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Tang A, Ertel KA, Keen R, Beyer L, Eckert N, Mita C, Pintro K, Okuzono SS, Yazawa A, Slopen N. Parent-child separation and cardiometabolic outcomes and risk factors in adulthood: A systematic review. Psychoneuroendocrinology 2023; 152:106084. [PMID: 36996574 PMCID: PMC10565792 DOI: 10.1016/j.psyneuen.2023.106084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 03/11/2023] [Accepted: 03/12/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Parent-child separation has been associated with negative mental health across childhood and adulthood, yet little is known about the long-term impacts for cardiovascular health. This systematic review synthesized and evaluated the quality of the literature examining the association between exposures to parent-child separation and cardiometabolic outcomes in adulthood. METHODS Following a registered protocol, online databases (Pubmed, PsycInfo, and Web of Science) were searched for relevant studies. Studies were included if they (a) defined the exposure before age 18 as institutionalization, foster care placement, parental incarceration, separation due to parents migrating for economic reasons, or asylum and war; and (b) quantified the association between parent-child separation and cardiometabolic events and diagnoses (e.g., coronary heart disease, diabetes) and risk factors (e.g., body mass index, fat distribution, serum-based metabolic markers, inflammatory markers in adulthood (≥ age 18). Studies lacking an unexposed comparison group were excluded. The risk for bias in each study was assessed with a modified Newcastle-Ottawa Scale. RESULTS Of the 1938 studies identified, 13 met our inclusion criteria. Two of the four studies examining associations between parent-child separation and cardiometabolic events and diagnoses found positive associations with coronary heart disease and diabetes. Amongst the 13 studies examining associations with any type of adult cardiometabolic risk factors, eight studies reported at least one positive association. Sub-analyses considering separate reasons for parent-child separation provided clearer insights: War evacuation was associated with hypertension and high blood pressure across four studies from the same cohort; out-of home care experiences largely evidenced null results across five different studies, and two studies on parental incarceration suggested positive associations with elevated inflammation, BMI and blood pressure. CONCLUSIONS The connections between parent-child separation and adult cardiometabolic outcomes and risk factors are currently inconsistent. The results may depend on the reason for separation, age of assessment, analytic differences and other psychosocial variables that are often unmeasured in this literature.
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Affiliation(s)
- Alva Tang
- Department of Psychology, University of Texas at Dallas, USA.
| | - Karen A Ertel
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA; Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, USA
| | - Ryan Keen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA
| | - Logan Beyer
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA; Harvard Medical School, Harvard University, USA
| | | | - Carol Mita
- Countway Library of Medicine, Harvard Medical School, USA
| | - Kedie Pintro
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA
| | - Sakurako S Okuzono
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA
| | - Aki Yazawa
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA; Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA; Center on the Developing Child, Harvard University, USA
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Bister L, Janssen F, Vogt T. Early-life exposure to economic stress and metabolic risks in young adulthood: the children of the reunification in East Germany. J Epidemiol Community Health 2022; 76:786-791. [PMID: 35738894 DOI: 10.1136/jech-2021-218637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 06/12/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Research on the long-term health consequences of early-life exposure to economic crises is scarce. We examine for the first time the long-term effects of early-life exposure to an economic crisis on metabolic health risks. We study objective health measures, and exploit the quasi-experimental situation of the postreunification economic crisis in East Germany. METHODS Data were drawn from two waves of the longitudinal German Health Interview and Examination Survey for Children and Adolescents (2003-2006, 2014-2017). We compared 392 East Germans who were exposed to the economic crisis in utero and at ages 0-5 with 1123 of their West German counterparts using propensity score matching on individual and family characteristics. We assessed blood pressure, cholesterol, blood fat and body mass index (BMI); both combined as above-average metabolic health risks and individually at ages 19-30. RESULTS Early-life exposure to the economic crisis significantly increased the number of above-average metabolic health risks in young adulthood by 0.1482 (95% CI 0.0169 to 0.2796), which was 5.8% higher compared with no exposure. Among individuals exposed in utero, only females showed significant effects. Early-life exposure to the economic crisis was associated with increased systolic (0.9969, 95% CI -0.2806 to 2.2743) and diastolic blood pressure (0.6786, 95% CI -0.0802 to 1.4373), and with increased BMI (0.0245, 95% CI -0.6516 to 0.7001). CONCLUSION The increased metabolic health risks found for women exposed to the postreunification economic crisis in-utero are likely attributable to increased economic stress. While the observed differences are small, they may foreshadow the emergence of greater health disparities in older age.
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Affiliation(s)
- Lara Bister
- Population Research Centre, University of Groningen, Groningen, The Netherlands
| | - Fanny Janssen
- Population Research Centre, University of Groningen, Groningen, The Netherlands.,Netherlands Interdisciplinary Demographic Institute - KNAW / University of Groningen, The Hague, The Netherlands
| | - Tobias Vogt
- Population Research Centre, University of Groningen, Groningen, The Netherlands.,Prasanna School of Public Health, Manipal Academy for Higher Education, Manipal, India
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Nuñez P, Arguelles J, Perillan C. Sex-specific influence of maternal exposure to bisphenol A on sodium and fluid balance in response to dipsogenic challenges in rats. Appetite 2022; 176:106091. [DOI: 10.1016/j.appet.2022.106091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/06/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022]
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Suglia SF, Appleton AA, Bleil ME, Campo RA, Dube SR, Fagundes CP, Heard-Garris NJ, Johnson SB, Slopen N, Stoney CM, Watamura SE. Timing, duration, and differential susceptibility to early life adversities and cardiovascular disease risk across the lifespan: Implications for future research. Prev Med 2021; 153:106736. [PMID: 34293381 PMCID: PMC8595689 DOI: 10.1016/j.ypmed.2021.106736] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Early life adversities (ELA), include experiences such as child maltreatment, household dysfunction, bullying, exposure to crime, discrimination, bias, and victimization, and are recognized as social determinants of cardiovascular disease (CVD). Strong evidence shows exposure to ELA directly impacts cardiometabolic risk in adulthood and emerging evidence suggests there may be continuity in ELA's prediction of cardiometabolic risk over the life course. Extant research has primarily relied on a cumulative risk framework to evaluate the relationship between ELA and CVD. In this framework, risk is considered a function of the number of risk factors or adversities that an individual was exposed to across developmental periods. The cumulative risk exposure approach treats developmental periods and types of risk as equivalent and interchangeable. Moreover, cumulative risk models do not lend themselves to investigating the chronicity of adverse exposures or consider individual variation in susceptibility, differential contexts, or adaptive resilience processes, which may modify the impact of ELA on CVD risk. To date, however, alternative models have received comparatively little consideration. Overall, this paper will highlight existing gaps and offer recommendations to address these gaps that would extend our knowledge of the relationship between ELA and CVD development. We focus specifically on the roles of: 1) susceptibility and resilience, 2) timing and developmental context; and 3) variation in risk exposure. We propose to expand current conceptual models to incorporate these factors to better guide research that examines ELA and CVD risk across the life course.
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Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Emory University, Atlanta, GA, United States of America.
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Albany, NY, United States of America
| | - Maria E Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States of America
| | - Rebecca A Campo
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Shanta R Dube
- Public Health Program, Levine College of Health Sciences, Wingate University, Wingate, NC, United States of America
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
| | - Nia J Heard-Garris
- Division of Advanced General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Sara B Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Catherine M Stoney
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Sarah E Watamura
- Department of Psychology, University of Denver, Denver, CO, United States of America
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Berhe O, Gerhardt S, Schmahl C. Clinical Outcomes of Severe Forms of Early Social Stress. Curr Top Behav Neurosci 2021; 54:417-438. [PMID: 34628586 DOI: 10.1007/7854_2021_261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Early social stress, particularly severe but nevertheless frequent forms such as abuse and neglect, are among the major risk factors for the development of mental disorders. However, we only have very limited knowledge of the psychobiological disease mechanisms underlying the influence of early life stress and stress-related disorders during this vulnerable phase of life. Early stress can have long-lasting adverse effects on the brain and other somatic systems, e.g. through influences on brain development. In adulthood, the prior experience of abuse or neglect can result in complex clinical profiles. Besides conditions such as mood and anxiety disorders as well as posttraumatic stress disorder, substance use disorders (SUD) are among the most prevalent sequelae of early social stress. Current social stress further influences the development and maintenance of these disorders, e.g., by increasing the risk of relapses. In this chapter, we will first give an overview of currently used methods to assess the phenomenology and pathophysiology of stress-related disorders and then focus on the phenomenological and neurobiological background of the interaction between early social stress and SUD. We will give an overview of important insights from neuroimaging studies and will also highlight recent findings from studies using digital tools such as ecological momentary assessment or virtual reality to capture the influence of early social stress as well as current social stress in everyday life of persons with SUD.
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Affiliation(s)
- Oksana Berhe
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Sarah Gerhardt
- Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany.
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Andrade JL, Hong YR, Lee AM, Miller DR, Williams C, Thompson LA, Bright MA, Cardel MI. Adverse Childhood Experiences Are Associated with Cardiometabolic Risk among Hispanic American Adolescents. J Pediatr 2021; 237:267-275.e1. [PMID: 34147498 DOI: 10.1016/j.jpeds.2021.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/31/2021] [Accepted: 06/14/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess the relationship between adverse childhood experiences (ACEs) and cardiometabolic risk among Hispanic adolescents. STUDY DESIGN This cross-sectional study was conducted at an academic research center in Gainesville, Florida. Participants were locally recruited, and data were collected from June 2016 to July 2018. Participants (n = 133, 60.2% female) were healthy adolescents aged 15-21 years who self-identified as Hispanic, were born in the US, and had a body mass index (BMI) between ≥18.5 and ≤40 kg/m2. Primary outcomes were BMI, body fat percentage, waist circumference, and resting blood pressure. Associations between ACEs and cardiometabolic measures were assessed by multivariable logistic regression models, which controlled for sex, age, parental education, and food insecurity. Results were sex-stratified to assess potential variations. RESULTS Reporting ≥4 ACEs (28.6%) was significantly associated with a greater BMI (P = .004), body fat percentage (P = .02), and diastolic blood pressure (P = .05) compared with reporting <4 ACEs. Female participants reporting ≥4 ACEs were significantly more likely to have a greater BMI (P = .04) and body fat percentage (P = .03) whereas male participants reporting ≥4 ACEs were significantly more likely to have a greater BMI (P = .04), systolic blood pressure (P = .03), and diastolic blood pressure (P = .03). CONCLUSIONS Hispanic adolescent participants who experienced ≥4 ACEs were more likely to have elevated risk markers of obesity and cardiometabolic disease. Further research is needed to elucidate the physiological mechanisms driving these relationships.
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Affiliation(s)
- Joanne L Andrade
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Young-Rock Hong
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
| | - Alexandra M Lee
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Darci R Miller
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Charlette Williams
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Lindsay A Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL; Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL
| | - Melissa A Bright
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL; Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL; WW International, Inc, New York, NY.
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Bleil ME, Spieker SJ, Booth-LaForce C. Targeting Parenting Quality to Reduce Early Life Adversity Impacts on Lifespan Cardiometabolic Risk. Front Psychol 2021; 12:678946. [PMID: 34149571 PMCID: PMC8211431 DOI: 10.3389/fpsyg.2021.678946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Mounting evidence that early life adversity (ELA) exposures confer risk for cardiometabolic disease over the lifespan motivated this narrative review to examine parenting quality as a potential intervention target to reduce ELA exposures or mitigate their impact as a way of reducing or preventing cardiometabolic disease. We describe findings from the limited number of family-based intervention studies in ELA-exposed children that have tested parenting impacts on cardiometabolic health outcomes. We then describe the implications of this work and make recommendations for future research that will move this field forward.
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Affiliation(s)
- Maria E. Bleil
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
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Sensitive periods for psychosocial risk in childhood and adolescence and cardiometabolic outcomes in young adulthood. Dev Psychopathol 2021; 32:1864-1875. [PMID: 33427189 DOI: 10.1017/s0954579420001248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Greater psychosocial risk in childhood and adolescence predicts poorer cardiometabolic outcomes in adulthood. We assessed whether the timing of psychosocial risk from infancy through adolescence predicts cardiometabolic outcomes in young adulthood. Young adults and their mothers participated in a longitudinal study beginning in infancy in Santiago, Chile (N = 1040). At infancy, 5 years, 10 years, and adolescence, mothers reported on depressive symptoms, stressful experiences, support for child development in the home, father absence, parental education, and socioeconomic status (SES) to create a psychosocial risk composite at each time point. Young adults (52.1% female; 21-27 years) provided fasting serum samples and participated in anthropometric and blood pressure (BP) assessments, including a dual-energy X-ray absorptiometry (DXA) scan for measuring body fat. Greater infant psychosocial risk was associated with a greater young adult metabolic syndrome score (β = 0.07, 95% confidence intervals (CI): 0.01 to 0.13, p = 0.02), a higher body mass index and waist circumference composite (β = 0.08, 95% CI: 0.03 to 0.13, p = 0.002), and a higher body fat (DXA) composite (β = 0.07, 95% CI: 0.01 to 0.12, p = 0.02). No psychosocial risk measure from any time point was associated with BP. Infant psychosocial risk predicted cardiometabolic outcomes in young adulthood better than psychosocial risk at 5 years, 10 years, or adolescence, mean of psychosocial risk from infancy through adolescence, and maximum of psychosocial risk at any one time. Consistent with the Developmental Origins of Health and Disease model, findings suggest that infancy is a sensitive period for psychosocial risk leading to poorer cardiometabolic outcomes in young adulthood.
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S Machado IB, Tofanelli MR, Saldanha da Silva AA, Simões E Silva AC. Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date. Curr Pediatr Rev 2021; 17:15-37. [PMID: 33430749 DOI: 10.2174/1573396317999210111200222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted. OBJECTIVE The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors. METHODS This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus. RESULTS The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms. CONCLUSION The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.
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Affiliation(s)
- Isabella Barreto S Machado
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Matheus Rampinelli Tofanelli
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ariadna A Saldanha da Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Rafiq T, O’Leary DD, Dempster KS, Cairney J, Wade TJ. Adverse Childhood Experiences (ACEs) Predict Increased Arterial Stiffness from Childhood to Early Adulthood: Pilot Analysis of the Niagara Longitudinal Heart Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:505-514. [PMID: 33269049 PMCID: PMC7683677 DOI: 10.1007/s40653-020-00311-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An association among adults between adverse childhood experiences (ACEs) and arterial stiffness and between arterial stiffness and cardiovascular disease has been established. Recent cross-sectional evidence suggests that ACEs is linked to the development and progression of arterial stiffness, but it remains unclear when these changes begin to manifest. We examine the relationship between ACEs and changes in arterial stiffness from childhood into adulthood using population-based longitudinal data. The Niagara Longitudinal Heart Study (NLHS) pilot data included 76 young adults (females = 44), with an average age of 21 years (SD = 1), and had a follow-up period of 9 years. Mixed effects modeling was used to examine the effect of ACEs on changes in arterial stiffness over time adjusting for sex, changes in heart rate, systolic blood pressure, body mass index, and physical activity. Individuals with four or more ACEs have a greater increase in arterial stiffness over time from childhood into young adulthood. This increase was similar for both males and females and independent of the effects of change in heart rate, systolic blood pressure, body mass index, and physical activity. Exposure to ACEs is associated with greater increase in arterial stiffness, a marker for cardiovascular disease among adults. This suggests that interventions targeted at individuals with high exposure to ACEs early on in life could lower the risk of arterial stiffness and in turn the cascade of events leading to cardiovascular disease.
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Affiliation(s)
- Talha Rafiq
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
| | - Deborah D. O’Leary
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
| | - Kylie S. Dempster
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
| | - John Cairney
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland Australia
| | - Terrance J. Wade
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
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Abstract
OBJECTIVE This study aimed to study the association between maternal history of childhood adversity and blood pressure in pregnancy. METHODS A total of 127 pregnant women completed measures of adverse childhood experiences (ACE) and prenatal stress between June 2015 and April 2019. At 11 weeks' gestation (range, 6-17 weeks), we measured 24-hour ambulatory blood pressure. All women were considered to be at risk for pregnancy complications due to elevated body mass index and self-reporting snoring in pregnancy. RESULTS Women were, on average, 30 years old (range, 19-40 years), and average (standard deviation) body mass index in this sample was 34 (7) kg/m (range, 27-55 kg/m). Higher ACE scores were associated with higher nighttime blood pressure (systolic blood pressure: β = 0.23, p = .013; diastolic blood pressure: β = 0.22, p = .028). There were no significant associations between the ACE score and daytime blood pressure. Women with four or more ACEs were more likely to display nocturnal blood pressure nondipping (odds ratio = 3.97, 95% confidence interval = 1.38-11.40). Associations between ACE and nocturnal blood pressure remained significant after adjusting for symptoms of prenatal stress. CONCLUSIONS Results indicate that experiences of childhood adversity are associated with elevated nocturnal blood pressure and loss of a typical decline in blood pressure between day and night.
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Janů A, Malinakova K, Kosarkova A, Tavel P. Associations of childhood trauma experiences with religious and spiritual struggles. J Health Psychol 2020; 27:292-304. [PMID: 32830557 DOI: 10.1177/1359105320950793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Childhood trauma is associated with many interpersonal and psychosocial problems in adulthood. The aim of this study was to explore the associations with a spiritual area of personality, namely religious and spiritual struggles (R/S struggles). A nationally representative sample of 1,000 Czech respondents aged 15 years and older participated in the survey. All types of CT were associated with an increased level of all six types of R/S struggles, with the highest values for demonic struggles. Thus, the findings of this study might be important for clinical practice and pastoral care as well as a further research.
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Affiliation(s)
- Anna Janů
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Klara Malinakova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Alice Kosarkova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
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Lacey RE, Minnis H. Practitioner Review: Twenty years of research with adverse childhood experience scores - Advantages, disadvantages and applications to practice. J Child Psychol Psychiatry 2020; 61:116-130. [PMID: 31609471 DOI: 10.1111/jcpp.13135] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Adverse childhood experience (ACE) scores have become a common approach for considering childhood adversities and are highly influential in public policy and clinical practice. Their use is also controversial. Other ways of measuring adversity - examining single adversities, or using theoretically or empirically driven methods - might have advantages over ACE scores. METHODS In this narrative review we critique the conceptualisation and measurement of ACEs in research, clinical practice, public health and public discourse. RESULTS The ACE score approach has the advantages - and limitations - of simplicity: its simplicity facilitates wide-ranging applications in public policy, public health and clinical settings but risks over-simplistic communication of risk/causality, determinism and stigma. The other common approach - focussing on single adversities - is also limited because adversities tend to co-occur. Researchers are using rapidly accruing datasets on ACEs to facilitate new theoretical and empirical approaches but this work is at an early stage, e.g. weighting ACEs and including severity, frequency, duration and timing. More research is needed to establish what should be included as an ACE, how individual ACEs should be weighted, how ACEs cluster, and the implications of these findings for clinical work and policy. New ways of conceptualising and measuring ACEs that incorporate this new knowledge, while maintaining some of the simplicity of the current ACE questionnaire, could be helpful for clinicians, practitioners, patients and the public. CONCLUSIONS Although we welcome the current focus on ACEs, a more critical view of their conceptualisation, measurement, and application to practice settings is urgently needed.
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Affiliation(s)
- Rebecca E Lacey
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Helen Minnis
- Institute of Health and Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Soares S, Santos AC, Peres FS, Barros H, Fraga S. Early life socioeconomic circumstances and cardiometabolic health in childhood: Evidence from the Generation XXI cohort. Prev Med 2020; 133:106002. [PMID: 32007527 DOI: 10.1016/j.ypmed.2020.106002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/09/2020] [Accepted: 01/25/2020] [Indexed: 11/15/2022]
Abstract
Social adversity is thought to become biologically embedded during sensitive periods of development which could set children on a trajectory of increased risk for later diseases. This study estimated the association between early socioeconomic circumstances and cardiometabolic biomarkers during childhood. We analyzed data from 2962 participants in the birth cohort Generation XXI. Early socioeconomic circumstances included parental education and occupation and household income measured at the child's birth; cardiometabolic biomarkers included a set of parameters that were determined at seven and 10years old. The association between early socioeconomic circumstances and cardiometabolic biomarkers in children aged seven and 10years old was estimated using generalized estimating equations. We observed, after adjustment for birth weight, sex, five-a-day fruit and vegetable intake and sedentary activity, that children with low educated mothers presented higher body mass index z-score (β=0.22; 95%CI: 0.12, 0.33), higher waist circumference (β=1.14; 95%CI: 0.55, 1.73) and increased systolic blood pressure z-score (β=0.15; 95%CI: 0.08, 0.22) at the age of seven. At 10years, children with mothers with low education, presented higher body mass index z-score (β =0.32; 95%CI: 0.21, 0.43), higher waist circumference (β=2.79; 95%CI: 1.94, 3.64), increased diastolic blood pressure z-score (β=0.11; 95%CI: 0.06, 0.17) and increased systolic blood pressure s-score (β=0.20; 95%CI: 0.12, 0.28). When repeated measures of cardiometabolic biomarkers were taken into account, the association between socioeconomic circumstances and cardiometabolic biomarkers remained significant. Low socioeconomic circumstances have a possible detrimental effect on children's cardiometabolic health. Thus, socioeconomic adversity might impact health outcomes already in the first decade of life, emphasizing the early social patterning of cardiometabolic health and the need of social policies targeting children and families to modify or reverse its negative impact on health.
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Affiliation(s)
- Sara Soares
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | | | - Henrique Barros
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Sílvia Fraga
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal.
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Dalmasso C, Leachman JR, Ensor CM, Yiannikouris FB, Giani JF, Cassis LA, Loria AS. Female Mice Exposed to Postnatal Neglect Display Angiotensin II-Dependent Obesity-Induced Hypertension. J Am Heart Assoc 2019; 8:e012309. [PMID: 31752639 PMCID: PMC6912962 DOI: 10.1161/jaha.119.012309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Abstract
Background We have previously reported that female mice exposed to maternal separation and early weaning (MSEW), a model of early life stress, show exacerbated diet-induced obesity associated with hypertension. The goal of this study was to test whether MSEW promotes angiotensin II-dependent hypertension via activation of the renin-angiotensin system in adipose tissue. Methods and Results MSEW was achieved by daily separations from the dam and weaning at postnatal day 17, while normally reared controls were weaned at postnatal day 21. Female controls and MSEW weanlings were placed on a low-fat diet (LF, 10% kcal from fat) or high-fat diet (HF, 60% kcal from fat) for 20 weeks. MSEW did not change mean arterial pressure in LF-fed mice but increased it in HF-fed mice compared with controls (P<0.05). In MSEW mice fed a HF, angiotensin II concentration in plasma and adipose tissue was elevated compared with controls (P<0.05). In addition, angiotensinogen concentration was increased solely in adipose tissue from MSEW mice (P<0.05), while angiotensin-converting enzyme protein expression and activity were similar between groups. Chronic enalapril treatment (2.5 mg/kg per day, drinking water, 7 days) reduced mean arterial pressure in both groups of mice fed a HF (P<0.05) and abolished the differences due to MSEW. Acute angiotensin II-induced increases in mean arterial pressure (10 μg/kg SC) were attenuated in untreated MSEW HF-fed mice compared to controls (P<0.05); however, this response was similar between groups in enalapril-treated mice. Conclusions The upregulation of angiotensinogen and angiotensin II in adipose tissue could be an important mechanism by which female MSEW mice fed a HF develop hypertension.
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Affiliation(s)
- Carolina Dalmasso
- Department of Pharmacology and Nutritional SciencesUniversity of KentuckyLexingtonKY
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Jacqueline R. Leachman
- Department of Pharmacology and Nutritional SciencesUniversity of KentuckyLexingtonKY
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Charles M. Ensor
- Department of Pharmacology and Nutritional SciencesUniversity of KentuckyLexingtonKY
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Frederique B. Yiannikouris
- Department of Pharmacology and Nutritional SciencesUniversity of KentuckyLexingtonKY
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Jorge F. Giani
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Lisa A. Cassis
- Department of Pharmacology and Nutritional SciencesUniversity of KentuckyLexingtonKY
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Analia S. Loria
- Department of Pharmacology and Nutritional SciencesUniversity of KentuckyLexingtonKY
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
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16
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Timothy A, Benegal V, Shankarappa B, Saxena S, Jain S, Purushottam M. Influence of early adversity on cortisol reactivity, SLC6A4 methylation and externalizing behavior in children of alcoholics. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109649. [PMID: 31082414 DOI: 10.1016/j.pnpbp.2019.109649] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/29/2019] [Accepted: 05/09/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Children of parents with alcoholism face considerable stress, and often have externalizing behaviors. Early adversity is known to affect DNA methylation and the functioning of the HPA axis. We investigated the association of early adversity with cortisol reactivity, 5HTTLPR genotype, site specific DNA methylation in the SLC6A4 gene and externalizing behavior in children of alcoholics (COA), and a matched sample of control children. METHODS We examined children of alcoholics (N = 50) and age matched control children (N = 50) for exposure to early adversity (both prenatal and postnatal), assessed their salivary cortisol reactivity and evaluated their levels of emotional and behavioral difficulty in terms of externalizing and internalizing behavior. Site-specific DNA methylation at a previously characterized SLC6A4 region was determined in salivary DNA using pyrosequencing. The 5HTTLPR region of the SLC6A4 gene was also genotyped. RESULTS COA had significantly higher experience of early adversity than control children. Cortisol reactivity was reduced in COA, and negatively correlated with early adversity. Both early adversity and cortisol reactivity correlated with externalizing behavior. SLC6A4 methylation was higher in COA, and correlated with early adversity. SLC6A4 genotype did not show association with any of the variables. CONCLUSION Our study provides further evidence that early adversity is associated with blunted cortisol reactivity, increased site-specific CpG DNA methylation at the SLC6A4 gene, and high externalizing behavior.
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Affiliation(s)
- Anurag Timothy
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore 560029, India; Department of Psychiatry, Base Hospital Delhi Cantt, New Delhi 110010, India
| | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Bhagyalakshmi Shankarappa
- Molecular Genetics Lab, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India; St Johns Medical College Hospital, Bangalore, India
| | - Sachin Saxena
- Department of Psychiatry, Base Hospital Delhi Cantt, New Delhi 110010, India
| | - Sanjeev Jain
- Molecular Genetics Lab, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Meera Purushottam
- Molecular Genetics Lab, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
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van Dammen L, Bush NR, de Rooij SR, Mol BWJ, Groen H, Hoek A, Roseboom TJ. Childhood adversity and women's cardiometabolic health in adulthood: associations with health behaviors, psychological distress, mood symptoms, and personality. BMC WOMENS HEALTH 2019; 19:102. [PMID: 31337378 PMCID: PMC6652022 DOI: 10.1186/s12905-019-0797-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/02/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND We tested whether childhood adversity is associated with poor cardiometabolic health in adulthood among a sample of overweight or obese Dutch women of reproductive age. Health behaviors, psychological distress, mood symptoms, or personality traits were included as potential mediators. METHODS Data came from a follow-up visit (N = 115), carried out in 2016/2017, of a randomized controlled lifestyle intervention trial in 577 obese infertile women. The associations between total adversity exposure score and cardiometabolic health were tested with regression models. Sleep, smoking and eating behavior, symptoms of depression, anxiety and stress, and personality traits were potential mediators. RESULTS Childhood adversity scores were not associated with cardiometabolic outcomes but were associated with poorer sleep quality score (M = 7.2 (SD = 3.5) for those with ≥2 types of events versus 4.8 (2.9) for those with no events; p = 0.022), higher external eating score (26.4 (8.7) versus 21.8 (10.3); p = 0.038), higher perceived stress score (17.1 (6.8) versus 12.3 (4.5); p = 0.016), post-traumatic stress score (1.9 (1.5) versus 0.6 (1.1); p < 0.001), and lower agreeableness score (28.2 (4.2) versus 30.3 (3.1); p = 0.035). CONCLUSION Childhood adversity was associated with poorer health behaviors including sleep and eating behavior, and more stress-related symptoms, but not with women's cardiometabolic health.
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Affiliation(s)
- Lotte van Dammen
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA. .,Departments of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. .,Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Nicole R Bush
- Departments of Psychiatry and Pediatrics, University of California San Francisco, San Francisco, California, USA.,Division of Developmental Medicine, Center for Health and Community, San Francisco, California, USA
| | - Susanne R de Rooij
- Departments of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC at the University of Amsterdam, Amsterdam, The Netherlands
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annemieke Hoek
- Departments of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tessa J Roseboom
- Departments of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC at the University of Amsterdam, Amsterdam, The Netherlands.,Obstetrics and Gynaecology, Amsterdam UMC at the University of Amsterdam, Amsterdam, The Netherlands
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18
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Obi IE, McPherson KC, Pollock JS. Childhood adversity and mechanistic links to hypertension risk in adulthood. Br J Pharmacol 2019; 176:1932-1950. [PMID: 30656638 PMCID: PMC6534788 DOI: 10.1111/bph.14576] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/17/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023] Open
Abstract
Adverse childhood experiences (ACEs), defined as traumatic events in childhood that range from various forms of abuse to household challenges and dysfunction, have devastating consequences on adult health. Epidemiological studies in humans and animal models of early life stress (ELS) have revealed a strong association and insight into the mechanistic link between ACEs and increased risk of cardiovascular disease (CVD). This review focuses on the mechanistic links of ACEs in humans and ELS in mice and rats to vasoactive factors and immune mediators associated with CVD and hypertension risk, as well as sex differences in these phenomena. Major topics of discussion in this review are as follows: (a) epidemiological associations between ACEs and CVD risk focusing on hypertension, (b) evidence for association of ACE exposures to immune-mediated and/or vasoactive pathways, (c) rodent models of ELS-induced hypertension risk, (d) proinflammatory mediators and vasoactive factors as mechanisms of ELS-induced hypertension risk. We also provide some overall conclusions and directions of further research. LINKED ARTICLES: This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc.
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Affiliation(s)
- Ijeoma E. Obi
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| | - Kasi C. McPherson
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| | - Jennifer S. Pollock
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
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19
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Fall CHD, Kumaran K. Metabolic programming in early life in humans. Philos Trans R Soc Lond B Biol Sci 2019; 374:20180123. [PMID: 30966889 PMCID: PMC6460078 DOI: 10.1098/rstb.2018.0123] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 12/25/2022] Open
Abstract
An association of low birth weight with an increased risk of adult cardiovascular disease and diabetes led to the developmental origins of health and disease (DOHaD) hypothesis, which proposes that undernutrition during early development permanently 'programmes' organ structure and metabolism, leading to vulnerability to later cardio-metabolic disease. High birth weight caused by maternal gestational diabetes is also associated with later diabetes, suggesting that fetal over-nutrition also has programming effects. Post-natal factors (excess weight gain/obesity, smoking, poor diets and physical inactivity) interact with fetal exposures to increase disease risk. Animal studies have shown permanent metabolic effects in offspring after alterations to maternal or early post-natal diets but evidence in humans is largely limited to observational and quasi-experimental situations such as maternal famine exposure. Randomized trials of maternal nutritional interventions during pregnancy have so far had limited follow-up of the offspring. Moreover, interventions usually started after the first trimester and therefore missed key peri-conceptional or early pregnancy events such as epigenetic changes, placentation and fetal organogenesis. Recent and ongoing trials intervening pre-conceptionally and powered for long-term offspring follow-up will address these issues. While current preventive strategies for cardio-metabolic disease focus on high-risk individuals in mid-life, DOHaD concepts offer a 'primordial' preventive strategy to reduce disease in future generations by improving fetal and infant development. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.
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Affiliation(s)
- Caroline H. D. Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Kalyanaraman Kumaran
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, South India
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20
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Albott CS, Forbes MK, Anker JJ. Association of Childhood Adversity With Differential Susceptibility of Transdiagnostic Psychopathology to Environmental Stress in Adulthood. JAMA Netw Open 2018; 1:e185354. [PMID: 30646399 PMCID: PMC6324405 DOI: 10.1001/jamanetworkopen.2018.5354] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
IMPORTANCE Multivariable comorbidity research indicates that childhood adversity increases the risk for the development of common mental disorders. This risk is explained by underlying internalizing and externalizing transdiagnostic constructs that are amplified by environmental stressors. The differential susceptibility model suggests that this interaction of risk and environment is bidirectional: at-risk individuals will have worse outcomes in high-stress environments but better outcomes in in low-stress environments. OBJECTIVE To test the differential susceptibility model by examining how a history of adverse childhood experiences moderates the association between life stress and transdiagnostic psychopathology. DESIGN, SETTING, AND PARTICIPANTS Data came from the US National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a population-based observational longitudinal survey administered to adults (≥18 years of age). Participants completed the survey at wave 1 (from 2001 through 2002) and wave 2 (from 2004 through 2005). Responses from 34 458 participants were used for the analyses from March 3, 2017, through October 8, 2018. MAIN OUTCOMES AND MEASURES Latent variables for internalizing-fear, internalizing-distress, externalizing, and general psychopathology were created to represent continuous levels of psychopathology in each wave. Latent variables were also created to represent continuous levels of life stress at each wave. Level of childhood adversity was characterized based on the number of types of childhood adversity experienced (no [0 types], low [1-2 types], and high [≥3 types] exposure). Analyses examined how the interaction between level of childhood adversity and adult life stress was associated with change in adult transdiagnostic psychopathology factors. RESULTS Of the 34 458 participants included in the analysis (58.0% women and 42.0% men; mean [SD] age, 46.0 [17.4] years at wave 1 and 49.0 [17.3] years at wave 2), 40.5% had no adverse childhood experiences, 34.6% had 1 to 2, and 24.9% had 3 or more. At wave 1, 61.5% of the sample endorsed at least 1 stressful life event and 27.2% met criteria for at least 1 mental disorder; at wave 2, these figures were 64.7% and 29.7%, respectively. Childhood adversity moderated the association between changes in adult life stress and changes in all transdiagnostic psychopathology factors. Specifically, higher levels of childhood adversity had a stronger association between adult life stress and adult transdiagnostic psychopathology factors. Further, significant differences between childhood adversity groups occurred in the mean scores of all transdiagnostic psychopathology factors for both increases and decreases in life stress, providing preliminary evidence of differential susceptibility. CONCLUSIONS AND RELEVANCE Results provide empirical support for childhood adversity as a differential susceptibility factor engendering heightened functional and dysfunctional reactivity to later stress.
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Affiliation(s)
- C Sophia Albott
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis
| | - Miriam K Forbes
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Justin J Anker
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis
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21
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Melo C, Vizin RCL, Silva NU, Ishikawa DT, Echeverry MB, Carrettiero DC, Almeida MC. Early maternal separation promotes alterations in the thermoregulatory profile of adult Wistar rats. J Therm Biol 2018; 78:151-160. [PMID: 30509631 DOI: 10.1016/j.jtherbio.2018.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 02/06/2023]
Abstract
Stressful lifelong events may influence psychiatric diseases, like depression and anxiety. Interestingly, depressed patients have dysfunction of thermoregulatory cooling mechanisms. Thus, understanding the mechanisms related to the thermoregulatory changes in stress-related pathologies is important to better understand the symptoms and treatments for those diseases. However, the influence of early-life stress on the thermoregulatory profile of adults is unknown. In this study, we aimed to evaluate the thermoregulatory profile of adult male Wistar rats submitted to early-life stress by maternal separation (MS). On postnatal days 2-14, rats were submitted daily to MS for 3 h per day. At 3-4 months of age, anxiety-like behavior was evaluated using the open field test and elevated plus maze, depression-like behavior was evaluated using the forced swim test and thermoregulatory profile were also evaluated. In the behavioral tests, MS animals exhibited anxiety- and depression-like behaviors, and had higher core body temperatures during dark period of the circadian cycle, when compared to controls. In addition, MS animals presented higher hyperthermic and vasoconstriction responses than control animals when exposed to the warmth environment, and engaged in cold-seeking behavior whenever possible to select their preferred ambient temperature. The results suggest that, besides emotional alterations, MS induces a change in the thermoregulatory profile of rats that persists into adulthood.
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Affiliation(s)
- C Melo
- Graduate Program in Neuroscience and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil
| | - R C L Vizin
- Graduate Program in Neuroscience and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil
| | - N U Silva
- Center for Natural and Human Sciences (CCNH), Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil
| | - D T Ishikawa
- Graduate Program in Neuroscience and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil
| | - M B Echeverry
- Graduate Program in Neuroscience and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil; Center for Mathematics, Computation and Cognition (CMCC), UFABC, São Bernardo do Campo, SP, Brazil
| | - D C Carrettiero
- Graduate Program in Neuroscience and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil; Center for Natural and Human Sciences (CCNH), Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil
| | - M C Almeida
- Graduate Program in Neuroscience and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil; Center for Natural and Human Sciences (CCNH), Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil.
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22
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Bernatova I, Puzserova A, Balis P, Sestakova N, Horvathova M, Kralovicova Z, Zitnanova I. Chronic Stress Produces Persistent Increases in Plasma Corticosterone, Reductions in Brain and Cardiac Nitric Oxide Production, and Delayed Alterations in Endothelial Function in Young Prehypertensive Rats. Front Physiol 2018; 9:1179. [PMID: 30210360 PMCID: PMC6123386 DOI: 10.3389/fphys.2018.01179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 08/06/2018] [Indexed: 12/25/2022] Open
Abstract
This study was designed to investigate whether oxidative stress, nitric oxide (NO) deficiency and/or endothelial dysfunction (ED) are present in young borderline hypertensive rats (BHR) and whether these pathologies can be causally involved in the initiation of blood pressure (BP) increases. Additionally, we tested the hypothesis that crowding stress, experienced during the peripubertal period, may produce persistent or delayed disorders in corticosterone release, NO synthesis, oxidative status and/or endothelial function that could accelerate BP increases. To test these hypotheses, 5-week-old male BHR and normotensive Wistar-Kyoto rats (WKY) were either kept in control conditions (for 2 and 4 weeks, respectively) or exposed to social stress produced by crowding for 2 weeks (stress). After cessation of crowding, a group of rats of each phenotype was kept in control conditions for the next 2 weeks (post-stress). Systolic BP of 5-week-old BHR was significantly increased vs. age-matched WKY (127 ± 3 vs. 104 ± 3 mmHg, p < 0.01) and remained significantly higher throughout the course of the experiment. Despite elevated BP, no signs of oxidative damage to plasma lipids, NO deficiency or ED were observed in control BHR vs. age-matched WKY. Crowding stress elevated plasma corticosterone and accelerated BP increases only in BHR; these effects persisted 2 weeks post-stress. Crowding failed to induce oxidative damage to plasma lipids in either phenotype, but it produced persistent decreases in NO production in the hypothalamus and brainstem of both strains of rats, as well as in the hearts of BHR. In contrast, crowding failed to reduce NO production in the aortae or acetylcholine-induced relaxations of the femoral arteries in both strains investigated. However, significantly reduced aortic NO production was observed in BHR 2 weeks post-stress vs. age-matched controls, which was in agreement with reduced NO-dependent components of vasorelaxation. In conclusion, this study’s data showed that oxidative stress, NO deficiency and ED are not causally involved in initiation of blood pressure increase in BHR. However, exposure to stressful environments produced persistent increases in plasma corticosterone and reductions of brain and cardiac NO production followed by a delayed decrease in the NO-dependent component of endothelium-dependent relaxation—changes that collectively accelerated BP increases only in BHR.
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Affiliation(s)
- Iveta Bernatova
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Angelika Puzserova
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Peter Balis
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Natalia Sestakova
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Martina Horvathova
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Zuzana Kralovicova
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Ingrid Zitnanova
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, Slovakia
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23
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Haapanen MJ, Perälä MM, Salonen MK, Kajantie E, Simonen M, Pohjolainen P, Pesonen AK, Räikkönen K, Eriksson JG, von Bonsdorff MB. Early life stress and frailty in old age: the Helsinki birth cohort study. BMC Geriatr 2018; 18:179. [PMID: 30103697 PMCID: PMC6090686 DOI: 10.1186/s12877-018-0873-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence suggests that early life stress (ELS) may extend its effect into adulthood and predispose an individual to adverse health outcomes. We investigated whether wartime parental separation, an indicator of severe ELS, would be associated with frailty in old age. METHODS Of the 972 participants belonging to the present sub-study of the Helsinki Birth Cohort Study, 117 (12.0%) had been evacuated abroad unaccompanied by their parents in childhood during World War II. Frailty was assessed at a mean age of 71 years according to Fried's criteria. RESULTS Thirteen frail men (4 separated and 9 non-separated) and 20 frail women (2 separated and 18 non-separated) were identified. Compared to the non-separated men, men who had been separated had an increased relative risk ratio (RRR) of frailty (age-adjusted RRR 3.93, 95% CI 1.02, 15.11) that persisted after adjusting for several confounders. No associations were observed among women (RRR 0.62; 95% CI 0.13, 2.94). CONCLUSIONS These preliminary results suggest that ELS might extend its effects not just into adulthood but also into old age, and secondly, that men may be more vulnerable to the long-term effects of ELS.
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Affiliation(s)
- M. J. Haapanen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, PO Box 20, FI-00014 Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - M. M. Perälä
- Folkhälsan Research Center, Helsinki, Finland
- Department of Public Health Solutions, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - M. K. Salonen
- Folkhälsan Research Center, Helsinki, Finland
- Department of Public Health Solutions, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - E. Kajantie
- Department of Public Health Solutions, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M. Simonen
- Finnish Centre of Excellence in Intersubjectivity in Interaction, University of Helsinki, Helsinki, Finland
| | | | - A. K. Pesonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - K. Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - J. G. Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, PO Box 20, FI-00014 Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Public Health Solutions, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - M. B. von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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De Miguel C, Obi IE, Ho DH, Loria AS, Pollock JS. Early life stress induces immune priming in kidneys of adult male rats. Am J Physiol Renal Physiol 2018; 314:F343-F355. [PMID: 28971994 PMCID: PMC5899229 DOI: 10.1152/ajprenal.00590.2016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 12/31/2022] Open
Abstract
Early life stress (ELS) in humans is associated with elevated proinflammatory markers. We hypothesized that ELS induces activation of the immune response in a rat model of ELS, maternal separation (MatSep), in adulthood. MatSep involves separating pups from the dam from postnatal day 2 to postnatal day 14 for 3 h/day. Control rats are nonseparated littermates. We determined circulating and renal immune cell numbers, renal immune cell activation markers, renal cytokine levels, and the renal inflammatory gene expression response to low-dose lipopolysaccharide (LPS) in male MatSep and control rats. We observed that MatSep did not change the percentage of gated events for circulating CD3+, CD4+, CD8+, and CD4+/Foxp3+ cells or absolute numbers of mononuclear and T cells in the circulation and kidneys; however, MatSep led to an increase in activation of renal neutrophils as well as CD44+ cells. Renal toll-like receptor 4 (TLR4) and interleukin 1 beta (IL-1β) was significantly increased in MatSep rats, specifically in the outer and inner medulla and distal nephron, respectively. Evaluation of renal inflammatory genes showed that in response to a low-dose LPS challenge (2 mg/kg iv) a total of 20 genes were significantly altered in kidneys from MatSep rats (17 genes were upregulated and 3 were downregulated), as opposed to no significant differences in gene expression in control vs. control + LPS groups. Taken together, these findings indicate that MatSep induces priming of the immune response in the kidney.
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Affiliation(s)
- Carmen De Miguel
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Ijeoma E Obi
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Dao H Ho
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | - Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky , Lexington, Kentucky
| | - Jennifer S Pollock
- Section of Cardio-Renal Physiology and Medicine, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
- Department of Medicine, Augusta University , Augusta, Georgia
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McNeil CJ, Myint PK, Sandu AL, Potter JF, Staff R, Whalley LJ, Murray AD. Increased diastolic blood pressure is associated with MRI biomarkers of dementia-related brain pathology in normative ageing. Age Ageing 2018; 47:95-100. [PMID: 29106439 DOI: 10.1093/ageing/afx102] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/12/2017] [Indexed: 11/12/2022] Open
Abstract
Background hypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer's disease pathology. Objective to examine relationships between blood pressure (BP) components and brain pathology in older adults. Subjects two hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years. Methods BP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships. Results higher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = -0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = -0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011). Conclusion increased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer's diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies.
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Affiliation(s)
- Christopher J McNeil
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Phyo Kyaw Myint
- AGEING: Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Medicine for the Elderly, NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - John F Potter
- Norwich Medical School, Norwich Research Park Cardiovascular Research Group, University of East Anglia, Norwich, UK
| | - Roger Staff
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
- NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Lawrence J Whalley
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
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Herzog JI, Schmahl C. Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Front Psychiatry 2018; 9:420. [PMID: 30233435 PMCID: PMC6131660 DOI: 10.3389/fpsyt.2018.00420] [Citation(s) in RCA: 257] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/15/2018] [Indexed: 01/08/2023] Open
Abstract
Introduction: Adverse childhood experiences (ACE) such as sexual and physical abuse or neglect are frequent in childhood and constitute a massive stressor with long-lasting adverse effects on the brain, mental and physical health.The aim of this qualitative review is to present a concise overview of the present literature on the impact of ACE on neurobiology, mental and somatic health in later adulthood. Methods: The authors reviewed the existing literature on the impact of ACE on neurobiology, mental and somatic health in later adulthood and summarized the results for a concise qualitative overview. Results: In adulthood, the history of ACE can result in complex clinical profiles with several co-occurring mental and somatic disorders such as posttraumatic stress disorder, depression, borderline personality disorder, obesity and diabetes. Although a general stress effect in the development of the disorders and neural alterations can be assumed, the role of type and timing of ACE is of particular interest in terms of prevention and treatment of ACE-related mental and somatic conditions. It has been suggested that during certain vulnerable developmental phases the risk for subsequent ACE-related disorders is increased. Moreover, emerging evidence points to sensitive periods and specificity of ACE-subtypes in the development of neurobiological alterations, e.g., volumetric and functional changes in the amygdala and hippocampus. Conclusion: Longitudinal studies are needed to investigate complex ACE-related characteristics and mechanisms relevant for mental and somatic disorders by integrating state of the art knowledge and methods. By identifying and validating psychosocial and somatic risk factors and diagnostic markers one might improve the development of innovative somatic and psychological treatment options for individuals suffering from ACE-related disorders.
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Affiliation(s)
- Julia I Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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27
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Bleil ME, Booth-LaForce C, Benner AD. Race disparities in pubertal timing: Implications for cardiovascular disease risk among African American women. POPULATION RESEARCH AND POLICY REVIEW 2017; 36:717-738. [PMID: 30127541 PMCID: PMC6097246 DOI: 10.1007/s11113-017-9441-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Compared to white girls, sexual maturation is accelerated in African American girls as measured by indicators of pubertal development, including age at first menses. Increasing epidemiological evidence suggests that the timing of pubertal development may have strong implications for cardio-metabolic health in adolescence and adulthood. In fact, younger menarcheal age has been related prospectively to poorer cardiovascular risk factor profiles, a worsening of these profiles over time, and an increase in risk for cardiovascular events, including non-fatal incident cardiovascular disease and cardiovascular-specific and all-cause mortality. Yet, because this literature has been limited almost exclusively to white girls/women, whether this same association is present among African American girls/women has not been clarified. In the current narrative review, the well-established vulnerability of African American girls to experience earlier pubertal onset is discussed as are findings from literatures examining the health outcomes of earlier pubertal timing and its antecedents, including early life adversity exposures often experienced disproportionately in African American girls. Gaps in these literatures are highlighted especially with respect to the paucity of research among minority girls/women, and a conceptual framework is posited suggesting disparities in pubertal timing between African American and white girls may partially contribute to well-established disparities in adulthood risk for cardio-metabolic disease between African American and white women. Future research in these areas may point to novel areas for intervention in preventing or lessening the heightened cardio-metabolic risk among African American women, an important public health objective.
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Affiliation(s)
- Maria E. Bleil
- Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195, USA
| | - Cathryn Booth-LaForce
- Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195, USA
| | - Aprile D. Benner
- Human Development and Family Sciences, University of Texas at Austin, Box G1800, Austin, TX 78712, USA
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28
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Rihmer Z, Gonda X, Döme P. Is Mania the Hypertension of the Mood? Discussion of A Hypothesis. Curr Neuropharmacol 2017; 15:424-433. [PMID: 28503115 PMCID: PMC5405605 DOI: 10.2174/1570159x14666160902145635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 01/17/2023] Open
Abstract
Beyond both being biphasic/bidirectional disorders (hypo)mania and essential hypertension share a surprising number of similarities and an overlap between their genetics, biological background, underlying personality and temperamental factors, precipitating factors, comorbidity and response to treatment, indicating a possibly partially shared biological background. Based on theoretical knowledge, similarities related to characteristics, manifestation and course, and the results of pharmacological studies related to the effects and side effects of pharmacotherapies used in the treatment of these two distinct disorders, the authors outline a hypothesis discussing the similar origins of these two phenomena and thus mania being the hypertension of mood in memory of Athanasios Koukopoulos, one of the greatest researchers and theoreticists of mania of all time.
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Affiliation(s)
- Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Xénia Gonda
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Péter Döme
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
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Abstract
OBJECTIVE Identifying the life course health effects of childhood adversity is a burgeoning area of research, particularly in relation to cardiovascular disease (CVD). However, adversity measurement varies widely across studies, which may hamper our ability to make comparisons across studies and identify mechanisms linking adversity to CVD. The purposes of this review are to summarize adversity measurement approaches in the context of CVD, identify gaps, and make recommendations for future research. METHODS PubMed and PsycINFO searches were conducted through June 2016. Studies were selected if CVD end point or predisease risk markers were investigated in association with a measure of childhood adversity. Forty-three studies were reviewed. A meta-analysis was not conducted because of the variation in exposures and outcomes assessed. RESULTS Adversity measurement was heterogeneous across studies. Metrics included different sets of adverse events, relational factors, and socioeconomic indicators. Thirty-seven percent measured childhood adversity prospectively, 23% examined a CVD end point, and 77% treated adversity as an unweighted summary score. Despite the heterogeneity in measurement, most studies found a positive association between childhood adversity and CVD risk, and the association seems to be dose-response. CONCLUSIONS The literature on childhood adversity and CVD would benefit from improving consistency of measurement, using weighted adversity composites, modeling adversity trajectories over time, and considering socioeconomic status as an antecedent factor instead of a component part of an adversity score. We suggest conceptual and analytic strategies to enhance, refine, and replicate the observed association between childhood adversity and CVD risk.
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Puzserova A, Bernatova I. Blood pressure regulation in stress: focus on nitric oxide-dependent mechanisms. Physiol Res 2017; 65:S309-S342. [PMID: 27775419 DOI: 10.33549/physiolres.933442] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Stress is considered a risk factor associated with the development of various civilization diseases including cardiovascular diseases, malignant tumors and mental disorders. Research investigating mechanisms involved in stress-induced hypertension have attracted much attention of physicians and researchers, however, there are still ambiguous results concerning a causal relationship between stress and long-term elevation of blood pressure (BP). Several studies have observed that mechanisms involved in the development of stress-induced hypertension include increased activity of sympathetic nervous system (SNS), glucocorticoid (GC) overload and altered endothelial function including decreased nitric oxide (NO) bioavailability. Nitric oxide is well known neurotransmitter, neuromodulator and vasodilator involved in regulation of neuroendocrine mechanisms and cardiovascular responses to stressors. Thus NO plays a crucial role in the regulation of the stress systems and thereby in the BP regulation in stress. Elevated NO synthesis, especially in the initial phase of stress, may be considered a stress-limiting mechanism, facilitating the recovery from stress to the resting levels via attenuation of both GC release and SNS activity as well as by increased NO-dependent vasorelaxation. On the other hand, reduced levels of NO were observed in the later phases of stress and in subjects with genetic predisposition to hypertension, irrespectively, in which reduced NO bioavailability may account for disruption of NO-mediated BP regulatory mechanisms and accentuated SNS and GC effects. This review summarizes current knowledge on the role of stress in development of hypertension with a special focus on the interactions among NO and other biological systems affecting blood pressure and vascular function.
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Affiliation(s)
- A Puzserova
- Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovak Republic.
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31
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Murphy MO, Cohn DM, Loria AS. Developmental origins of cardiovascular disease: Impact of early life stress in humans and rodents. Neurosci Biobehav Rev 2017; 74:453-465. [PMID: 27450581 PMCID: PMC5250589 DOI: 10.1016/j.neubiorev.2016.07.018] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/06/2016] [Accepted: 07/19/2016] [Indexed: 02/07/2023]
Abstract
The Developmental Origins of Health and Disease (DOHaD) hypothesizes that environmental insults during childhood programs the individual to develop chronic disease in adulthood. Emerging epidemiological data strongly supports that early life stress (ELS) given by the exposure to adverse childhood experiences is regarded as an independent risk factor capable of predicting future risk of cardiovascular disease. Experimental animal models utilizing chronic behavioral stress during postnatal life, specifically maternal separation (MatSep) provides a suitable tool to elucidate molecular mechanisms by which ELS increases the risk to develop cardiovascular disease, including hypertension. The purpose of this review is to highlight current epidemiological studies linking ELS to the development of cardiovascular disease and to discuss the potential molecular mechanisms identified from animal studies. Overall, this review reveals the need for future investigations to further clarify the molecular mechanisms of ELS in order to develop more personalized therapeutics to mitigate the long-term consequences of chronic behavioral stress including cardiovascular and heart disease in adulthood.
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Affiliation(s)
- M O Murphy
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - D M Cohn
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - A S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States.
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32
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Petersen JD, Kyvik KO, Heitmann BL, Vámosi ME. The association between parental separation during childhood and obesity in adulthood: a Danish twin study. Obes Sci Pract 2017; 2:436-443. [PMID: 28090349 PMCID: PMC5192531 DOI: 10.1002/osp4.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 09/13/2016] [Accepted: 10/01/2016] [Indexed: 11/08/2022] Open
Abstract
Objective The purpose of this study was to examine if parental separation during childhood is associated with obesity in adulthood. Methods A co‐twin case–control study of 146 adult same‐sexed twin pairs with discordant body mass index (BMI) (i.e. one of the twins should have a BMI of 20–25 kg/m2, and the co‐twin's BMI ≥ 30 kg/m2) was selected from Danish Twin Registry (DTR). In total of 236 eligible twin individuals participated in the study. Childhood parental separation (defined as separation from one of the biological parents, regardless of the reason for separation) for at least one year prior to age 17 was self‐reported. The statistical analysis includes logistic and linear regression models using STATA 13.0. Results There were no differences in the odds of developing obesity in adulthood between the twin who stayed with a father and the co‐twin who was separated from him for at least 1 year prior to age 17 [OR = 1.22, 95%CI (0.46–3.34), p = 0.65]. Separation from a mother also showed no differences in the odds for developing obesity [OR = 0.90, 95%CI (0.32–2.46), p = 0.82]. Conclusions Because of the limited number of discordant twin pairs for childhood parental separation, we cannot provide evidence to suggest that separation from parents in childhood was associated with developing obesity in adulthood. Further studies of pooling discordant twins from several countries should be considered.
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Affiliation(s)
- J. D. Petersen
- Research Unit for General Practice, Department of Public HealthUniversity of Southern DenmarkOdense CDenmark
- Research Unit for Dietary Studies at the Parker InstituteBispebjerg and Frederiksberg HospitalCopenhagenDenmark
| | - K. O. Kyvik
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
- Odense Patient Data Explorative NetworkOdense University HospitalOdenseDenmark
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, Institute of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - B. L. Heitmann
- Research Unit for Dietary Studies at the Parker InstituteBispebjerg and Frederiksberg HospitalCopenhagenDenmark
- The Boden Institute of Obesity, Nutrition Exercise and Eating DisordersUniversity of SydneyAustralia
- The National Institute of Public HealthUniversity of Southern DenmarkDenmark
- Department of Public Health, Section for General PracticeUniversity of CopenhagenDenmark
| | - M. E. Vámosi
- Institute of Public Health, Department of Nursing ScienceUniversity of AarhusDenmark
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Coplan JD, Rozenboym AV, Fulton SL, Panthangi V, Tang J, Thiramangalakdi L, Perera TD, Liu Y, Kamran H, Owens MJ, Nemeroff CB, Rosenblum LA, Kral JG, Salciccioli L, Lazar J. Reduced left ventricular dimension and function following early life stress: A thrifty phenotype hypothesis engendering risk for mood and anxiety disorders. Neurobiol Stress 2017; 8:202-210. [PMID: 29888314 PMCID: PMC5991339 DOI: 10.1016/j.ynstr.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/02/2017] [Accepted: 01/02/2017] [Indexed: 10/29/2022] Open
Abstract
Background Early life stress (ELS) in macaques in the form of insecure maternal attachment putatively induces epigenetic adaptations resulting in a "thrifty phenotype" throughout the life cycle. For instance, ELS induces persistent increases in insulin resistance, hippocampal and corpus callosum atrophy and reduced "behavioral plasticity", which, taken together, engenders an increased risk for mood and anxiety disorders in humans but also a putative sparing of calories. Herein, we test the hypothesis whether a thrifty phenotype induced by ELS is peripherally evident as hypotrophy of cardiac structure and function, raising the possibility that certain mood disorders may represent maladaptive physiological and central thrift adaptations. Methods 14 adult bonnet macaques (6 males) exposed to the maternal variable foraging demand (VFD) model of ELS were compared to 20 non-VFD adult subjects (6 males). Left ventricle end-diastolic dimension (LVEDD), Left ventricle end-systolic dimension (LVESD) and stroke volume (SV) were calculated using echocardiography. Blood pressure and heart rate were measured only in females. Previously obtained neurobehavioral correlates available only in males were analyzed in the context of cardiac parameters. Results Reduced LVESD (p < 0.05) was observed when controlled for age, sex, body weight and crown-rump length whereas ejection fraction (EF) (p = 0.037) was greater in VFD-reared versus non-VFD subjects. Pulse pressure was lower in VFD versus non-VFD females (p < 0.05). Male timidity in response to a human intruder was associated with reduced LVEDD (p < 0.05). Conclusions ELS is associated with both structural and functional reductions of left ventricular measures, potentially implying a body-wide thrifty phenotype. Parallel "thrift" adaptations may occur in key brain areas following ELS and may play an unexplored role in mood and anxiety disorder susceptibility.
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Affiliation(s)
- Jeremy D Coplan
- Department of Psychiatry and Behavioral Sciences, State University of New York (SUNY) -Downstate, Brooklyn, NY, United States
| | | | - Sasha L Fulton
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, United States
| | - Venkatesh Panthangi
- Department of Psychiatry and Behavioral Sciences, State University of New York (SUNY) -Downstate, Brooklyn, NY, United States
| | - Jean Tang
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, United States
| | | | - Tarique D Perera
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, United States
| | - Yang Liu
- Division of Cardiology, Department of Medicine, SUNY-Downstate, Brooklyn, NY, United States
| | - Haroon Kamran
- Division of Cardiology, Department of Medicine, SUNY-Downstate, Brooklyn, NY, United States
| | - Michael J Owens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Emory, GA, United States
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami Health Systems, Miami, NY, United States
| | - Leonard A Rosenblum
- Department of Psychiatry and Behavioral Sciences, State University of New York (SUNY) -Downstate, Brooklyn, NY, United States
| | - John G Kral
- Departments of Internal Medicine and Surgery, SUNY-Downstate, Brooklyn, NY, United States
| | - Louis Salciccioli
- Division of Cardiology, Department of Medicine, SUNY-Downstate, Brooklyn, NY, United States
| | - Jason Lazar
- Division of Cardiology, Department of Medicine, SUNY-Downstate, Brooklyn, NY, United States
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Ho DH, Burch ML, Musall B, Musall JB, Hyndman KA, Pollock JS. Early life stress in male mice induces superoxide production and endothelial dysfunction in adulthood. Am J Physiol Heart Circ Physiol 2016; 310:H1267-74. [PMID: 26921433 DOI: 10.1152/ajpheart.00016.2016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/24/2016] [Indexed: 02/07/2023]
Abstract
Early life stress (ELS) is a risk for cardiovascular disease in adulthood although very little mechanistic insight is available. Because oxidative stress and endothelial dysfunction are major contributors to cardiovascular risk, we hypothesized that ELS induces endothelial dysfunction in adult male mice via increased superoxide production. Studies employed a mouse model of ELS, maternal separation with early weaning (MSEW), in which litters were separated from the dam for 4 h/day [postnatal days (PD) 2-5] and 8 h/day (PD6-16), and weaned at PD17. Control litters remained undisturbed until weaning at PD21. When compared with control mice, thoracic aortic rings from adult male MSEW mice displayed significant endothelial dysfunction that was reversed by the superoxide scavenger, polyethylene glycol-superoxide dismutase (PEG-SOD). PEG-SOD-inhibitable superoxide production by aortae from MSEW mice was significantly greater than observed in control aortae, although unaffected by nitric oxide synthase inhibition, suggesting that uncoupled nitric oxide synthase was not responsible for the accelerated superoxide production. Aortic SOD expression, plasma SOD activity, and total antioxidant activity were similar in MSEW and control mice, indicating unaltered antioxidant capacity in MSEW mice. Increased expression of the NADPH oxidase subunits, NOX2 and NOX4, was evident in the aortae of MSEW mice. Moreover, endothelial dysfunction and superoxide production in MSEW mice was reversed with the NADPH oxidase inhibitor, apocynin, indicating increased NADPH oxidase-dependent superoxide production and endothelial dysfunction. The finding that MSEW induces superoxide production and endothelial dysfunction in adult mice may provide a mechanistic link between ELS and adult cardiovascular disease risk.
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Affiliation(s)
- Dao H Ho
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Mariah L Burch
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and Department of Medicine, Augusta University, Augusta, Georgia
| | - Benjamin Musall
- Department of Medicine, Augusta University, Augusta, Georgia
| | | | - Kelly A Hyndman
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Jennifer S Pollock
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and Department of Medicine, Augusta University, Augusta, Georgia
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35
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Tampubolon G. Growing Up in Poverty, Growing Old in Infirmity: The Long Arm of Childhood Conditions in Great Britain. PLoS One 2015; 10:e0144722. [PMID: 26675009 PMCID: PMC4682716 DOI: 10.1371/journal.pone.0144722] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 11/23/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The ageing population poses a tremendous challenge in understanding the sources of inequalities in health. Though they appear to be far removed, childhood conditions are known to be inextricably linked with adult health, and in turn on health in later life. The long arm of childhood conditions hypothesis is often tested using recollection of childhood circumstances, but such subjective recall can yield potentially inaccurate or possibly biased inferences. We tested the long arm hypothesis on three outcomes in later life, arrayed from objective to subjective health, namely: gait speed, episodic memory and mental health. METHODS AND FINDINGS We used the English Longitudinal Study of Ageing 2006 enriched with retrospective life history (N = 5,913). To deal with recall problems two solutions, covariate measurement and endogenous treatment models, were applied. Retrospective childhood material lack includes growing up without running hot or cold water, fixed bath, indoor lavatory and central heating. Adjustment is made for an extensive set of confounders including sex, age, adult health, wealth, education, occupation, social support, social connections, chronic conditions, smoking, drinking, and physical exercise. It is found that material poverty when growing up shows no association with health when growing old, assuming accurate recall. Once recall problems are controlled, we found that childhood material poverty changes inversely with later life health. CONCLUSION A poorer childhood goes with slower gait, poorer memory and more depression in later life. This result provides a further impetus to eliminate child poverty.
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Affiliation(s)
- Gindo Tampubolon
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, United Kingdom
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Reho JJ, Fisher SA. The stress of maternal separation causes misprogramming in the postnatal maturation of rat resistance arteries. Am J Physiol Heart Circ Physiol 2015; 309:H1468-78. [PMID: 26371173 DOI: 10.1152/ajpheart.00567.2015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/03/2015] [Indexed: 11/22/2022]
Abstract
We examined the effect of stress in the first 2 wk of life induced by brief periods of daily maternal separation on developmental programming of rat small resistance mesenteric arteries (MAs). In MAs of littermate controls, mRNAs encoding mediators of vasoconstriction, including the α1a-adrenergic receptor, smooth muscle myosin heavy chain, and CPI-17, the inhibitory subunit of myosin phosphatase, increased from after birth through sexual [postnatal day (PND) 35] and full maturity, up to ∼80-fold, as measured by quantitative PCR. This was commensurate with two- to fivefold increases in maximum force production to KCl depolarization, calcium, and the α-adrenergic agonist phenylephrine, and increasing systolic blood pressure. Rats exposed to maternal separation stress as neonates had markedly accelerated trajectories of maturation of arterial contractile gene expression and function measured at PND14 or PND21 (weaning), 1 wk after the end of the stress protocol. This was suppressed by the α-adrenergic receptor blocker terazosin (0.5 mg·kg ip(-1)·day(-1)), indicating dependence on stress activation of sympathetic signaling. Due to the continued maturation of MAs in control rats, by sexual maturity (PND35) and into adulthood, no differences were observed in arterial function or response to a second stressor in rats stressed as neonates. Thus early life stress misprograms resistance artery smooth muscle, increasing vasoconstrictor function and blood pressure. This effect wanes in later stages, suggesting plasticity during arterial maturation. Further studies are indicated to determine whether stress in different periods of arterial maturation may cause misprogramming persisting through maturity and the potential salutary effect of α-adrenergic blockade in suppression of this response.
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Affiliation(s)
- John J Reho
- Departments of Medicine (Cardiovascular Medicine) and Physiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven A Fisher
- Departments of Medicine (Cardiovascular Medicine) and Physiology, University of Maryland School of Medicine, Baltimore, Maryland
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Neighborhood socioeconomic status during childhood versus puberty in relation to endogenous sex hormone levels in adult women. Nurs Res 2015; 64:211-20. [PMID: 25932699 DOI: 10.1097/nnr.0000000000000096] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Socioeconomic adversity in early life is related to cardiovascular risk in adulthood; however, no studies have examined whether such adversity may be related to endogenous sex hormones, which are themselves associated with cardiovascular outcomes, or whether the timing of adversity exposures (childhood vs. puberty) matters. OBJECTIVE The goal of the current study was to separately examine neighborhood socioeconomic status (SES) during periods of childhood and puberty in relation to adulthood levels of endogenous sex hormones (estradiol [E2], testosterone), sex hormone binding globulin (SHBG), and a derived index of bioavailable testosterone (free androgen index). METHODS In a sample of 143 premenopausal women (mean age = 36.8 [SD = 5.5]; 51.7% White, 32.2% African American, 5.6% Latina, 7.0% Chinese, and 3.5% Filipina), retrospective reports of residential address information in designated periods of childhood and puberty were used to derive U.S. census-based neighborhood SES composite scores characterizing the socioeconomic environments of women during these periods. RESULTS In covariate-adjusted analyses, higher neighborhood SES in puberty predicted higher levels of SHBG in adulthood, but neighborhood SES during childhood did not (standardized regression coefficient = .24, p = .01 vs. standardized regression coefficient = .04, p = .75, respectively). Neighborhood SES was not predictive of other hormones (E2, testosterone, and free androgen index). DISCUSSION The current findings suggest that puberty may be a time of particular vulnerability to the effects of neighborhood SES on SHBG levels, which have been linked to cardiovascular risk factor profiles and atherosclerotic disease progression.
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Su S, Wang X, Pollock JS, Treiber FA, Xu X, Snieder H, McCall WV, Stefanek M, Harshfield GA. Adverse childhood experiences and blood pressure trajectories from childhood to young adulthood: the Georgia stress and Heart study. Circulation 2015; 131:1674-81. [PMID: 25858196 DOI: 10.1161/circulationaha.114.013104] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 02/13/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND The purposes of this study were to assess the long-term effect of adverse childhood experiences (ACEs) on blood pressure (BP) trajectories from childhood to young adulthood and to examine whether this relation is explained by childhood socioeconomic status (SES) or risk behaviors that are associated with ACEs. METHODS AND RESULTS Systolic and diastolic BPs were measured up to 16 times (13 times on average) over a 23-year period in 213 African Americans and 181 European Americans 5 to 38 years of age. Retrospective data on traumatic experiences before 18 years of age were collected, including abuse, neglect, and household dysfunction. Individual growth curve modeling within a multilevel framework was used to examine the relation between exposure to ACEs and BP development. No main effect of ACEs on average BP levels was found. However, a significant interaction of ACE score with age(3) was observed (systolic BP, P=0.033; diastolic BP, P=0.017). Subjects who experienced multiple traumatic events during childhood showed a faster rise in BP levels after 30 years of age than those without ACEs. As expected, a graded association of ACEs with childhood socioeconomic status and negative health behaviors was observed (P<0.001). The ACE-systolic BP relation was not explained by these factors, whereas the ACE-diastolic BP relation was partially mediated by illicit drug use. CONCLUSION In this novel longitudinal study, we observed that participants who were exposed to multiple ACEs displayed a greater increase in BP levels in young adulthood compared with their counterparts without ACEs.
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Affiliation(s)
- Shaoyong Su
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
| | - Xiaoling Wang
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
| | - Jennifer S Pollock
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
| | - Frank A Treiber
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
| | - Xiaojing Xu
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
| | - Harold Snieder
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
| | - W Vaughn McCall
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
| | - Michael Stefanek
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
| | - Gregory A Harshfield
- From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.)
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Ho DH. Transgenerational epigenetics: the role of maternal effects in cardiovascular development. Integr Comp Biol 2014; 54:43-51. [PMID: 24813463 DOI: 10.1093/icb/icu031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Transgenerational epigenetics, the study of non-genetic transfer of information from one generation to the next, has gained much attention in the past few decades due to the fact that, in many instances, epigenetic processes outweigh direct genetic processes in the manifestation of aberrant phenotypes across several generations. Maternal effects, or the influences of maternal environment, phenotype, and/or genotype on offsprings' phenotypes, independently of the offsprings' genotypes, are a subcategory of transgenerational epigenetics. Due to the intimate role of the mother during early development in animals, there is much interest in investigating the means by which maternal effects can shape the individual. Maternal effects are responsible for cellular organization, determination of the body axis, initiation and maturation of organ systems, and physiological performance of a wide variety of species and biological systems. The cardiovascular system is the first to become functional and can significantly influence the development of other organ systems. Thus, it is important to elucidate the role of maternal effects in cardiovascular development, and to understand its impact on adult cardiovascular health. Topics to be addressed include: (1) how and when do maternal effects change the developmental trajectory of the cardiovascular system to permanently alter the adult's cardiovascular phenotype, (2) what molecular mechanisms have been associated with maternally induced cardiovascular phenotypes, and (3) what are the evolutionary implications of maternally mediated changes in cardiovascular phenotype?
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Affiliation(s)
- Dao H Ho
- Section of Cardio-Renal Physiology and Medicine, Division of Nephrology, Birmingham, University of Alabama at Birmingham, AL 35294, USA
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Martí N, Lorente J, Valero M, Ibarz A, Saura D. Recovery and Use of By-Products from Fruit Juice Production. JUICE PROCESSING 2014. [DOI: 10.1201/b16740-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Savolainen K, Eriksson JG, Kananen L, Kajantie E, Pesonen AK, Heinonen K, Räikkönen K. Associations between early life stress, self-reported traumatic experiences across the lifespan and leukocyte telomere length in elderly adults. Biol Psychol 2014; 97:35-42. [PMID: 24530884 DOI: 10.1016/j.biopsycho.2014.02.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 02/04/2014] [Accepted: 02/04/2014] [Indexed: 11/26/2022]
Abstract
Early life stress (ELS) poses a risk for mental disorders and aging-related diseases. Accelerated biological aging, reflected in shorter leukocyte telomere length (LTL), may underlie these risks. We examined whether objectively recorded ELS and retrospectively self-reported traumatic experiences across the lifespan are associated with LTL in later adulthood. Of 1486 participants, 215 had been exposed to ELS, namely to temporary separation from both parents in childhood. Participants self-reported emotionally or physically traumatic experiences across the lifespan at a mean age of 63.2 years. LTL was measured using a quantitative PCR method at a mean age of 61.5 years. Separation or self-reported traumatic experiences were not associated with LTL. However, separated participants who self-reported traumatic experiences had shorter LTL. Our results suggest that while ELS or self-reported traumatic experiences are not per se associated with LTL measured decades later, ELS may in combination with self-reported traumatic events be associated with accelerated biological aging.
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Affiliation(s)
- Katri Savolainen
- Institute of Behavioural Sciences, University of Helsinki, Finland.
| | - Johan G Eriksson
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institution for Health and Welfare, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; Unit of General Practice, Helsinki University Central Hospital, Finland; Vaasa Central Hospital, Vaasa, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Laura Kananen
- Research Programs Unit, Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Finland; Department of Medical Genetics, Haartman Institute, Faculty of Medicine, University of Helsinki, Finland
| | - Eero Kajantie
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institution for Health and Welfare, Helsinki, Finland; Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland
| | | | - Kati Heinonen
- Institute of Behavioural Sciences, University of Helsinki, Finland
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Finland
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Loria AS, Ho DH, Pollock JS. A mechanistic look at the effects of adversity early in life on cardiovascular disease risk during adulthood. Acta Physiol (Oxf) 2014; 210:277-87. [PMID: 24330084 DOI: 10.1111/apha.12189] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 12/23/2022]
Abstract
Early origins of adult disease may be defined as adversity or challenges during early life that alter physiological responses and prime the organism to chronic disease in adult life. Adverse childhood experiences or early life stress (ELS) may be considered a silent independent risk factor capable of predicting future cardiovascular disease risk. Maternal separation (MatSep) provides a suitable model to elucidate the underlying molecular mechanisms by which ELS increases the risk to develop cardiovascular disease in adulthood. The aim of this review is to describe the links between behavioural stress early in life and chronic cardiovascular disease risk in adulthood. We will discuss the following: (i) adult cardiovascular outcomes in humans subjected to ELS, (ii) MatSep as an animal model of ELS as well as the limitations and advantages of this model in rodents and (iii) possible ELS-induced mechanisms that predispose individuals to greater cardiovascular risk. Overall, exposure to a behavioural stressor early in life sensitizes the response to a second stressor later in life, thus unmasking an exaggerated cardiovascular dysfunction that may influence quality of life and life expectancy in adulthood.
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Affiliation(s)
- A. S. Loria
- Section of Experimental Medicine; Department of Medicine; Georgia Regents University; Augusta GA USA
| | - D. H. Ho
- Section of Experimental Medicine; Department of Medicine; Georgia Regents University; Augusta GA USA
| | - J. S. Pollock
- Section of Experimental Medicine; Department of Medicine; Georgia Regents University; Augusta GA USA
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Eriksson M, Räikkönen K, Eriksson JG. Early life stress and later health outcomes-findings from the Helsinki Birth Cohort Study. Am J Hum Biol 2013; 26:111-6. [DOI: 10.1002/ajhb.22502] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 12/14/2013] [Accepted: 12/15/2013] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mia Eriksson
- Department of Psychology; Institute of Behavioral Sciences; University of Helsinki; Helsinki Finland
- Department of General Practice and Primary Health Care; University of Helsinki; Helsinki Finland
- Texas Christian University; Forth Worth Texas
| | - Katri Räikkönen
- Department of Psychology; Institute of Behavioral Sciences; University of Helsinki; Helsinki Finland
| | - Johan G. Eriksson
- Department of General Practice and Primary Health Care; University of Helsinki; Helsinki Finland
- Department of Health Promotion and Chronic Disease Prevention; National Institute for Health and Welfare; Helsinki Finland
- Unit of General Practice; Helsinki University Central Hospital; Helsinki Finland
- Folkhälsan Research Center; Helsinki Finland
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Early life stress and physical and psychosocial functioning in late adulthood. PLoS One 2013; 8:e69011. [PMID: 23861956 PMCID: PMC3702583 DOI: 10.1371/journal.pone.0069011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/11/2013] [Indexed: 12/14/2022] Open
Abstract
Background Severe stress experienced in early life may have long-term effects on adult physiological and psychological health and well-being. We studied physical and psychosocial functioning in late adulthood in subjects separated temporarily from their parents in childhood during World War II. Methods The 1803 participants belong to the Helsinki Birth Cohort Study, born 1934–44. Of them, 267 (14.8%) had been evacuated abroad in childhood during WWII and the remaining subjects served as controls. Physical and psychosocial functioning was assessed with the Short Form 36 scale (SF-36) between 2001 and 2004. A test for trends was based on linear regression. All analyses were adjusted for age at clinical examination, social class in childhood and adulthood, smoking, alcohol intake, physical activity, body mass index, cardiovascular disease and diabetes. Results Physical functioning in late adulthood was lower among the separated men compared to non-separated men (b = −0.40, 95% confidence interval [95% CI]: −0.71 to −0.08). Those men separated in school age (>7 years) and who were separated for a duration over 2 years had the highest risk for lower physical functioning (b = −0.89, 95% CI: −1.58 to −0.20) and (b = −0.65, 95% CI: −1.25 to −0.05), respectively). Men separated for a duration over 2 years also had lower psychosocial functioning (b = −0.70, 95% CI: −1.35 to −0.06). These differences in physical and psychosocial functioning were not observed among women. Conclusion Early life stress may increase the risk for impaired physical functioning in late adulthood among men. Timing and duration of the separation influenced the physical and psychosocial functioning in late adulthood.
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Wainwright NWJ, Levy S, Pico J, Luben RN, Surtees PG, Khaw KT. Social adversity experience and blood pressure control following antihypertensive medication use in a community sample of older adults. Int J Behav Med 2013; 21:456-63. [PMID: 23677855 DOI: 10.1007/s12529-013-9319-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Psychosocial stress is a risk factor for hypertension and has been shown to affect response to treatment for psychiatric illnesses. PURPOSE We investigate the relationship between a history of social adversity experience and blood pressure control following antihypertensive medication use. METHODS A total of 1,186 participants selected from the European Prospective Investigation into Cancer-Norfolk study (531 men and 655 women, aged 42 to 80 years) had attended two health checks at which blood pressure measurements were taken; were taking antihypertensive medication at the second, but not the first health check; and had completed a questionnaire assessment of their social and psychological circumstances which included details of traumatic experiences in childhood and of adverse life events, long-term difficulties, and perceived stress in adulthood. RESULTS Experience of recent loss events in adulthood was associated with a smaller reduction in systolic blood pressure after starting hypertension treatment (β = 1.78, 95 % confidence interval 0.15-3.40, per life event), independently of age, sex, preexisting health conditions, cigarette smoking history, alcohol consumption, physical activity, and obesity. CONCLUSION Results from this study suggest that stress caused by recent losses may be associated with reduced effectiveness of treatment for hypertension. Subject to replication, these findings may help determine the specific physiological mechanisms by which medication treatment effectiveness is affected by stress.
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Affiliation(s)
- Nicholas W J Wainwright
- International Health Research Group, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge, CB1 8RN, UK,
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