Adversity in childhood is associated with an increased risk of cardiovascular disease in early adulthood, new Danish research published today shows.
In what is the largest study to date to assess the links between childhood adversity and CVD, a team from the University of Copenhagen used data from the DANish LIFE course (DANLIFE) cohort, which includes continuously recorded information from numerous nationwide registers.
They identified 1,263,013 children who were living in Denmark until their 16th birthday and who were not diagnosed with CVD or congenital heart disease during this time.
The children were born between January 1980 and December 2001 and they were followed up until 31 December 2018.
Writing in European Heart Journal, the team said during this time 4,118 developed CVD between their 16th birthday and the end of 2018, by which time the oldest were 38 years old.
Senior study author Professor Naja Hulvej Rod, head of epidemiology at the Department of Public Health, said when compared to, they found young adults who had experienced adversity had about a 60% higher risk of developing cardiovascular disease than young adults who experienced little adversity.
This was particularly true for those who had experienced serious illnesses, such as cancer, heart or lung diseases, or death in the family, and those who had experienced high and accelerating levels of adversity in childhood, he said.
Those figures correspond to 10 to 18 extra cases of CVD per 100,000 person years. The average incidence rate of CVD among 30-year-olds is about 50 cases of CVD per 100,000 person-years.
Prof Rod said: “The association we saw between childhood adversity and CVD in early adulthood may be explained partly by behaviours that can affect health, such as drinking alcohol, smoking and physical inactivity.
“Childhood is a sensitive period characterised by rapid cognitive and physical developments; the frequent and chronic exposure to adversity in childhood may influence the development of the physiological stress response, and this may provide an important explanation for the mechanisms underlying these findings.”
The research team divided the children into five groups based on adversity experienced between the ages of 0 and 15, with those in group one experiencing low adversity during childhood and those in group five having high adversity.
After adjusting for risk factors, they found there was little difference in the risk of developing CVD between the 2,195 men and 1,923 women in the study, but the risk was highest among people who experienced severe illness or death in the family and among those who experienced high and increasing rates of adversity throughout childhood and adolescence.
Prof Rod concluded: “The incidence of CVD is low in early adult life but increases substantially during this period. This highlights the importance of research into non-genetic early life risk factors, which may be targeted for early prevention.
“The experience of adversity is common among children, and, in this study, we show that children who experience long-term and severe stress from serious illnesses and death in the family, and children who are exposed to high rates of adversity, including deprivation, family loss, and dysfunctional and stressful family relationships, have a higher risk of developing CVD in early adulthood.
“Targeting the social origins of such adversity and ensuring supportive structures for families who are, for example, struggling with disease in the family may potentially carry long-term protective effects.”
The researchers are planning to investigate the possible underlying mechanisms for their findings to help towards their understanding of the impact of childhood adversity on CVD prognosis and survival.
This will include access to health care, possible non-compliance with treatments, and other health problems among children from socially difficult backgrounds.
Bengtsson J, Elsenberg LK, Andersen GS et al. Childhood adversity and cardiovascular disease in early adulthood: a Danish cohort study”. European Heart Journal 15 November 2022
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