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Zhang Y, Lin C, Li H, Li L, Zhou X, Xiong Y, Yan J, Xie M, Zhang X, Zhou C, Yang L. The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping. BMC Psychiatry 2024; 24:346. [PMID: 38720293 PMCID: PMC11077779 DOI: 10.1186/s12888-024-05792-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Studies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship. METHODS Data were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping. RESULTS Approximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028). CONCLUSIONS Anxiety and negative coping were important mediating factors for rural older adult's childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality.
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Affiliation(s)
- Yuqin Zhang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Chengwei Lin
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Hongwei Li
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Lei Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Deyang Integrated Traditional Chinese and Western Medicine Hospital, Deyang, 618000, China
| | - Xueyan Zhou
- Centre for Aging Health Service of Deyang City, Deyang, 618000, China
| | - Ying Xiong
- Health Commission of Deyang City, Deyang, 618000, China
| | - Jin Yan
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Mengxue Xie
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Xueli Zhang
- Sichuan Provincial Health Information Center, Chengdu, 610015, Sichuan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research,School of Public Health, Cheeloo College of Medicine,Shandong University, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
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Souama C, Milaneschi Y, Lamers F, Vinkers CH, Giltay EJ, Liemburg EJ, Penninx BWJH. Metabolic syndrome after childhood trauma: a 9-year longitudinal analysis. Psychol Med 2024; 54:1373-1381. [PMID: 37981868 DOI: 10.1017/s0033291723003264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Childhood trauma (CT) has been cross-sectionally associated with metabolic syndrome (MetS), a group of biological risk factors for cardiometabolic disease. Longitudinal studies, while rare, would clarify the development of cardiometabolic dysregulations over time. Therefore, we longitudinally investigated the association of CT with the 9-year course of MetS components. METHODS Participants (N = 2958) from the Netherlands Study of Depression and Anxiety were assessed four times across 9 years. The CT interview retrospectively assessed childhood emotional neglect and physical, emotional, and sexual abuse. Metabolic outcomes encompassed continuous MetS components (waist circumference, triglycerides, high-density lipoprotein [HDL] cholesterol, blood pressure [BP], and glucose) and count of clinically elevated MetS components. Mixed-effects models estimated sociodemographic- and lifestyle-adjusted longitudinal associations of CT with metabolic outcomes over time. Time interactions evaluated change in these associations. RESULTS CT was reported by 49% of participants. CT was consistently associated with increased waist (b = 0.32, s.e. = 0.10, p = 0.001), glucose (b = 0.02, s.e. = 0.01, p < 0.001), and count of MetS components (b = 0.04, s.e. = 0.01, p < 0.001); and decreased HDL cholesterol (b = -0.01, s.e.<0.01, p = .020) and systolic BP (b = -0.33, s.e. = 0.13, p = 0.010). These associations were mainly driven by severe CT and unaffected by lifestyle. Only systolic BP showed a CT-by-time interaction, where CT was associated with lower systolic BP initially and with higher systolic BP at the last follow-up. CONCLUSIONS Over time, adults with CT have overall persistent poorer metabolic outcomes than their non-maltreated peers. Individuals with CT have an increased risk for cardiometabolic disease and may benefit from monitoring and early interventions targeting metabolism.
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Affiliation(s)
- Camille Souama
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Complex Trait Genetics, Amsterdam, The Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Department of Anatomy & Neurosciences, Amsterdam University Medical Center location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- GGZ inGeest Mental Health Care, 1081 HJ Amsterdam, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Edith J Liemburg
- Rob Giel Research Center, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
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Sheng Z, Xiao W, Zhu S, Hao J, Ma J, Yao L, Song P. The association between adverse childhood experiences and sensory impairment in middle-aged and older adults: Evidence from a nationwide cohort study in China. CHILD ABUSE & NEGLECT 2024; 149:106598. [PMID: 38158282 DOI: 10.1016/j.chiabu.2023.106598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Sensory impairment (SI), as prevalent condition among the elderly, presents a substantial public health burden. OBJECTIVES To investigate the association of cumulative and individual adverse childhood experiences (ACEs) with SI. METHODS Chinese residents aged 45 years and above were recruited from the China Health and Retirement Longitudinal Study 2011-2018, using stratified random sampling. The number of ACEs was classified into "0 ACE", "1 to 3 ACEs", and "≥4 ACEs". SI was assessed with self-rated visual or hearing status. SI categories included single sensory impairment (SSI), which can be divided into single vision impairment and single hearing impairment. Possessing both vision impairment and hearing impairment was considered as dual sensory impairment (DSI). Longitudinal SI progression encompassed "maintained no SI", "no SI to SSI", "no SI to DSI", "maintained SSI", "SSI to DSI", and "maintained DSI". Logistic regression and restricted cubic splines models were used for analysis. RESULTS A total of 6812 participants entered the cross-sectional analysis and 5299 entered the longitudinal analysis. Compared to 0 ACE, ≥4 ACEs had a positive association with DSI (OR = 1.57, 95 % CI = 1.20-2.06) but not with single vision impairment (OR = 1.17, 95 % CI: 0.88-1.55) or single hearing impairment (OR = 1.10, 95 % CI: 0.71-1.70), and this association was observed only in females (OR = 1.73, 95 % CI = 1.20-2.51). A linear association was found between cumulative ACEs and both single vision impairment (p = 0.044) and DSI (p < 0.001). Compared to 0 ACE, ≥4 ACEs was associated with a higher risk of progression from SSI to DSI (OR = 1.71, 95 % CI = 1.03-2.84), and the maintained DSI (OR = 2.23, 95 % CI =1.37-3.65). CONCLUSION ACEs were found to be associated with an increased risk and more severe progression of SI later in life. It is imperative to address different types of ACE and incorporate sex-specific measures to mitigate the enduring sensory impact of ACEs.
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Affiliation(s)
- Ziyue Sheng
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenhan Xiao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Siyu Zhu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiajun Hao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiaying Ma
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lingzi Yao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Massengale K, Barnes VA, Williams C, Mansuri A, Norland K, Altvater M, Bailey H, Harris RA, Su S, Wang X. Nocturnal blood pressure dipping, blood pressure variability, and cognitive function in early and middle-aged adults. J Clin Hypertens (Greenwich) 2024; 26:235-240. [PMID: 38332546 PMCID: PMC10918738 DOI: 10.1111/jch.14764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 02/10/2024]
Abstract
Higher nighttime blood pressure (BP), less BP dipping, and higher BP variability have been linked with worse cognitive function in the elderly. The goal of this study is to explore whether this relationship already exists in early and middle adulthood. We further examined whether ethnic differences between African Americans and European Americans in BP parameters can explain ethnic differences in cognitive function. 24-h ambulatory BP monitoring and cognitive function were obtained from 390 participants (average age: 37.2 years with a range of 25-50; 54.9% African Americans; 63.6% females). We observed that higher nighttime BP, decreased dipping, and higher variability were significantly associated with lower scores on the Picture Sequence Memory Test. Significant negative associations between variability and overall composite scores were also observed. No significant associations between average 24-h or daytime BP and cognitive function were observed. Ethnic differences in nighttime diastolic pressures and dipping can explain 6.81% to 10.8% of the ethnicity difference in the score of the Picture Sequence Memory Test (ps < .05). This study suggests that the associations of nighttime BP, dipping, and variability with cognitive function already exist in young and middle-aged adults. Ethnic differences in nighttime BP and dipping can at least partially explain ethnic differences in cognitive function. The stronger association of these parameters with cognitive function than daytime or average BP in this age range raises the importance of using ambulatory BP monitoring for more precise detection of abnormal BP patterns in young adulthood.
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Affiliation(s)
| | - Vernon A. Barnes
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Celestin Williams
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Asifhusen Mansuri
- Division of Pediatric Nephrology and HypertensionChildren's Hospital of GeorgiaMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Kimberly Norland
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Michelle Altvater
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Hallie Bailey
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Ryan A. Harris
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Shaoyong Su
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Xiaoling Wang
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
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Kraal AZ, Zaheed AB, Krasnova A, Vadari H, Byrd DR, Zahodne LB. Time-lagged associations between two adverse childhood experiences and later-life cognitive function through educational attainment and stroke. J Int Neuropsychol Soc 2024; 30:107-116. [PMID: 37401463 DOI: 10.1017/s135561772300036x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) have been associated with worse cognitive health in older adulthood. This study aimed to extend findings on the specificity, persistence, and pathways of associations between two ACEs and cognition by using a comprehensive neuropsychological battery and a time-lagged mediation design. METHOD Participants were 3304 older adults in the Health and Retirement Study Harmonized Cognitive Assessment Protocol. Participants retrospectively reported whether they were exposed to parental substance abuse or experienced parental physical abuse before age 18. Factor scores derived from a battery of 13 neuropsychological tests indexed cognitive domains of episodic memory, executive functioning, processing speed, language, and visuospatial function. Structural equation models examined self-reported years of education and stroke as mediators, controlling for sociodemographics and childhood socioeconomic status. RESULTS Parental substance abuse in childhood was associated with worse later-life cognitive function across all domains, in part via pathways involving educational attainment and stroke. Parental physical abuse was associated with worse cognitive outcomes via stroke independent of education. CONCLUSIONS This national longitudinal study in the United States provides evidence for broad and persistent indirect associations between two ACEs and cognitive aging via differential pathways involving educational attainment and stroke. Future research should examine additional ACEs and mechanisms as well as moderators of these associations to better understand points of intervention.
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Affiliation(s)
- A Zarina Kraal
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- G. H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Afsara B Zaheed
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Anna Krasnova
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Harita Vadari
- Department of General Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - DeAnnah R Byrd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Laura B Zahodne
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
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Afzal HB, Jahangir T, Mei Y, Madden A, Sarker A, Kim S. Can adverse childhood experiences predict chronic health conditions? Development of trauma-informed, explainable machine learning models. Front Public Health 2024; 11:1309490. [PMID: 38332940 PMCID: PMC10851779 DOI: 10.3389/fpubh.2023.1309490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/27/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Decades of research have established the association between adverse childhood experiences (ACEs) and adult onset of chronic diseases, influenced by health behaviors and social determinants of health (SDoH). Machine Learning (ML) is a powerful tool for computing these complex associations and accurately predicting chronic health conditions. Methods Using the 2021 Behavioral Risk Factor Surveillance Survey, we developed several ML models-random forest, logistic regression, support vector machine, Naïve Bayes, and K-Nearest Neighbor-over data from a sample of 52,268 respondents. We predicted 13 chronic health conditions based on ACE history, health behaviors, SDoH, and demographics. We further assessed each variable's importance in outcome prediction for model interpretability. We evaluated model performance via the Area Under the Curve (AUC) score. Results With the inclusion of data on ACEs, our models outperformed or demonstrated similar accuracies to existing models in the literature that used SDoH to predict health outcomes. The most accurate models predicted diabetes, pulmonary diseases, and heart attacks. The random forest model was the most effective for diabetes (AUC = 0.784) and heart attacks (AUC = 0.732), and the logistic regression model most accurately predicted pulmonary diseases (AUC = 0.753). The strongest predictors across models were age, ever monitored blood sugar or blood pressure, count of the monitoring behaviors for blood sugar or blood pressure, BMI, time of last cholesterol check, employment status, income, count of vaccines received, health insurance status, and total ACEs. A cumulative measure of ACEs was a stronger predictor than individual ACEs. Discussion Our models can provide an interpretable, trauma-informed framework to identify and intervene with at-risk individuals early to prevent chronic health conditions and address their inequalities in the U.S.
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Affiliation(s)
- Hanin B. Afzal
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Tasfia Jahangir
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Yiyang Mei
- School of Law, Emory University, Atlanta, GA, United States
| | - Annabelle Madden
- Teachers College, Columbia University, New York, NY, United States
| | - Abeed Sarker
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, GA, United States
| | - Sangmi Kim
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
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Xu Y, Barnes VA, Harris RA, Altvater M, Williams C, Norland K, Looney J, Crandall R, Su S, Wang X. Sleep Variability, Sleep Irregularity, and Nighttime Blood Pressure Dipping. Hypertension 2023; 80:2621-2626. [PMID: 37800322 PMCID: PMC10873041 DOI: 10.1161/hypertensionaha.123.21497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Circadian rhythm regulates many important biological functions in humans. The goal of this study is to explore the impact of day-to-day deviations in the sleep-wake cycle on nighttime blood pressure (BP) dipping and further examine whether the ethnic difference in day-to-day deviations in sleep patterns can explain the ethnic difference in nighttime BP dipping. METHODS Twenty-four-hour ambulatory BP monitoring and 7-day accelerometer data were obtained from 365 adult participants (age range, 18.7-50.1 years; 52.6% Black participants and 47.3% European Americans; 64.1% females). Systolic BP dipping level was used to represent nighttime BP dipping. The SD of sleep duration was calculated as the index of sleep variability, and the SD of sleep midpoint was calculated as the index of sleep irregularity. RESULTS A 1-hour increase in the SD of sleep midpoint was associated with a 1.16% decrease in nighttime BP dipping (P<0.001). A 1-hour increase in the SD of sleep duration was associated with a 1.39% decrease in nighttime BP dipping (P=0.017). The ethnic difference in the SD of sleep midpoint can explain 29.2% of the ethnicity difference in BP dipping (P=0.008). CONCLUSIONS Sleep variability and sleep irregularity are associated with blunted BP dipping in the general population. In addition, data from the present investigation also demonstrate that the ethnic difference in sleep irregularity could partly explain the ethnic difference in BP dipping, an important finding that may help reduce the health disparity between Black participants and European Americans.
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Affiliation(s)
- Yanyan Xu
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
- Center for Biotechnology and Genomic Medicine (Y.X., X.W.), Medical College of Georgia, Augusta University, GA
| | - Vernon A Barnes
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Ryan A Harris
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Michelle Altvater
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Celestine Williams
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Kimberly Norland
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Jacob Looney
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Reva Crandall
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Shaoyong Su
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Xiaoling Wang
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
- Center for Biotechnology and Genomic Medicine (Y.X., X.W.), Medical College of Georgia, Augusta University, GA
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Wójcik M, Alvarez-Pitti J, Kozioł-Kozakowska A, Brzeziński M, Gabbianelli R, Herceg-Čavrak V, Wühl E, Lucas I, Radovanović D, Melk A, González Lopez-Valcarcel B, Fernández-Aranda F, Mazur A, Lurbe E, Borghi C, Drożdż D. Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview. Front Cardiovasc Med 2023; 10:1268364. [PMID: 38054100 PMCID: PMC10694215 DOI: 10.3389/fcvm.2023.1268364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.
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Affiliation(s)
- Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
| | - Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Agnieszka Kozioł-Kozakowska
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
| | - Michał Brzeziński
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Kraków, Poland
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Vesna Herceg-Čavrak
- Faculty of Health Science, Libertas International University, Zagreb, Croatia
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Ignacio Lucas
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Dragan Radovanović
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Anette Melk
- Children’s Hospital, Hannover Medical School, Hannover, Germany
| | - Beatriz González Lopez-Valcarcel
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Empar Lurbe
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dorota Drożdż
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
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9
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Olaniyan AC, Nabors LA, King KA, Merianos AL. Adverse Childhood Experiences and Electronic Cigarette Use among U.S. Young Adults. TOXICS 2023; 11:907. [PMID: 37999559 PMCID: PMC10675573 DOI: 10.3390/toxics11110907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Adverse childhood experiences (ACEs), which are potentially traumatic childhood events, have been associated with increased tobacco product use. Less is known about electronic cigarette (e-cigarette) use during young adulthood. This study explored the associations between ACEs and current e-cigarette use among U.S. young adults. (2) Methods: This study was a secondary analysis of 2021 Behavioral Risk Factor Surveillance System data including 2537 young adults aged 18-24 years. Unadjusted and adjusted logistic regression analyses were conducted. (3) Results: Of the participants, 19.2% currently used e-cigarettes, and 22.1% reported 1 ACE, 13.0% reported 2 ACEs, 10.7% reported 3 ACEs, and 30.6% reported ≥4 ACEs. Unadjusted results indicated that participants who experienced 1 ACE (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.01-3.07), 2 ACEs (OR = 2.18, 95%CI = 1.24-3.83), 3 ACEs (OR = 2.63, 95%CI = 1.41-4.90), and ≥4 ACEs (OR = 3.69, 95%CI = 2.23-6.09) were at increased odds of reporting current e-cigarette use than participants who experienced 0 ACEs. Adjusted results indicated that participants who experienced 3 ACEs were at 2.20 times higher odds (95%CI = 1.15-4.23) and participants who experienced ≥4 ACEs were at 2.73 times higher odds (95%CI = 1.58-4.71) of reporting current e-cigarette use than participants who experienced 0 ACEs. (4) Conclusions: Young adults exposed to ACEs are at risk of using e-cigarettes.
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Affiliation(s)
- Afolakemi C. Olaniyan
- School of Population & Health Sciences, Dillard University, New Orleans, LA 70122, USA;
| | - Laura A. Nabors
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Keith A. King
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
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10
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Esernio-Jenssen D, Morrobel A, Hansen SE, Kincaid HM. Exploring Associations Between Abnormal Weight Classifications and Child Maltreatment Diagnoses. Clin Pediatr (Phila) 2023:99228231204452. [PMID: 37804149 DOI: 10.1177/00099228231204452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Child maltreatment poses not only immediate danger, but as a type of toxic stress, it creates higher risk of biologic dysfunction later in life. Pediatricians are in a unique position to diagnose child maltreatment, but they need evidence-based guidance for when to initiate screening when injury is occult. In this retrospective cohort study of 855 pediatric patients diagnosed with child maltreatment, researchers explored whether type or number of diagnoses was associated with abnormal pediatric weight in either direction. Diagnoses and weight assessed at intake were extracted from medical records for analysis. Statistically significant associations were found between weight classification and child maltreatment type as well as diagnosis count. Neglect was most frequently diagnosed, and children with ≥2 diagnoses were more likely to be classified as underweight, overweight, or obese. Findings support abnormal pediatric weight as a biologic signal of adversity that warrants safety screening in the clinical setting.
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Affiliation(s)
- Debra Esernio-Jenssen
- Department of Pediatrics, Lehigh Valley Health Network, Allentown, PA, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Lehigh Valley Reilly Children's Hospital, Allentown, PA, USA
| | | | - Susan E Hansen
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, PA, USA
| | - Hope M Kincaid
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, PA, USA
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11
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He J, Wang R, Liu J, Yip P. Effects of Adverse Childhood Experiences on Sleep Quality in People With Drug Addiction and Non-Addicts and the Role of Resilience Between Them. Psychol Rep 2023; 126:2158-2171. [PMID: 35353658 DOI: 10.1177/00332941221076776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
People with drug addiction are more likely to suffer from sleep disorders than non-addicts. The roles that childhood adversity experiences and resilience play in the development of sleep disorders will be explored in this study. A total of 459 participants with drug addiction and 400 non-addicts were investigated with the Adverse Childhood Experiences (ACEs) Scale, Pittsburgh Sleep Quality Index (PSQI), and Connor-Davidson Resilience Scale from April 2019 to December 2020. Our results suggested that participants with drug addiction had worse sleep quality compared to non-addicts. Resilience acted as a mediator and significantly affected the relationship between ACEs and sleep quality. For all participants who experienced ACEs, individuals with high resilience reported lower PSQI score, the regulatory effect of medium and high resilience on sleep quality was better than that of low resilience. Moreover, comparing to the non-addicts who experienced mild ACEs, high resilience showed a good buffer effect on the sleep quality for people with drug addiction. And high resilience played a stronger regulatory role in females as compared to males. The results help to broaden the relevant research in the field of sleep and we should pay attention to the role of resilience in regulating sleep quality.
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Affiliation(s)
- Jingzhen He
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Rufang Wang
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jun Liu
- Sichuan Drug Rehabilitation Administration, Chengdu, China
| | - Peter Yip
- Physical Therapy Department, Florida Southern College, Lakeland, FL, USA
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12
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Kellum CE, Kemp KM, Mrug S, Pollock JS, Seifert ME, Feig DI. Adverse childhood experiences are associated with vascular changes in adolescents that are risk factors for future cardiovascular disease. Pediatr Nephrol 2023; 38:2155-2163. [PMID: 36622441 PMCID: PMC10234926 DOI: 10.1007/s00467-022-05853-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, are associated with a higher risk of cardiovascular disease (CVD) and indicators of future CVD risk in adulthood, such as greater vascular stiffness. The impact of ACEs in adolescence is unclear, and understanding how ACEs relate to blood pressure (BP) and vascular function during early life is key for the development of prevention strategies to reduce CVD risk. We hypothesized that exposure to ACEs would be associated with changes in central hemodynamics such as increased vascular stiffness and higher BP during adolescence. METHODS This pilot study enrolled 86 adolescents recruited from the Children's of Alabama. A validated ACE questionnaire was employed, and ACEs were modeled both as a continuous variable and a categorical variable (ACE ≥ 1 vs. ACE = 0). The primary outcomes used are considered to be indicators of future cardio-renal disease risk: aortic augmentation index normalized to 75 bpm (Alx75, a surrogate for vascular stiffness), carotid-femoral PWV (m/s), and ambulatory BP patterns. RESULTS Adolescents with ACE ≥ 1 had significantly higher Alx75 (ACE: 5.2% ± 2.2 compared to no ACE: - 1.4% ± 3.0; p = 0.043). PWV only reflected this trend when adjustments were made for the body mass index. Adolescents with ACEs showed no differences in ambulatory BP patterns during the 24-h, wake, or sleep periods compared to adolescents with no ACEs. CONCLUSIONS ACEs were associated with higher AIx75 in adolescence, which is a risk factor for future CVD. Adolescence could present an opportunity for early detections/interventions to mitigate adverse cardiovascular outcomes in adulthood. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Cailin E Kellum
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Keri M Kemp
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Jennifer S Pollock
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA.
| | - Michael E Seifert
- Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Daniel I Feig
- Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
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13
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Liu C, He Y, Venn AJ, Jose MD, Tian J. Childhood modifiable risk factors and later life chronic kidney disease: a systematic review. BMC Nephrol 2023; 24:184. [PMID: 37349734 PMCID: PMC10288726 DOI: 10.1186/s12882-023-03232-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Relationships between adulthood modifiable risk factors and chronic kidney disease (CKD) are well-established, but associations with childhood risk factors are unclear. This study systematically assesses the published evidence about childhood modifiable risk factors and adulthood CKD. METHODS We searched MEDLINE, EMBASE, and Web of Science to 6th May 2022. Articles were included if (1) they were population-based longitudinal studies, (2) exposures were potentially modifiable, for example through pharmacological or lifestyle modifications, including clinical conditions/measures (diabetes, blood pressure, adiposity, and dyslipidaemia); health behaviours (smoking, alcohol consumption, physical activity, fitness, and poor nutrition); and socio-economic factors (socio-economic position), and occurred during childhood (ages 2-19 years), and (3) outcome was CKD or surrogate markers of CKD in adulthood (ages 20 years or older). Three reviewers independently extracted the data. RESULTS 15,232 articles were identified after deduplication; 17 articles met the inclusion criteria, reporting childhood blood pressure (n = 8), adiposity (n = 4), type 2 diabetes (n = 1), socio-economic position (n = 1), famine (n = 1), cardiorespiratory fitness (n = 1), and a healthy lifestyle score (n = 1). The results suggested positive associations of childhood adiposity, type 2 diabetes, and low socio-economic position and cardiorespiratory fitness in females with CKD in adulthood. Findings were inconsistent on associations between childhood BP and CKD in adulthood. Childhood healthy lifestyle score and exposure to famine were not associated with risk of CKD in adulthood. CONCLUSIONS The limited evidence suggests childhood factors may contribute to the CKD risk in adulthood, particularly adiposity, type 2 diabetes, and low socio-economic position and cardiorespiratory fitness in females. Further high-quality community-based studies are needed with long-term follow-up and investigation of a broader range of modifiable risk factors.
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Affiliation(s)
- Conghui Liu
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Ye He
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Matthew D Jose
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
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14
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崔 孟, 马 奇, 陈 曼, 马 涛, 王 鑫, 刘 婕, 张 奕, 陈 力, 蒋 家, 袁 雯, 郭 桐, 董 彦, 马 军, 星 一. [Association between different growth patterns and metabolic syndrome in children and adolescents aged 7 to 17 years]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:415-420. [PMID: 37291915 PMCID: PMC10258052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To analyze the association between different growth patterns and metabolic syndrome in children and adolescents aged 7 to 17 years, and to provide suggestions for the prevention and control of metabolic syndrome in Chinese children and adolescents. METHODS Data were collected from the research project "Development and Application of Technology and Related Standards for Prevention and Control of Major Diseases among Students" of public health industry in 2012. This project is a cross-sectional study design. A total of 65 347 students from 93 primary and secondary schools in 7 provinces including Guangdong were selected by stratified cluster random sampling method. Given the budget, 25% of the students were randomly selected to collect blood samples. In this study, 10 176 primary and middle school students aged 7 to 17 years with complete physical measurements and blood biochemical indicators were selected as research objects. Chi-square test was used to compare the distribution differences of growth patterns under different demographic characteristics. Birth weight, waist circumference and blood biochemical indexes were expressed in the form of mean ± standard deviation, and the differences among different groups were compared by variance analysis. Binary Logistic regression model was used to analyze the relationship between different growth patterns and metabolic syndrome in children and adolescents aged 7 to 17 years. RESULTS The prevalence of metabolic syndrome in children and adolescents was 6.56%, 7.18% in boys and 5.97% in girls. The risk of metabolic syndrome was higher in the catch-down growth group than in the normal growth group (OR=1.417, 95%CI: 1.19-1.69), and lower in the catch-up growth group(OR=0.66, 95%CI: 0.53-0.82). After adjusting for gender, age and so on, the risk of developing metabolic syndrome in the catch-down growth group was higher than that in the normal growth group (OR=1.25, 95%CI: 1.02-1.52), but there was no significant difference between the catch-up growth group and the normal growth group (OR=0.79, 95%CI: 0.62-1.01). Stratified analysis showed that the association between different growth patterns and metabolic syndrome was statistically significant in the 7-12 years group, urban population, and Han Chinese student population. CONCLUSION There is a correlation between different growth patterns and metabolic syndrome in children and adolescents. The risk of developing metabolic syndrome in children and adolescents with catch-down growth is higher than that in the normal growth group, which suggests that attention should be paid to the growth and development of children and adolescents, timely correction of delayed growth and prevention of adverse health outcomes.
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Affiliation(s)
- 孟杰 崔
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 奇 马
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 曼曼 陈
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 涛 马
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 鑫鑫 王
- 宁夏医科大学公共卫生与管理学院流行病与卫生统计学系,银川 750004Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China
| | - 婕妤 刘
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 奕 张
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 力 陈
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 家诺 蒋
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 雯 袁
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 桐君 郭
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 彦会 董
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 军 马
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 一 星
- 北京大学公共卫生学院儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
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15
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Alexander BT, South AM, August P, Bertagnolli M, Ferranti EP, Grobe JL, Jones EJ, Loria AS, Safdar B, Sequeira-Lopez MLS. Appraising the Preclinical Evidence of the Role of the Renin-Angiotensin-Aldosterone System in Antenatal Programming of Maternal and Offspring Cardiovascular Health Across the Life Course: Moving the Field Forward: A Scientific Statement From the American Heart Association. Hypertension 2023; 80:e75-e89. [PMID: 36951054 PMCID: PMC10242542 DOI: 10.1161/hyp.0000000000000227] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
There is increasing interest in the long-term cardiovascular health of women with complicated pregnancies and their affected offspring. Emerging antenatal risk factors such as preeclampsia appear to increase the risk of hypertension and cardiovascular disease across the life course in both the offspring and women after pregnancy. However, the antenatal programming mechanisms responsible are complex and incompletely understood, with roots in alterations in the development, structure, and function of the kidney, heart, vasculature, and brain. The renin-angiotensin-aldosterone system is a major regulator of maternal-fetal health through the placental interface, as well as kidney and cardiovascular tissue development and function. Renin-angiotensin-aldosterone system dysregulation plays a critical role in the development of pregnancy complications such as preeclampsia and programming of long-term adverse cardiovascular health in both the mother and the offspring. An improved understanding of antenatal renin-angiotensin-aldosterone system programming is crucial to identify at-risk individuals and to facilitate development of novel therapies to prevent and treat disease across the life course. Given the inherent complexities of the renin-angiotensin-aldosterone system, it is imperative that preclinical and translational research studies adhere to best practices to accurately and rigorously measure components of the renin-angiotensin-aldosterone system. This comprehensive synthesis of preclinical and translational scientific evidence of the mechanistic role of the renin-angiotensin-aldosterone system in antenatal programming of hypertension and cardiovascular disease will help (1) to ensure that future research uses best research practices, (2) to identify pressing needs, and (3) to guide future investigations to maximize potential outcomes. This will facilitate more rapid and efficient translation to clinical care and improve health outcomes.
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16
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Carbone JT, Hicks LM, Brown S, Saini EK, Dayton CJ. Adverse Childhood Experiences: Associations with a Blunted Cortisol Stress Response During Pregnancy. Matern Child Health J 2023:10.1007/s10995-023-03651-2. [PMID: 37000382 DOI: 10.1007/s10995-023-03651-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Adverse Childhood Experiences (ACEs) are associated with a range of negative physical and mental health outcomes, yet there is limited research focused on the effect of ACEs on stress responses during pregnancy. Expectant mothers experience an increase in cortisol levels as pregnancy progresses, with this increase having important implications for fetal and early infant development. Little is known about the impact of ACEs on maternal cortisol levels. This study explored the relationship between maternal ACEs and cortisol response among expectant mothers nearing or in the third trimester of pregnancy. METHODS 39 expectant mothers were exposed to a Baby Cry Protocol via an infant simulator, with salivary cortisol collected at five points in time (N = 181). Stepwise, multilevel model creation resulted in a random intercept and random slope model with an interaction term for total number of ACEs and week of pregnancy. RESULTS The repeated measures data showed that cortisol levels decreased across collection times, from arrival at the lab, through the Baby Cry Protocol, to recovery. Predictive margins for the interaction term showed that while exposure to a greater number of ACEs was associated with higher cortisol levels early in the third trimester, the expected increase in cortisol late in pregnancy was blunted for expectant mothers who were exposed to a greater number of ACEs. DISCUSSION These findings findings suggest the importance of ACEs screening and intervention efforts as part of prenatal care.
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Affiliation(s)
- Jason T Carbone
- School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI, 48202, USA.
| | - Laurel M Hicks
- University of Colorado Boulder, Renée Crown Wellness Institute, Boulder, CO, USA
| | - Suzanne Brown
- School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI, 48202, USA
| | | | - Carolyn J Dayton
- School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI, 48202, USA
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA
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17
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Farina MP, Kim JK, Crimmins EM. Racial/Ethnic Differences in Biological Aging and Their Life Course Socioeconomic Determinants: The 2016 Health and Retirement Study. J Aging Health 2023; 35:209-220. [PMID: 35984401 PMCID: PMC9898094 DOI: 10.1177/08982643221120743] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives: This study examined differences in accelerated biological aging among non-Hispanic Blacks, Hispanics, and non-Hispanic Whites in the United States and assessed whether including life course socioeconomic conditions attenuated observed racial/ethnic differences. Methods: Data came from the Venous Blood Collection Subsample of the Health and Retirement Study. We used a comprehensive summary measure of biological age (BA-22). We determined whether key lifetime socioeconomic conditions contributed to racial/ethnic differences in biological aging. Results: Findings indicated that non-Hispanic Blacks and Hispanics have accelerated aging, and non-Hispanic Whites have decelerated aging. Racial/ethnic differences were strongly tied to educational attainment. We also observed a significant difference by birthplace for Hispanics. US-born Hispanics had accelerated biological aging, whereas foreign-born Hispanics did not. In age-stratified analyses, these racial/ethnic differences were found for adults aged 56-74, but not for adults aged 75+. Conclusions: These findings provide insight into biological differences underlying racial/ethnic disparities in health.
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Affiliation(s)
- Mateo P Farina
- Andrus Gerontology Center, University of Southern California, Los Angeles, CA, USA
| | - Jung Ki Kim
- Andrus Gerontology Center, University of Southern California, Los Angeles, CA, USA
| | - Eileen M. Crimmins
- Andrus Gerontology Center, University of Southern California, Los Angeles, CA, USA
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18
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Dempster KS, Wade TJ, MacNeil AJ, O'Leary DD. Adverse childhood experiences are associated with altered cardiovascular reactivity to head-up tilt in young adults. Am J Physiol Regul Integr Comp Physiol 2023; 324:R425-R434. [PMID: 36693169 DOI: 10.1152/ajpregu.00148.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with greater prevalence of cardiovascular disease and altered acute stress reactivity. The current study investigated the effect of ACEs on hemodynamic and autonomic responses to orthostatic stress imposed by 60° head-up tilt (HUT) in young adults. Two-hundred twenty-six healthy young adults (age = 22.6 ± 1.5 yr; n = 116 females) without cardiovascular disease participated and had complete data. Participants underwent supine blood pressure (BP), R-R interval (RRI), cardiac output (CO), total peripheral resistance (TPR), and cardiovagal baroreflex sensitivity (cvBRS) testing followed by a transition to 60° HUT where measures were reassessed. Childhood adversity exposures were assessed based on categorical exposure and nonexposure to childhood household dysfunction and maltreatment, and <4 and ≥4 types of ACEs. Significantly greater increases in SBP (P < 0.05), DBP, MAP, and TPR (P < 0.01; all) following 60° HUT were observed in individuals with ≥4 compared with those with <4 types of ACEs. Attenuated decreases in RRI and cvBRS were observed in those with ≥4 types of ACEs (P < 0.05). Experiencing ≥4 types of ACEs was associated with augmented BP and TPR reactivity and a blunted decrease in cvBRS in response to 60° HUT in young adults. Results suggest that a reduced vagal response to orthostatic stress is present in those who have experienced ≥4 types of ACEs that may promote autonomic dysfunction. Future research examining the sympathetic and vagal baroreflex branches is warranted.
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Affiliation(s)
- Kylie S Dempster
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
| | - Terrane J Wade
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
| | - Adam J MacNeil
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Deborah D O'Leary
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
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19
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Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Thomas EBK, Taylor A, Teague TK, Jenkins NDM. Progressive exercise training improves cardiovascular psychophysiological outcomes in young adult women with a history of adverse childhood experiences. J Appl Physiol (1985) 2023; 134:742-752. [PMID: 36727632 PMCID: PMC10027078 DOI: 10.1152/japplphysiol.00524.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
Adverse childhood experiences (ACEs) are early-life psychosocial stressors that are associated with poorer mental health and increased cardiovascular disease (CVD) risk in a dose-dependent manner. We examined the feasibility of an 8-wk combined aerobic and resistance exercise training program to improve systolic (SBP) and diastolic blood pressure (DBP), serum endothelin-1 (ET-1), resilience, hope agency, and hope pathways in young women with ACEs. Forty-two healthy women (21 ± 3 yr) with ≥4 (ACE+; n = 28) or 0 ACEs (ACE-; n = 14) participated in this study. Women with ACEs were randomly assigned to an exercise (ACE+EXT; n = 14) or nonexercise control (ACE+CON; n = 14) group, whereas all ACE- participants were assigned to a nonexercise control (n = 14) group. Hope agency and DBP did not change in any group (P ≥ 0.43), but hope pathways improved only in ACE+EXT (means ± SE change; +1.6 ± 0.74 au, P = 0.032, Hedges' g = 0.53). ET-1 decreased in ACE+EXT only (-0.31 ± 0.15 pg/mL, P = 0.043, g = 0.46). Although the interactions for resilience and SBP did not reach significance (P = 0.05-0.06), forced post hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, P = 0.012, g = 0.64) and SBP tended to improve (-4.0 ± 2.0 mmHg, P = 0.053, g = 0.51) in ACE+EXT only. There were significant associations between changes in hope pathways and SBP (ρ = -0.43, P = 0.023) and ET-1 (ρ = -0.53, P = 0.005), and between changes in SBP and ET-1 (ρ = 0.49; P = 0.012) in the ACE+ group. In summary, structured exercise training reduces serum ET-1 levels, improves positive psychological coping, and may improve SBP in young women with ACEs. The relationships among the changes in hope pathways, SBP, and ET-1 suggest a cardiovascular psychophysiological relationship in young women with ACEs.NEW & NOTEWORTHY This randomized controlled pilot trial shows, for the first time, that 8 wk of structured, progressive exercise training lowers serum endothelin-1 (ET-1) and improves positive psychological coping in young women with significant early-life psychosocial stress. Furthermore, the observed associations among changes in psychological attributes, ET-1, and systolic blood pressure signify a potential interplay between positive psychology and cardiovascular disease risk among women with adverse childhood experiences.
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Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio, United States
| | | | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Stillwater, Oklahoma, United States
| | - Emily B K Thomas
- Department of Psychology and Brain Sciences, University of Iowa, Iowa City, Iowa, United States
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Science, Tulsa, Oklahoma, United States
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa, United States
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20
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de la Rosa R, Zablotny D, Ye M, Bush NR, Hessler D, Koita K, Bucci M, Long D, Thakur N. Biological Burden of Adverse Childhood Experiences in Children. Psychosom Med 2023; 85:108-117. [PMID: 36728584 PMCID: PMC9930178 DOI: 10.1097/psy.0000000000001167] [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] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to examine relationships between adverse childhood experiences (ACEs) and related life events and allostatic load (AL)-"wear and tear" from chronic stress-in a pediatric population. METHODS Children were screened with the PEdiatric ACEs and Related Life Event Screener (PEARLS) tool, a 17-item questionnaire capturing experiences of abuse, neglect, household challenges, and related life events. Biological data were available for 207 participants, and AL was operationalized using clinical or empirical cutoff points across 4 physiological systems (i.e., cardiac, metabolic, inflammatory, neurologic). Covariate-adjusted multivariable regression models were used to examine associations between AL with adversity and health. RESULTS Children (mean age = 6.5 years, range = 1-11 years) had an average AL score of 1.9 (standard deviation = 1.7), and a U-shaped relationship was observed with child's age. Continuous PEARLS and original ACE scores were not associated with AL. However, children with a reported PEARLS score of 1 to 2 or original ACEs score of 1 to 3 had 1.5 (incidence rate ratio [IRR] = 1.50, 95% confidence interval [CI] = 1.09-2.08) and 1.4 (IRR = 1.41, 95% CI = 1.08-1.84) times greater AL, respectively, compared with participants with none reported. In secondary analyses, caregiver mental illness was associated with higher child AL (adjusted IRR = 1.27, 95% CI = 1.01-1.58). AL was also associated with poorer perceived child general health (adjusted β = -0.87, 95% CI = -1.58 to -0.15) and greater odds of child obesity (adjusted odds ratio = 1.51, 95% CI = 1.23-1.89). CONCLUSIONS Measuring AL in a pediatric population requires careful consideration of age. Higher AL was associated with a greater number of reported adversities and worse child health.
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Affiliation(s)
- Rosemarie de la Rosa
- From the Department of Medicine (de la Rosa, Zablotny, Ye, Thakur), University of California San Francisco, San Francisco; School of Public Health (de la Rosa), University of California Berkeley, Berkeley; Departments of Psychiatry and Behavioral Science (Bush) and Pediatrics (Bush and Long) and Family and Community Medicine (Hessler), University of California San Francisco, San Francisco; UCSF Benioff Children's Hospital Oakland (Long), Oakland; Center for Youth Wellness (Koita, Bucci), San Francisco, California
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21
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Mrug S, Pollock J, Pollock D, Seifert M, Johnson KA, Knight DC. Early Life Stress, Coping, and Cardiovascular Reactivity to Acute Social Stress. Psychosom Med 2023; 85:118-129. [PMID: 36728859 PMCID: PMC9918702 DOI: 10.1097/psy.0000000000001165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Early life stress (ELS) occurring during childhood and adolescence is an established risk factor for later cardiovascular disease and dysregulated reactivity to acute social stress. This study examined whether ELS associations with baseline cardiovascular functioning, cardiovascular stress reactivity and recovery, and emotional stress reactivity vary across levels of emotion-oriented, task-oriented, and avoidant coping styles. METHODS The sample included 1027 adolescents and young adults (mean age = 19.29 years; 50% female; 64% Black, 34% non-Hispanic White) who reported on their ELS exposure and coping styles. Participants completed a standardized acute social stress test (the Trier Social Stress Test [TSST]), with heart rate (HR) and blood pressure (BP) measured before, during, and after the TSST. Self-reports of negative emotions during the TSST indexed emotional stress reactivity. RESULTS Multiple regression models adjusting for demographic factors and body mass index showed that ELS was associated with lower HR stress reactivity, avoidant coping was related to lower systolic BP and diastolic BP during stress and lower systolic BP during recovery, and higher emotion-oriented coping and lower task-oriented coping predicted greater emotional stress reactivity. A consistent pattern emerged where emotion-oriented coping amplified the associations between ELS and maladaptive stress responses (blunted cardiovascular stress reactivity and recovery; enhanced emotional stress reactivity), whereas lower levels of emotion-oriented coping were associated with resilient profiles among those who experienced ELS (lower resting HR, lower emotional stress reactivity, average HR and BP stress reactivity and recovery). However, low levels of emotion-oriented coping also conferred a risk of higher BP during recovery for those with high levels of ELS. CONCLUSIONS These results suggest that low to moderate levels of emotion-oriented coping promote optimal cardiovascular and emotional reactivity to acute stress among individuals exposed to ELS.
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Affiliation(s)
- Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham
| | - Jennifer Pollock
- CardioRenal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham
| | - David Pollock
- CardioRenal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham
| | - Michael Seifert
- Division of Pediatric Nephrology, Department of Pediatrics, University of Alabama at Birmingham
| | | | - David C. Knight
- Department of Psychology, University of Alabama at Birmingham
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22
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Hall A, West X, Brown M, Hall E, Kim E, Leib A, Mergaman P, Salih Z, Aronoff S. Association of Adverse Childhood Experiences and Resilience With Obesity, High Blood Pressure, and Parental Report of Behavioral Health Symptoms in Children: A Cross Sectional Study. Glob Pediatr Health 2023; 10:2333794X231159518. [PMID: 36911753 PMCID: PMC9996718 DOI: 10.1177/2333794x231159518] [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: 01/26/2023] [Accepted: 02/07/2023] [Indexed: 03/08/2023] Open
Abstract
The interplay between Adverse Childhood Experiences (ACEs) and resilience on health in children is not well understood. Parents completed 3 questionnaires: ACEs, Child and Youth Resilience Measure (CYRM), and the Pediatric Symptom Checklist-17(PSC-17). BMI and blood pressure were measured. 19.8% of children had 4 or more ACEs, resilience ranged from 25 to 51, 14.3% had a positive PSC-17 score, 25.6% were obese, 3.1% had systolic hypertension, and 1.2% had diastolic hypertension. Higher ACEs (ACE OR: 1.398, 95% CI = 1.044-1.893, P = .026) and lower resilience (Resilience OR: 0.740, 95% CI 0.668-0.812; P = 1.13 × 10-9) were predictive of increased reports of behavioral health symptoms, but not obesity or hypertension. The personal resilience subscale was a predictor of positive PSC-17 score (OR 0.646, 95% CI = 0.546-0.749, P = 3.18 × 10-8); relationship subscale was not. Cultivating resilience, especially personal aspects, may provide an effective intervention for behavioral health symptoms in children.
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Affiliation(s)
- Ashleigh Hall
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Xandria West
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Marilyn Brown
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Erin Hall
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.,Seattle Children's Hospital 4800 Sand Point Way NE Seattle, WA, USA
| | - Ella Kim
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Alexa Leib
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.,West Chester Medical Center, Valhalla, NY, USA
| | - Paige Mergaman
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.,Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zanaib Salih
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Stephen Aronoff
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
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23
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Carson MY, Barinas‐Mitchell E, Maki PM, Thurston RC. Childhood Maltreatment and Arterial Stiffness Among Midlife Women. J Am Heart Assoc 2022; 11:e026081. [PMID: 36314495 PMCID: PMC9673641 DOI: 10.1161/jaha.122.026081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background Childhood maltreatment has been associated with arterial stiffness. This relationship has not been examined specifically among women at midlife, a time of increased arterial stiffness in women. This study tested whether childhood maltreatment is associated with arterial stiffness among a cohort of midlife women. Methods and Results A total of 162 nonsmoking perimenopausal and postmenopausal women free of clinical cardiovascular disease (mean age, 54 years; 72% White race, 23% Black race, and 5% Asian/Pacific Islander or Mixed race) completed the Child Trauma Questionnaire at baseline. At a follow-up visit 5 years later, blood pressure and carotid-femoral pulse wave velocity (a measure of arterial stiffness) were assessed. Relationships between childhood maltreatment and carotid-femoral pulse wave velocity were tested in linear regression models, adjusting for time between visits, age, race and ethnicity, education, body mass index, heart rate, hypertension medication, and diastolic blood pressure. Seventy-one women (44% of the sample) met criteria for a history of childhood maltreatment. Women with a history of childhood maltreatment had higher carotid-femoral pulse wave velocity (B [SE]=0.47 [0.21]; P=0.03) than women without this history, controlling for time between visits, age, race and ethnicity, education, body mass index, heart rate, hypertension medication, and diastolic blood pressure. Conclusions Among these midlife women, childhood maltreatment was associated with arterial stiffness, highlighting the potential long-term cardiovascular implications of childhood maltreatment.
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Affiliation(s)
| | - Emma Barinas‐Mitchell
- Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghPA
| | - Pauline M. Maki
- Department of Psychiatry, Psychology, and Obstetrics & GynecologyUniversity of Illinois at ChicagoChicagoIL
| | - Rebecca C. Thurston
- Department of PsychologyUniversity of PittsburghPA,Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghPA,Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
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24
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Iannarelli NJ, Wade TJ, Dempster KS, Moore J, MacNeil AJ, O'Leary DD. No Mediation Effect of Telomere Length or Mitochondrial DNA Copy Number on the Association Between Adverse Childhood Experiences (ACEs) and Central Arterial Stiffness. J Am Heart Assoc 2022; 11:e026619. [DOI: 10.1161/jaha.122.026619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Adverse childhood experiences (ACEs) have been linked to increased cardiovascular disease (CVD) risk. Previous reports have suggested that accelerated biological aging—indexed by telomere length (TL) and mitochondrial DNA copy number (mtDNAcn)—may contribute to associations between ACEs and cardiovascular health outcomes. Here, we examine the potential mediating effects of TL and mtDNAcn on the association between ACEs and central arterial stiffness—an intermediate cardiovascular health outcome—as a novel pathway linking ACEs to CVD risk among young adults.
Methods and Results
One hundred and eighty‐five (n=102 women; mean age, 22.5±1.5 years) individuals provided information on ACEs. TL (kb per diploid cell) and mtDNAcn (copies per diploid cell) were quantified using quantitative polymerase chain reaction techniques. Central arterial stiffness was measured as carotid‐femoral pulse wave velocity (cfPWV; m/s). Multiple linear regression analyses were used to examine the associations between ACEs, TL, mtDNAcn, and cfPWV. ACEs were positively associated with cfPWV (
β
=0.147,
P
=0.035). TL (
β
=−0.170,
P
=0.011) and mtDNAcn (
β
=−0.159,
P
=0.019) were inversely associated with cfPWV. Neither TL (
β
=−0.027,
P
=0.726) nor mtDNAcn (
β
=0.038,
P
=0.620) was associated with ACEs. Neither marker mediated the association between ACEs and cfPWV.
Conclusions
An increasing number of ACEs were associated with a faster cfPWV and thus, a greater degree of central arterial stiffness. ACEs were not associated with either TL or mtDNAcn, suggesting that these markers do not represent a mediating pathway linking ACEs to central arterial stiffness.
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Affiliation(s)
- Nathaniel J. Iannarelli
- 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
| | - 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
| | - 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
| | - Jessy Moore
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
| | - Adam J. MacNeil
- 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
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25
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Yang Y, Dai J, Min J, Wu H, Huang S, Li Q, Chai J. Prevalence trends of hypertension and influence factors among children and adolescents aged 7-17 years in China, 2011-2015: A serial cross-sectional study. Front Public Health 2022; 10:887285. [PMID: 36311569 PMCID: PMC9608369 DOI: 10.3389/fpubh.2022.887285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/30/2022] [Indexed: 01/21/2023] Open
Abstract
Hypertension has rapidly increased in the last decades throughout the world. It is an emerging disease. However, limited information is available on secular trends and factors of childhood and adolescents' hypertension in China. In this study, 5-year successive data were derived from a cross-sectional study of the China Health and Nutrition Survey (CHNS) in 2011 and 2015. We used systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) at least 95th percentile on the basis of age, sex, and height percentiles to define hypertension (HBP). A total of 2,827 children and adolescents aged 7-17 years were included. The age-standardized prevalence of hypertension was increased significantly across 5 years: the standardized prevalence of hypertension was increased from 8.08% (2011) to 11.46% (2015) in China (P < 0.01). The mean SBP of boys increased from 101.21 to 102.79 mmHg, while the mean SBP of girls increased from 98.96 to 100.04 mmHg. The mean DBP of boys increased from 61.20 to 67.40 mmHg, while the mean DBP of girls increased from 64.34 to 65.76 mmHg. The prevalence of hypertension grew continuously in both sexes, but the pace of change for boys was more rapid than that for girls. This study confirmed that the association between rural (odds ratio [OR] = 1.394, 95%CI 1.032-1.883), overweight/obesity (OR = 2.621, 95%CI 1.506-4.562), and BP levels was highly correlated (P < 0.05). The possible protecting factors associated with hypertension were being a girl (OR = 0.788, 95%CI 0.595-1.043). There was no association between weekly physical activity, daily sleep duration, and hypertension (P > 0.05). Further in-depth analysis of influencing factors and comprehensive interventions should be urgently implemented to combat the hypertension epidemic among children and adolescents in China.
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Affiliation(s)
- Yunjuan Yang
- Department of School Health, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China,Public Health School, Kunming Medical University, Kunming, China,Public Health School, Dali University, Dali, China,*Correspondence: Yunjuan Yang
| | - Jing Dai
- Management and Economy School, Kunming University of Science and Technology, Kunming, China
| | | | - Huamei Wu
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Songquan Huang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qingsheng Li
- Department of School Health, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Jiajia Chai
- Management and Economy School, Kunming University of Science and Technology, Kunming, China
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26
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Miller NE, Lacey RE. Childhood adversity and cardiometabolic biomarkers in mid-adulthood in the 1958 British birth cohort. SSM Popul Health 2022; 19:101260. [PMID: 36238817 PMCID: PMC9550530 DOI: 10.1016/j.ssmph.2022.101260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Studies that have examined associations between adverse childhood experiences (ACEs) and cardiometabolic biomarkers in adulthood are limited as they mainly focus on childhood maltreatment. This study aimed to examine the association between a range of prospectively and retrospectively reported ACEs and cardiometabolic biomarkers in mid-adulthood. Multiply-imputed data on 8511 participants from the National Child Development Study (1958 British birth cohort) were used. ACEs were prospectively reported at ages 7, 11 and 16, and retrospectively reported at age 33/44/45. Cardiometabolic outcomes assessed at age 44/45 included glycated haemoglobin (HbA1c), cholesterol (total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)), triglycerides, blood pressure (systolic and diastolic), body mass index, waist circumference and metabolic syndrome. Parental separation/divorce, physical neglect, emotional neglect and psychological abuse were associated with lower HDL cholesterol. Parental offending and physical neglect were associated with higher triglyceride concentrations. Parental offending was also associated with increased HbA1c. Exposure to 2+ (vs. 0) prospective ACEs was associated with lower HDL cholesterol. All these associations were after adjustment for sex and multiple early life factors. To conclude, several individual ACEs are associated with poorer cardiometabolic risk factor profiles in mid-adulthood. Furthermore, exposure to two or more prospective ACEs is associated with lower HDL cholesterol concentrations in mid-adulthood. Parental separation/divorce in childhood is associated with lower high-density lipoprotein cholesterol in mid-adulthood. Physical neglect in childhood is associated with poorer lipid profiles in mid-adulthood. Psychological abuse in childhood is associated with lower high-density lipoprotein cholesterol in mid-adulthood. Parental offending in childhood is associated with higher triglycerides and glycated haemoglobin in mid-adulthood.
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27
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Chen AK, Wang X, McCluskey LP, Morgan JC, Switzer JA, Mehta R, Tingen M, Su S, Harris RA, Hess DC, Rutkowski EK. Neuropsychiatric sequelae of long COVID-19: Pilot results from the COVID-19 neurological and molecular prospective cohort study in Georgia, USA. Brain Behav Immun Health 2022; 24:100491. [PMID: 35873350 PMCID: PMC9290328 DOI: 10.1016/j.bbih.2022.100491] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/05/2022] Open
Abstract
Background As the coronavirus disease 2019 (COVID-19) pandemic continues, there has been a growing interest in the chronic sequelae of COVID-19. Neuropsychiatric symptoms are observed in the acute phase of infection, but there is a need for accurate characterization of how these symptoms evolve over time. Additionally, African American populations have been disproportionately affected by the COVID-19 pandemic. The COVID-19 Neurological and Molecular Prospective Cohort Study in Georgia (CONGA) was established to investigate the severity and chronicity of these neurologic findings over the five-year period following infection. Methods The CONGA study aims to recruit COVID-19 positive adult patients in Georgia, United States from both the inpatient and outpatient setting, with 50% being African American. This paper reports our preliminary results from the baseline visits of the first 200 patients recruited who were on average 125 days since having a positive COVID-19 test. The demographics, self-reported symptoms, comorbidities, and quantitative measures of depression, anxiety, smell, taste, and cognition were analyzed. Cognitive measures were compared to demographically matched controls. Blood and mononuclear cells were drawn and stored for future analysis. Results Fatigue was the most reported symptom in the study cohort (68.5%). Thirty percent of participants demonstrated hyposmia and 30% of participants demonstrated hypogeusia. Self-reported neurologic dysfunction did not correlate with dysfunction on quantitative neurologic testing. Additionally, self-reported symptoms and comorbidities were associated with depression and anxiety. The study cohort performed worse on cognitive measures compared to demographically matched controls, and African American patients scored lower compared to non-Hispanic White patients on all quantitative cognitive testing. Conclusion Our results support the growing evidence that there are chronic neuropsychiatric symptoms following COVID-19 infection. Our results suggest that self-reported neurologic symptoms do not appear to correlate with associated quantitative dysfunction, emphasizing the importance of quantitative measurements in the complete assessment of deficits. Self-reported symptoms are associated with depression and anxiety. COVID-19 infection appears to be associated with worse performance on cognitive measures, though the disparity in score between African American patients and non-Hispanic White patients is likely largely due to psychosocial, physical health, and socioeconomic factors. Neuropsychiatric symptoms are often reported following COVID-19 infection. Self-reported symptoms may not be associated with objective dysfunction. Self-reported symptoms may be associated with depression and anxiety. Cognitive testing may overestimate clinical impairment in disadvantaged populations.
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28
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Nguyen KA, Kengne AP, Abrahams N, Jewkes R, Mhlongo S, Peer N. Associations of childhood maltreatment with hypertension in South African women: a cross-sectional study. BMJ Open 2022; 12:e057436. [PMID: 36123062 PMCID: PMC9486236 DOI: 10.1136/bmjopen-2021-057436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To examine the associations of childhood maltreatment (CM) with hypertension, and the mediating effects of hypertension risk factors on the associations in South African women, using baseline data of the Rape Impact Cohort Evaluation longitudinal study. DESIGN Cross-sectional SETTING AND PARTICIPANTS: Self-reported data on CM exposure and its severity in 18-40-year-old women living in KwaZulu-Natal province were assessed. Logistic regression models, adjusted for traditional hypertension risk factors, rape exposure, HIV-infection, other traumatic exposures, depression scores and acute stress reactions (ASR) scores were used to examine the CM-hypertension associations. RESULTS Among 1797 women, 220 (12.2%) had hypertension; CM prevalence was higher in women with hypertension than without hypertension overall (70.9% vs 57.2%) and for each abuse type: sexual abuse (20.9% vs 12.4%), physical abuse (51.8% vs 41.5%), emotional abuse (40% vs 27.6%) and parental neglect (35% vs 25.7%). Exposures to 1-2 types and 3-4 types of CM were 46.4% and 24.5%, respectively, in women with hypertension, and lower in women without (42.9% and 14.3%, respectively). Exposures to any CM (adjusted OR: 1.62; 95% CI: 1.19 to 2.25), sexual abuse (1.64; 95% CI: 1.12 to 2.37), emotional abuse (1.57; 95% CI: 1.16 to 2.13), physical abuse (1.43; 95% CI: 1.07 to 1.92) and parental neglect (1.37; 95% CI: 1.00 to 1.86) were associated with hypertension. Exposures to an increasing number of abuse types and cumulative severity of CM overall (1.13; 95% CI: 1.05 to 1.21) and for each CM type were associated with increased odds of hypertension. Alcohol use, other trauma experienced, depression and ASR partially mediated these associations. CONCLUSION CM was associated with hypertension; the effects were greater with multiple abuse types and severe abuse, and were partially mediated by alcohol use, depression, ASR and other traumatic exposures. While CM must be prevented, effective mental health interventions to curb the uptake of unhealthy behaviours and the development of hypertension in women exposed to CM are key.
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Affiliation(s)
- Kim Anh Nguyen
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
- Department of Medicine, University of Cape Town, Observatory, Western Cape, South Africa
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Cape Town, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
- Department of Medicine, University of Cape Town, Observatory, Western Cape, South Africa
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Kapur G, Stenson AF, Chiodo LM, Delaney-Black V, Hannigan JH, Janisse J, Ratner HH. Childhood Violence Exposure Predicts High Blood Pressure in Black American Young Adults. J Pediatr 2022; 248:21-29.e1. [PMID: 35660017 DOI: 10.1016/j.jpeds.2022.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the impact of childhood adversity, including community violence exposure, on hypertension risk in Black American young adults to understand what risk factors (eg, prenatal factors, later exposures) and ages of adversity exposure increased hypertension risk. STUDY DESIGN The study included 396 Black American participants with data from prenatal, birth, and age 7-, 14-, and 19-year visits. At age 19 years, individuals with blood pressure (BP) measures >120 mmHg systolic and/or >80 mmHg diastolic were classified as having high blood pressure (HBP), and those with BP <120/80 mmHg were classified as normal. Associations between prenatal and birth risk factors; childhood adversity at age 7, 14, and 19 years; age 19 body mass index (BMI); and both systolic and diastolic BP at age 19 were tested using logistic regression models. RESULTS Age 19 BMI was positively associated with systolic and diastolic HBP status at age 19. Controlling for all covariates, community violence exposure at age 7 and 19 years was associated with 2.2-fold (95% CI, 1.242-3.859) and 2.0-fold (95% CI, 1.052-3.664) greater odds of systolic HBP, respectively, at age 19 years. Prenatal risk, birth risk, and other dimensions of childhood adversity were not associated with HBP in this cohort. CONCLUSION Childhood community violence exposure is a significant risk factor for HBP in young adults. As Black American children typically experience more community violence exposure than other American children, our results suggest that racial disparities in childhood community violence exposure may contribute to racial disparities in adult hypertension burden.
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Affiliation(s)
- Gaurav Kapur
- Department of Pediatrics, Wayne State University, Detroit, MI; Department of Pediatrics, Central Michigan University, Mount Pleasant, MI
| | - Anaïs F Stenson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI.
| | - Lisa M Chiodo
- College of Nursing, University of Massachusetts-Amherst, Amherst, MA
| | | | - John H Hannigan
- Department of Obstetrics & Gynecology, Wayne State University, Detroit, MI; C.S. Mott Center for Human Growth & Development, Wayne State University, Detroit, MI; Merrill-Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI; Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, MI; Department of Psychology, Wayne State University, Detroit, MI
| | - James Janisse
- Department of Family Medicine & Public Health Sciences, Wayne State University, Detroit, MI
| | - Hilary H Ratner
- Merrill-Palmer Skillman Institute for Child & Family Development, Wayne State University, Detroit, MI; Department of Psychology, Wayne State University, Detroit, MI
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Leachman JR, Cincinelli C, Ahmed N, Dalmasso C, Xu M, Gatineau E, Nikolajczyk BS, Yiannikouris F, Hinds TD, Loria AS. Early life stress exacerbates obesity in adult female mice via mineralocorticoid receptor-dependent increases in adipocyte triglyceride and glycerol content. Life Sci 2022; 304:120718. [PMID: 35714704 PMCID: PMC10987253 DOI: 10.1016/j.lfs.2022.120718] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/02/2022] [Accepted: 06/10/2022] [Indexed: 01/06/2023]
Abstract
Previously, we have shown that Maternal Separation and Early Weaning (MSEW) exacerbates high fat diet (HF)-induced visceral obesity in female offspring compared to normally reared female mice. Stress hormones such as glucocorticoids and mineralocorticoids are critical mediators in the process of fat expansion, and both can activate the mineralocorticoid receptor (MR) in the adipocyte. Therefore, this study aimed to, comprehend the specific effects of MSEW on adipose tissue basic homeostatic function, and investigate whether female MSEW mice show an exacerbated obesogenic response mediated by MR. Gonadal white adipose tissue (gWAT), a type of visceral fat, was collected to assess lipidomics, transcriptomics, and in vitro lipolysis assay. Obese female MSEW mice showed increased adiposity, elevated 44:2/FA 18:2 + NH4 lipid class and reduced mitochondrial DNA density compared to obese control counterparts. In addition, single-cell RNA sequencing in isolated pre- and mature adipocytes showed a ~9-fold downregulation of aquaglycerolporin 3 (Aqp3), a channel responsible for glycerol efflux in adipocytes. Obese MSEW mice showed high levels of circulating aldosterone and gWAT-derived corticosterone compared to controls. Further, the MR blocker spironolactone (Spiro, 100 mg/kg/day, 2 weeks) normalized the elevated intracellular glycerol levels, the greater in vitro lipolysis response, and the number of large size adipocytes in MSEW mice compared to the controls. Our data suggests that MR plays a role promoting adipocyte hypertrophy in female MSEW mice by preventing lipolysis via glycerol release in favor of triglyceride formation and storage.
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Affiliation(s)
- Jacqueline R Leachman
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Cole Cincinelli
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Nermin Ahmed
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Carolina Dalmasso
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Mei Xu
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Eva Gatineau
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Barbara S Nikolajczyk
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA; Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Frederique Yiannikouris
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Terry D Hinds
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA; Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, Lexington, KY, USA; Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA; SAHA Cardiovascular Center, University of Kentucky, Lexington, KY, USA.
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Hypertension and Associated Risk Factors among Children with Intellectual Disability: A Cross-Sectional Study. Nutrients 2022; 14:nu14153127. [PMID: 35956301 PMCID: PMC9370698 DOI: 10.3390/nu14153127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 12/02/2022] Open
Abstract
To investigate the prevalence of hypertension and associated risk factors in Chinese children with intellectual disability, a cross-sectional study was conducted in a sample of 558 children with intellectual disability aged 6–18 years in Hong Kong, and 452 (81.0%) with valid data were included in the data analysis. Blood pressure was measured according to a standard protocol. Hypertension was defined using the age-, gender-, and height-specific classification criteria recommended by the 2018 Chinese Guidelines for Children. Multivariate and hierarchical logistic regression was fitted to examine the associations of hypertension with potential risk factors. Overall, 31.4% of the participants were classified as having hypertension. Obese children were more likely to develop hypertension than non-obese children (adjusted OR = 2.77, 95% CI: 1.28, 5.99, p = 0.010). A paternal education of college or above and a paternal occupation of clerks, sales representatives, and workers were also associated with an increased risk of hypertension. The prevalence of hypertension is high among Chinese children with intellectual disability. Obesity was the strongest risk factor. Further longitudinal studies are warranted to confirm our findings. Nevertheless, preventions against obesity are promising to receive doubled benefits in reducing both obesity and hypertension, given its strong relationship with hypertension in this special population.
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Jenkins NDM, Robinson AT. How do Adverse Childhood Experiences get Under the Skin to Promote Cardiovascular Disease? A Focus on Vascular Health. FUNCTION 2022; 3:zqac032. [PMID: 35859580 PMCID: PMC9279110 DOI: 10.1093/function/zqac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 01/07/2023] Open
Affiliation(s)
- Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA
- Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Austin T Robinson
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, USA
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Rodriguez-Miguelez P, Looney J, Blackburn M, Thomas J, Pollock JS, Harris RA. The Link Between Childhood Adversity and Cardiovascular Disease Risk: Role of Cerebral and Systemic Vasculature. FUNCTION (OXFORD, ENGLAND) 2022; 3:zqac029. [PMID: 35774591 PMCID: PMC9228651 DOI: 10.1093/function/zqac029] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 01/07/2023]
Abstract
Adverse childhood experiences (ACEs) are traumatic events during the first years of life that are associated with a higher risk of developing cardiovascular disease (CVD) during adulthood. The medial prefrontal cortex (mPFC) is a core region in the brain that modulates emotions and is directly involved in the cardiovascular response to stress by increasing vascular resistance. In the present study we examined the relationship between ACEs, mPFC and peripheral vascular function. Forty-five, adults (33±5 yrs.) participated in the present study to evaluate cerebral hemodynamics and peripheral vascular function. The impact of adverse experiences was evaluated through the ACE questionnaire. Among those that experienced ACEs (ACE group, n = 22), there was a significantly (P < 0.001) reduced activation of the mPFC as well as greater peripheral vascular resistance observed in the small (P ≤ 0.035), conduit (P ≤ 0.042) and large (P ≤ 0.001) blood vessels, when compared to those that did not report ACEs (Control group, n = 23). In addition, relationships between the number of ACEs and mPFC activation (rs = -0.428; P = 0.003) and peripheral vascular function (rs ≤ -0.373; P ≤ 0.009) were observed. Findings from the present study support that adults who experienced ACEs exhibit a reduced activation of the mPFC along with systemic vascular dysfunction. In addition, individuals exposed to more childhood traumatic events exhibited a progressively greater inactivation of the mPFC and an increased peripheral vasoconstriction in a dose-dependent manner. These findings provide novel insights into the potential role that the brain and the peripheral vasculature may have in connecting adverse childhood events to the increased risk of CVD.
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Affiliation(s)
| | - Jacob Looney
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA
| | - Marsha Blackburn
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA
| | - Jeffrey Thomas
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA
| | - Jennifer S Pollock
- School of Medicine, University of Alabama at Birmingham, Birmingham 35294, Alabama, USA
| | - Ryan A Harris
- Georgia Prevention Institute, Augusta University, Augusta 30912, Georgia, USA,Sport and Exercise Science Research Institute, University of Ulster, Jordanstown BT37 0QB, Northern Ireland, UK
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Salt sensitivity of blood pressure in childhood and adolescence. Pediatr Nephrol 2022; 37:993-1005. [PMID: 34327584 DOI: 10.1007/s00467-021-05178-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/07/2021] [Accepted: 06/12/2021] [Indexed: 10/20/2022]
Abstract
Although moderation of sodium intake is recommended population-wide, it remains uncertain who benefits from salt restriction. Salt sensitivity refers to changes in blood pressure in response to sodium intake and may occur with or without hypertension. Unfortunately, there is no practical way to assess salt sensitivity in daily practice. Assessment of salt sensitivity even in research studies is challenging with varying protocols utilized which may contribute to differing results. Building on studies in animals and adults, risk factors and conditions associated with salt sensitivity have been identified in the pediatric and young adult populations. This review presents the limited evidence linking obesity, low birth weight, diabetes, chronic kidney disease, and race/ethnicity with salt sensitivity in children, adolescents, and young adults. The impact of stress on sodium handling is also reviewed. The influence of age on the timing of introduction of dietary salt restriction and the long-term influence of salt sensitivity on risk for hypertension are considered. Lastly, interventions other than salt restriction that may improve salt sensitivity and may inform recommendations to families are reviewed.
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35
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Stannard S, Berrington A, Alwan NA. The mediating pathways between parental separation in childhood and offspring hypertension at midlife. Sci Rep 2022; 12:7062. [PMID: 35488035 PMCID: PMC9054745 DOI: 10.1038/s41598-022-11007-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/15/2022] [Indexed: 11/12/2022] Open
Abstract
Social life course determinants of adult hypertension are relatively unknown. This paper examines how parental separation before age 10 relates to hypertension at age 46. Adjusting for parental confounders and considering the role of adult mediators, we aim to quantify unexplored mediating pathways in childhood using prospectively collected data. Data from the 1970 British Birth Cohort Study are utilised. Hypertension is measured by health care professionals at age 46. Potential mediating pathways in childhood include body mass index (BMI), systolic and diastolic blood pressure, illness, disability, family socioeconomic status (SES) and cognitive and developmental indicators at age 10. Additionally, we explore to what extent childhood mediators operate through adult mediators, including health behaviours, family SES, BMI and mental wellbeing. We also test for effect modification of the relationship between parental separation and hypertension by gender. Nested logistic regression models test the significance of potential mediating variables. Formal mediation analysis utilising Karlson Holm and Breen (KHB) method quantify the direct and indirect effect of parental separation on offspring hypertension at midlife. There was an association between parental separation and hypertension in mid-life in women but not men. For women, family SES and cognitive and behavioural development indicators at age 10 partly mediate the relationship between parental separation and hypertension at age 46. When adult mediators including, health behaviours, family SES, BMI and mental wellbeing are included, the associations between the childhood predictors and adult hypertension are attenuated, suggesting that these childhood mediators in turn may work through adult mediators to affect the risk of hypertension in midlife. We found family SES in childhood, cognitive and behaviour development indicators at age 10, including disruptive behaviour, coordination and locus of control in childhood, to be important mediators of the relationship between parental separation and midlife hypertension suggesting that intervening in childhood may modify adult hypertension risk.
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Affiliation(s)
- Sebastian Stannard
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK. .,ESRC Centre for Population Change, University of Southampton, Southampton, UK.
| | - Ann Berrington
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK.,ESRC Centre for Population Change, University of Southampton, Southampton, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Applied Research Collaboration Wessex, Southampton, UK
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36
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Caceres BA, Britton LE, Cortes YI, Makarem N, Suglia SF. Investigating the associations between childhood trauma and cardiovascular health in midlife. J Trauma Stress 2022; 35:409-423. [PMID: 34800058 PMCID: PMC9035028 DOI: 10.1002/jts.22752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/11/2022]
Abstract
Growing evidence suggests that childhood trauma is associated with poorer cardiovascular health in adulthood, but few studies have examined potential mediators of these associations. We examined the links between different forms of childhood trauma (i.e., abuse, neglect, cumulative trauma) and cardiovascular health and explored potential mediators. Cross-sectional data from 1,251 participants in the National Survey of Midlife Development in the United States' II Biomarker Project were analyzed. Path analyses were conducted to examine the associations between childhood trauma and cardiovascular health (i.e., American Heart Association's Life's Simple 7 [LS7] score). Depressive symptoms and sleep quality were explored as potential mediators, and exploratory analyses examined whether these associations were moderated by sex. Women reported more severe childhood emotional and sexual abuse and emotional neglect, p < .001 to p = .018, and higher LS7 scores, p = .027, than men. Path analyses demonstrated the total effects of increasing severity of all forms of childhood trauma with LS7 scores were significant, and cumulative childhood trauma was inversely associated with LS7 score Bs = -0.306- -0.076, p < .001-p = .048. The range of total effects of different forms of childhood trauma on LS7 scores mediated by depressive symptoms and sleep quality was 26.8%-57.5%. Sex moderated the associations between all forms of childhood trauma and cardiovascular health. Longitudinal studies are needed that examine mediators of the associations between childhood trauma and cardiovascular health. Findings suggest sex-specific, trauma-informed approaches for cardiovascular disease prevention in adults exposed to childhood trauma may be needed.
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Affiliation(s)
- Billy A Caceres
- Columbia University School of Nursing, New York, New York, USA
| | - Laura E Britton
- Columbia University School of Nursing, New York, New York, USA
| | - Yamnia I Cortes
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Shakira F Suglia
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Desai A, Sutradhar R, Lau C, Lee DS, Nathan PC, Gupta S. Morbidity and health care use among siblings of children with cancer: A population-based study. Pediatr Blood Cancer 2022; 69:e29438. [PMID: 34786814 DOI: 10.1002/pbc.29438] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Childhood cancer impacts the entire family unit. We sought to investigate its impact on the long-term physical health outcomes of siblings of children with cancer. PROCEDURE Pediatric cancer patients diagnosed in Ontario, Canada between 1988 and 2016 were linked to biological siblings. Sibling cases were matched to population controls based on sex, age, geographic location, and number of other children in the family. After individual linkage to health services data, we compared several outcomes between sibling cases and controls: (a) physical health conditions (such as diabetes, hypertension, and death); (b) acute health care use (hospitalization, low- and high-acuity emergency department [ED] visits); and (c) preventive health care use (periodic health checkups, influenza vaccinations). Cox proportional hazards, recurrent event, or logistic regression models were used as appropriate. RESULTS We identified 8529 sibling cases and 30,364 matched controls (median age at index: 6 years, median age at last follow-up 17 years). Compared to controls, siblings were at increased risk of hypertension (hazard ratio [HR] 1.8; 95% confidence interval [CI] 1.1-2.9; p = .01), had higher rates of low- and high-acuity ED visits (rate ratio 1.1; 95% CI 1.1-1.2; p < .001), and increased risk of hospitalization (HR 1.1; 95% CI 1.1-1.2; p < .001). Sibling cases were also more likely to receive preventive health care (p < .05). CONCLUSION Increased risk of hypertension, high-acuity ED visits, and hospitalizations suggest that siblings may experience poorer health compared to controls. Counseling families about this potential increased risk and long-term follow-up of siblings to monitor their physical health may be justified.
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Affiliation(s)
- Aditi Desai
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Douglas S Lee
- ICES, Toronto, Ontario, Canada.,Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Paul C Nathan
- The Hospital for Sick Children, Division of Haematology/Oncology, Toronto, Ontario, Canada
| | - Sumit Gupta
- The Hospital for Sick Children, Division of Haematology/Oncology, Toronto, Ontario, Canada
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Kim YJ, Levantsevych OM, Elon L, Lewis TT, Suglia SF, Bremner JD, Quyyumi AA, Pearce B, Raggi P, Vaccarino V, Shah AJ. Early life stress and autonomic response to acute mental stress in individuals with coronary heart disease. J Trauma Stress 2022; 35:521-532. [PMID: 35032417 PMCID: PMC9109683 DOI: 10.1002/jts.22766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/20/2021] [Accepted: 08/27/2021] [Indexed: 11/06/2022]
Abstract
Early life stress (ELS) has been associated with an increased risk of cardiovascular disease. We examined whether ELS was associated with autonomic function and stress reactivity among individuals with coronary heart disease (CHD). We included patients with stable CHD from two parallel studies, the Mental Stress Ischemia Prognosis Study (MIPS) and the Myocardial Infarction and Mental Stress Study 2 (MIMS2), and assessed ELS using the Early Trauma Inventory-Self-Report-Short Form. Participants underwent a laboratory-based mental stress task while undergoing ambulatory electrocardiographic monitoring. We used multivariate linear regression models to estimate the associations between ELS and heart rate variability (HRV; low frequency [LF], high frequency [HF], and LF and HF [LH] ratio). The analytic sample included 405 MIPS and 284 MIMS2 participants. Most participants endorsed at least one experience of ELS (92.2%). Although we did not observe associations between ELS and HRV outcomes in the overall sample, ELS was associated with lower LH ratio HRV during recovery in the posttraumatic stress disorder (PTSD) subgroup, ELS x PTSD interaction, p = .041. In the MIMS2 subgroup, ELS was associated with lower resting period LF HRV, B ̂ $ \widehat{B} $ = -0.16 ln ms2 ; 95% CI [-0.31, -0.02]. Exposure to physical trauma was associated with decreased HF HRV overall reactivity only among participants with high to moderate depressive symptoms, B ̂ $ \widehat{B} $ = -0.52 ln ms2 vs. B ̂ $ \widehat{B} $ = 0.01 ln ms2 , p = .013. Overall, heterogeneous associations between ELS and HRV emerged, suggesting the need for additional research regarding longer-term ambulatory HRV.
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Affiliation(s)
- Ye Ji Kim
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Lisa Elon
- Department of Biostatistics, Rollins School of Public Health, Emory University Atlanta, Georgia, USA
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shakira F. Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - J. Douglas Bremner
- Departments of Psychiatry and Radiology and Center for Positron Emission Tomography, Emory University School of Medicine Atlanta, Georgia, USA
| | - Arshed A. Quyyumi
- Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia, USA
| | - Bradley Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA, Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA, Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia, USA
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Xu L, Zimmermann M, Forkey H, Griffin J, Wilds C, Morgan WS, Byatt N, McNeal CJ. How to Mitigate Risk of Premature Cardiovascular Disease Among Children and Adolescents with Mental Health Conditions. Curr Atheroscler Rep 2022; 24:253-264. [PMID: 35320835 PMCID: PMC8940585 DOI: 10.1007/s11883-022-00998-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/26/2022]
Abstract
Purpose of Review The goal of this article is to characterize the myriad of ways that children with mental health conditions can be at risk for premature cardiovascular disease (CVD) and various modalities to ameliorate this risk in childhood in order to improve the life course of these children. Review Findings Child and adolescent mental health conditions are a common yet underrecognized risk factor for premature CVD. The American Heart Association has recently included psychiatric conditions as a CVD risk factor (CVDRF) and the evidence linking childhood adversity to cardiometabolic disease. There are bidirectional and additive effects from the intrinsic emotional dysregulation and inflammatory changes from the mental health condition, the associations with risky health behaviors, and in some cases, metabolic side effects from pharmacotherapy. These pathways can be potentiated by toxic stress, a physiologic response to stressors from childhood adversity. Toxic stress is also associated with development of mental health conditions with epigenetic effects that can result in transgenerational inheritance of cardiometabolic risk. Exposure to toxic stress and mental health conditions in isolation sometimes compounded by pharmacotherapies used in treatment increase the risk of cardiometabolic diseases in childhood. The multiple pathways, which adversely influence cardiometabolic outcomes, encourage clinicians to consider strategies to mitigate these factors and justify the importance of early screening and treatment for CVDRFs. Summary Mental health, health behaviors, and environmental factors co-occur and intersect in complex pathways that can increase CVD risk over the lifespan. Early detection and response can mitigate the risks associated with premature development of CVD.
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Affiliation(s)
- Lulu Xu
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Martha Zimmermann
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Heather Forkey
- Department of Pediatrics, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Jessica Griffin
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
- Department of Pediatrics, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Caitlin Wilds
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
- Boston Child Study Center, Boston, MA, 02116, USA
| | - Wynne S Morgan
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Nancy Byatt
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Catherine J McNeal
- Division of Cardiology, Department of Internal Medicine, Baylor Scott & White Health, Temple, TX, 76508, USA.
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40
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Datta B, Tiwari A. Adding to her woes: child bride's higher risk of hypertension at young adulthood. J Public Health (Oxf) 2022:6543034. [PMID: 35257178 DOI: 10.1093/pubmed/fdac026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/10/2021] [Accepted: 02/01/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Child marriage is associated with various adverse socio-economic and pregnancy outcomes. However, there remains a dearth of research on the long-term health implications of child marriage. As such, this study sought to expand upon the growing literature on child marriage, specifically examining the associations between child marriage and hypertension during young adult age. METHODS We obtained data of 5369 women aged 20-34 from the Tajikistan Demographic and Health Survey 2017. Using multivariable logistic regression framework, we estimated the adjusted odds in favor of being hypertensive for women who were married before the age of 18. We also explored the presence of several stressors to understand the role of probable medication factors. RESULTS We found that the odds of being hypertensive for young adult women married before the age of 18 were 1.6 (95% confidence interval: 1.1-2.4) times that of those who were not. Likelihood of having stressors, such as pregnancy loss or child death, marital control and spousal violence, was found higher among child brides compared to their peers. CONCLUSIONS Findings suggest that child marriage may increase the risk of hypertension among young adult women. This work reinforces recommendations by the United Nations to the end child marriage.
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Affiliation(s)
- B Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA 30912, USA.,Department of Population Health Sciences, Medical College of Georgia, Augusta University, GA 30912, USA
| | - A Tiwari
- Institute of Public and Preventive Health, Augusta University, Augusta, GA 30912, USA
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41
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Brindle RC, Pearson A, Ginty AT. Adverse childhood experiences (ACEs) relate to blunted cardiovascular and cortisol reactivity to acute laboratory stress: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 134:104530. [PMID: 35031343 DOI: 10.1016/j.neubiorev.2022.104530] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/08/2021] [Accepted: 01/09/2022] [Indexed: 12/24/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with poor future mental and physical health. Altered biological reactivity to mental stress may be a possible mechanism linking ACEs to poor health. However, it is not clear if ACEs relate to blunted or exaggerated stress reactivity. This meta-analysis aimed to determine whether exposure to ACEs is associated with cardiovascular and cortisol stress reactivity. A systematic review yielded 37 sources. Random-effects modelling tested the aggregate effects of 83 studies of the association between ACEs and stress reactivity. Exposure to ACEs was associated with relatively blunted cardiovascular and cortisol stress reactivity. Effect sizes did not vary as a function of sample sex or reactivity measure (e.g., heart rate, blood pressure, or cortisol). Meta-regression revealed preliminary evidence of greater blunting in samples of a younger age and samples reporting greater ACE exposure. Subgroup analyses for stress task, ACE measurement instrument, and sample race were not conducted because of a lack of between-study variability. Exposure to ACEs is associated with dysregulation of multiple components of the human stress response system.
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Affiliation(s)
- Ryan C Brindle
- Department of Cognitive and Behavioral Science, Washington and Lee University, Lexington, VA, United States; Neuroscience Program, Washington and Lee University, Lexington, VA, United States.
| | - Alexandra Pearson
- Department of Cognitive and Behavioral Science, Washington and Lee University, Lexington, VA, United States
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
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42
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He J, Yan X, Wang R, Zhao J, Liu J, Zhou C, Zeng Y. Does Childhood Adversity Lead to Drug Addiction in Adulthood? A Study of Serial Mediators Based on Resilience and Depression. Front Psychiatry 2022; 13:871459. [PMID: 35509889 PMCID: PMC9058108 DOI: 10.3389/fpsyt.2022.871459] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/16/2022] [Indexed: 11/18/2022] Open
Abstract
Drug addiction is a common problem worldwide. Research has shown adverse childhood experiences (ACEs) to be an important factor related to drug addiction. However, there are few studies on how ACEs lead to drug addiction and the role of resilience and depression in this process. Thus, the main purposes of the study were to determine the proportion of those with adverse childhood experiences who take drugs in adulthood and how resilience and depression affect this relationship. The results showed that (1) greater severity of ACEs made individuals more likely to take drugs; (2) ACEs were positively correlated with depression, and resilience was negatively correlated with ACEs and depression; and (3) ACEs not only affected drug addiction through resilience or depression alone but also through the combined action of resilience and depression, indicating that depression led to drug addiction while resilience weakened the effect of ACEs on depression and drug addiction. Furthermore, in the serial mediation model, abuse, neglect, and family dysfunction were significant predictors of drug addiction. Our results are encouraging in that they provide guidance in understanding the complex relationships among ACEs, resilience, depression, and drug addiction.
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Affiliation(s)
- Jingzhen He
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyu Yan
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Rufang Wang
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juyou Zhao
- Rehabilitation Department, Sichuan Drug Rehabilitation Administration, Chengdu, China
| | - Jun Liu
- Rehabilitation Department, Sichuan Drug Rehabilitation Administration, Chengdu, China
| | - Changwei Zhou
- Psychological Correction Center, Sichuan Ziyang Drug Rehabilitation Center, Ziyang, China
| | - Yumei Zeng
- Psychological Correction Center, Sichuan Ziyang Drug Rehabilitation Center, Ziyang, China
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43
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Goncalves Soares A, Zimmerman A, Zammit S, Karl A, Halligan SL, Fraser A. Abuse in Childhood and Cardiometabolic Health in Early Adulthood: Evidence From the Avon Longitudinal Study of Parents and Children. J Am Heart Assoc 2021; 10:e021701. [PMID: 34873916 PMCID: PMC9075220 DOI: 10.1161/jaha.121.021701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Although childhood abuse has been consistently associated with cardiovascular disease in later adulthood, its associations with cardiometabolic health in younger adults are poorly understood. We assessed associations between childhood physical, sexual, and psychological abuse and cardiometabolic outcomes at 18 and 25 years. Methods and Results We used data on 3223 participants of the ALSPAC (Avon Longitudinal Study of Parents and Children). Exposure to childhood abuse was self-reported retrospectively at 22 years. We used linear regression to assess the associations between childhood abuse and cardiometabolic outcomes at 18 and 25 years. At 18 years, physical (β 1.35 kg/m2; 95% CI, 0.66-2.05), sexual (β 0.57 kg/m2; 95% CI 0.04-1.11), and psychological (β 0.47 kg/m2; 95% CI 0.01-0.92) abuse were associated with higher body mass index. Physical abuse was also associated with lower high-density lipoprotein cholesterol (β -0.07 mmol/L; 95% CI, -0.13 to -0.01) and higher C-reactive protein (31%; 95% CI, 1%-69%), and sexual abuse was associated with higher heart rate (β 1.92 bpm; 95% CI 0.26-3.58). At age 25, all 3 types of abuse were additionally associated with higher insulin, and sexual abuse was associated with lower cholesterol (-0.14 mmol/L; 95% CI, -0.26 to -0.01). The age at which abuse occurred (<11or 11-17 years) had little influence on the associations, and when sex differences were evident, associations were stronger in men. Conclusions Childhood abuse is associated with negative cardiometabolic outcomes even by young adulthood. Further follow-up will determine whether associations strengthen across the life course and whether sex differences persist, which is essential for targeting effective screening programs and early interventions in those who suffered abuse in childhood.
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Affiliation(s)
- Ana Goncalves Soares
- Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom.,MRC Integrative Epidemiology Unit at the University of Bristol Bristol United Kingdom
| | - Annie Zimmerman
- Health Service & Population Research King's College London London United Kingdom
| | - Stan Zammit
- Division of Psychological Medicine and Clinical Neurosciences MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University Cardiff United Kingdom.,Centre for Academic Mental Health Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom
| | - Anke Karl
- Mood Disorders Centre University of Exeter Exeter United Kingdom
| | - Sarah L Halligan
- Department of Psychology University of Bath Bath United Kingdom.,Department of Psychiatry and Mental Health University of Cape Town Cape Town South Africa
| | - Abigail Fraser
- Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom.,MRC Integrative Epidemiology Unit at the University of Bristol Bristol United Kingdom
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44
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Brown MJ, Kaur A, James T, Avalos C, Addo PNO, Crouch E, Hill NL. Adverse Childhood Experiences and Subjective Cognitive Decline in the US. J Appl Gerontol 2021; 41:1090-1100. [PMID: 34898321 DOI: 10.1177/07334648211058718] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the association between adverse childhood experiences (ACEs) and subjective cognitive decline (SCD) among a representative sample of the adult US population. METHODS Data were obtained from the 2019 Behavioral Risk Factor Surveillance System (N = 82,688, ≥45 years). Adverse childhood experiences included sexual, physical/psychological and environmental ACEs, and a score. Multivariable logistic regression was used to determine the association between ACEs and SCD, and SCD-related outcomes. RESULTS Sexual (adjusted OR (aOR: 2.83; 95% CI: 2.42-3.31)), physical/psychological (aOR: 2.05; 95% CI: 1.83-2.29), and environmental (aOR: 1.94; 95% CI: 1.74-2.16) ACEs were associated with SCD in the past year. There was also a dose-response relationship between ACE score and SCD. CONCLUSION ACEs were associated with SCD. Interventions to maximize cognitive health in aging and prevent future cognitive impairment should consider the potential role of ACEs among affected populations.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,Office of the Study on Aging, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Titilayo James
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Carlos Avalos
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Prince N O Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,Department of Health Services Policy and Management, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Nikki L Hill
- College of Nursing, Pennsylvania State University, University Park, PA, USA
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45
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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: 10] [Impact Index Per Article: 3.3] [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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46
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Hao G, Halbert J, Su S, Bagi Z, Robinson V, Thayer J, Harshfield G, Kapuku G. Rapid decline of resting heart rate trajectories from childhood to young adulthood is paradoxically associated with increased cardiac mass. Acta Cardiol 2021; 76:1117-1123. [PMID: 33557704 DOI: 10.1080/00015385.2020.1871262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Little is known about the varied resting heart rate (RHR) trajectory patterns from childhood to young adulthood and their clinical significance. We aim to identify RHR trajectories from childhood to young adulthood, and to determine their relationship with left ventricular mass (LVM) index. METHODS RHR was measured up to 15 times over a 21-year period in 759 participants from childhood to young adulthood. LVM was measured using echocardiography and was normalised to body surface area to obtain LVM index in 546 participants. RESULTS Using latent class models, three trajectory groups in RHR from childhood to young adulthood were identified, including high-decreasing group (HDG), moderate-decreasing group (MDG), and low-decreasing group (LDG). We found that trajectory of RHR was a significant predictor of LVM index with faster decrease of RHR associated with higher levels of total peripheral resistance (P for trend <0.001) and LVM index (P for trend <0.001). Compared to the LDG, individuals in the HDG showed higher LVM index (β = 6.08, p < 0.001). In addition, the interactions between race and RHR trajectories for LVM index was significant (p < 0.05). CONCLUSION Our findings show an association between RHR trajectories from childhood to young adulthood with cardiac mass, suggesting that monitoring RHR may help identify subpopulation at high cardiovascular risk.
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Affiliation(s)
- Guang Hao
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - James Halbert
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Shayong Su
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Zsolt Bagi
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Vincent Robinson
- Division of Cardiology, Department of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Julian Thayer
- Department of Psychology and Neurosciences, The Ohio State University, Columbus, OH, USA
| | - Gregory Harshfield
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Gaston Kapuku
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.,Division of Cardiology, Department of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
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47
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Abstract
Cardiovascular disease risk is evident during childhood for patients with juvenile systemic lupus erythematosus, juvenile dermatomyositis, and juvenile idiopathic arthritis. The American Heart Association defines cardiovascular health as a positive health construct reflecting the sum of protective factors against cardiovascular disease. Disease-related factors such as chronic inflammation and endothelial dysfunction increase cardiovascular disease risk directly and through bidirectional relationships with poor cardiovascular health factors. Pharmacologic and nonpharmacologic interventions to improve cardiovascular health and long-term cardiovascular outcomes in children with rheumatic disease are needed.
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48
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Ernst B, Su S, Treiber F, Snieder H, Wang X. Diurnal Cortisol Slope and Nighttime Blood Pressure: A Study in European Americans and African Americans. Ethn Dis 2021; 31:481-488. [PMID: 34720551 DOI: 10.18865/ed.31.4.481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives African Americans (AAs) have higher nighttime blood pressure (BP) than European Americans (EAs). Stress has been suggested to play a role in this difference, but the mechanism is not well-understood. Flatter diurnal cortisol slope (DCS) is a well-known biological marker of stress. The objectives of this study were to: 1) examine ethnic differences in DCS; 2) evaluate the association between DCS and nighttime BP; and 3) determine the extent to which ethnic differences in nighttime BP can be explained by ethnic differences in DCS. Methods A total of 510 participants (age range: 14-35 years; 49.6% AAs, 54.5% females) provided four salivary cortisol samples at bedtime, wakeup, 30-minutes post-wakeup, and 60-minutes post-wakeup. Additionally, participants wore an ambulatory BP monitor for 24 hours. DCS was calculated as the average of the three morning samples minus the bedtime measurement. Results After adjustment for age, sex, BMI, and smoking, AAs had blunted DCS (P=.018) and higher nighttime systolic BP (SBP) and diastolic BP (DBP) (Ps<.001) compared with EAs. The DCS was inversely related to nighttime SBP and this relationship did not depend on ethnicity. The ethnic difference of nighttime SBP was significantly attenuated upon addition of DCS to the model. Mediation test showed that 9.5% of ethnic difference in nighttime SBP could be explained by DCS (P=.039). Conclusion This study confirms ethnic differences in DCS and nighttime BP and further demonstrates that the ethnic differences in DCS can, at least partially, explain the ethnic differences found in nighttime BP.
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Affiliation(s)
- Brooke Ernst
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Shaoyong Su
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Frank Treiber
- College of Nursing, Medical University of South Carolina, Charleston, SC
| | - Harold Snieder
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA.,Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Xiaoling Wang
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA
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Munezero T, Tomita A. Hypertension and Its Associated Mental Health Challenges Among Female African Refugees in Durban, South Africa. J Nerv Ment Dis 2021; 209:802-808. [PMID: 34310523 DOI: 10.1097/nmd.0000000000001387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Hypertension is a serious medical condition that leads to various adverse health complications when left untreated. In addition to psychological challenge that female migrant refugees are exposed to premigration, they encounter barriers to care postmigration from xenophobia that affects their hypertension. We investigated the extent and mental health drivers of hypertension in refugees in Durban, South Africa. We interviewed 178 adult female African help-seeking refugees/migrants for hypertension (blood pressure ≥130/90 mm Hg) and mental health challenges (e.g., adverse childhood experience [ACE] and depression using the Center for Epidemiologic Studies-Depression scale). Eighty-six percent (n = 153) of participants were hypertensive, and based on the adjusted regression models, exposure to at least one ACE (adjusted odds ratio [aOR], 2.83; 95% confidence interval [CI], 1.11-7.26) and depression (aOR, 3.54; 95% CI, 1.10-11.37) were associated with hypertension, independent of smoking, alcohol, obesity, and physical exercise status. Hypertension and its associated mental health challenges are overlooked conditions in this population, with further efforts for screening being needed.
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50
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Dalmasso C, Leachman JR, Ghuneim S, Ahmed N, Schneider ER, Thibault O, Osborn JL, Loria AS. Epididymal Fat-Derived Sympathoexcitatory Signals Exacerbate Neurogenic Hypertension in Obese Male Mice Exposed to Early Life Stress. Hypertension 2021; 78:1434-1449. [PMID: 34601958 PMCID: PMC8516729 DOI: 10.1161/hypertensionaha.121.17298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/19/2021] [Indexed: 01/06/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Carolina Dalmasso
- Department of Pharmacology and Nutritional Sciences, College of Medicine (C.D., J.R.L., S.G., N.A., O.T., A.S.L.), University of Kentucky, Lexington
| | - Jacqueline R. Leachman
- Department of Pharmacology and Nutritional Sciences, College of Medicine (C.D., J.R.L., S.G., N.A., O.T., A.S.L.), University of Kentucky, Lexington
| | - Sundus Ghuneim
- Department of Pharmacology and Nutritional Sciences, College of Medicine (C.D., J.R.L., S.G., N.A., O.T., A.S.L.), University of Kentucky, Lexington
| | - Nermin Ahmed
- Department of Pharmacology and Nutritional Sciences, College of Medicine (C.D., J.R.L., S.G., N.A., O.T., A.S.L.), University of Kentucky, Lexington
| | - Eve R. Schneider
- Department of Biology, College of Arts and Sciences (E.R.S., J.L.O.), University of Kentucky, Lexington
| | - Olivier Thibault
- Department of Pharmacology and Nutritional Sciences, College of Medicine (C.D., J.R.L., S.G., N.A., O.T., A.S.L.), University of Kentucky, Lexington
| | - Jeffrey L. Osborn
- Department of Biology, College of Arts and Sciences (E.R.S., J.L.O.), University of Kentucky, Lexington
| | - Analia S. Loria
- Department of Pharmacology and Nutritional Sciences, College of Medicine (C.D., J.R.L., S.G., N.A., O.T., A.S.L.), University of Kentucky, Lexington
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