Childhood Adversity Associated With Poor Blood Pressure Regulation

NEW ORLEANS — A history of childhood adversity was associated with blood pressure dysfunction from childhood into adulthood, researchers reported at the American Heart Association’s Scientific Sessions 2016.¹

“Adverse environments in early life have been consistently associated with the increased risk of hypertension in later life,” Shaoyong Su, PhD, lead author and associate professor of pediatrics at Augusta University Medical College of Georgia in Augusta, stated in a press release.² “We found that children who experienced childhood abuse or neglect, dysfunctional homes, and low socioeconomic status, were far more likely to have higher blood pressure at night as well as blood pressure variability over 24 hours, in addition to more rapid onset of hypertension at an earlier age.”

Dr Su and colleagues evaluated 373 patients aged 7 to 38 years who underwent 24-hour ambulatory blood pressure monitoring 15 times over 23 years, according to the abstract. The researchers used the weighted 24-hour standard deviation of ambulatory blood pressure readings to determine blood pressure variability.

Adverse childhood experiences were scored based on intensity (0 to 3 points) and classified based on household dysfunction, childhood mistreatment, and low socioeconomic status.

The researchers found no positive association between adverse childhood experiences and diastolic blood pressure during the day (β = 0.34, P =.23), but there was a positive association between the 2 factors at night (β = 0.52; P =.02).¹ Increased systolic blood pressure variability was present in patients with high adverse childhood experience scores over 24 hours (β = 0.16, P =.001) as well as during the day (β = 0.18, P =.002), but not at night (β = 0.06, P =.40).¹

Dr Su and colleagues noted that there was no interaction with age, and clinicians should start recognizing blood pressure variability in younger patients and asking them about adverse childhood experiences to identify these risk factors.¹

“This is not something most clinicians currently address, but it is a simple step that could identify many individuals at risk of adult hypertension and help them achieve control at an earlier age. This could avoid problems as they age,” Dr Su stated in the release.²

Disclosures: The researchers report no disclosures.

References

1. Su S, Treiber F, Harshfield Gl. Abstract 305. Impact of Childhood Adversities on Blood Pressure Regulation in Real Life: Results From a 23-Year Longitudinal Study Through Childhood to Young Adulthood. Presented at: American Heart Association’s Scientific Sessions 2016; November 12-16, 2016; New Orleans.
2. Childhood adversity linked to blood pressure dysfunction [press release]. Dallas, TX: American Heart Association/American Stroke Association Newsroom; November 14, 2016. http://newsroom.heart.org/news/Xchildhood-adversity-linked-to-blood-pressure-dysfunction. Accessed November 15, 2016.