially mitigated by adopting a healthy lifestyle later in life.
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页数:13
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