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Adverse Childhood Experiences Increase Risk for Ischemic Heart Disease

People with early-life trauma, particularly those who develop depression, must be considered at risk for development of IHD.

The search continues for factors that increase the risk for ischemic heart disease (IHD), a major cause of morbidity and mortality. These researchers used data from the Adverse Childhood Experiences (ACEs) Study to determine whether untoward events early in life are associated with an increased risk for IHD. The data were obtained from the records of 17,337 adult health plan members in California. Early-life traumas included child abuse, neglect, and household dysfunction.

Nine of the 10 categories of ACEs significantly increased the risk for IHD 1.3- to 1.7-fold, compared with no ACEs; the analysis was adjusted for age, sex, race, and education. Risks increased with the number of trauma categories experienced; remarkably, for individuals with seven or more ACEs, the odds ratio was 3.6. The magnitude of the effect of early-life trauma was as strong as the previously reported effects of depression and anger and of traditional risk factors (smoking, inactivity, obesity, diabetes, and hypertension). In a model accounting for these emotional and traditional risk factors, the risks for IHD were still elevated by ACEs.

Comment: This study represents an entirely new direction for research into the causality of IHD, and the findings provide additional links between early-life trauma, development of depression, and risk for cardiovascular disease. Individuals with early-life trauma, particularly those who develop depression, must be considered an at-risk group for development of IHD. The mechanism by which early trauma increases risk for heart disease is an area of intense current research.

— Charles Nemeroff, MD, PhD

Published in Journal Watch Psychiatry October 21, 2004

Citation(s):

Dong M et al. Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study. Circulation 2004 Sep 28; 110:1761-6.

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