Young Adults and Adverse Childhood Events: A Potent Measure of Cardiovascular Risk.
Am J Med
; 132(5): 605-613, 2019 05.
Article
em En
| MEDLINE
| ID: mdl-30639555
ABSTRACT
INTRODUCTION:
While cardiovascular disease is the leading cause of death, its determinants include unhealthy behaviors and clinical risk factors and are recognized as the "actual causes" of death. Risk likely accumulates over the life course, and adverse childhood experiences may increase the risk of "actual causes" of death. The objectives of the study are to determine the prevalence and test the association of adverse childhood experiences among unhealthy behaviors and risk factors as a primordial risk factor among young adults.METHODS:
Data were extracted from the 2009 and 2011 Behavioural Risk Factor Surveillance System. Individuals ages 18-99 years provided complete information on adverse childhood experiences, health behaviors, and risk factors. Adverse childhood experiences were categorized and evaluated as cumulative burden. Multivariable logistic models, including stratified analysis for young adults, tested the association of adverse childhood experiences burden with unhealthy behaviors and risk factors.RESULTS:
Among 45,482 study participants, 52% report one adverse childhood experience and 25% report 2 adverse childhood experience categories. Among the total study population, 37% report violence/emotional abuse, 34% report neglect, and 12% report sexual abuse. Even one adverse childhood experience is strongly associated with hypertension, dyslipidemia, and diabetes, and while the association increases in a dose-response (P trend < .001) for all, it is especially more pronounced among the younger adults, with minimal attenuation of effects in the fully adjusted models.CONCLUSION:
The prevalence of adverse childhood experiences in this study population is high. Even one adverse childhood experience is strongly and independently associated with cardiovascular risk factors, with implications for primordial prevention. Future studies are needed to develop screening and treatment strategies targeted to this high-risk group, especially among young adults.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
3_ND
/
6_ODS3_enfermedades_notrasmisibles
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de saúde:
1_doencas_nao_transmissiveis
/
2_muertes_prematuras_enfermedades_notrasmisibles
/
2_muertes_prevenibles
/
3_neglected_diseases
/
6_cardiovascular_diseases
/
7_non_communicable_diseases
Assunto principal:
Doenças Cardiovasculares
/
Adultos Sobreviventes de Eventos Adversos na Infância
/
Comportamentos de Risco à Saúde
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Experiências Adversas da Infância
Tipo de estudo:
Etiology_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Med
Ano de publicação:
2019
Tipo de documento:
Article