LAUSR

Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, have been associated with increased risk of cardiovascular disease (CVD) in adulthood. Understanding how ACEs affects blood pressure during early life is key for the development of early interventions that may reduce the risk of future CVD. We hypothesized that exposure to ACEs is associated with detrimental hemodynamic parameters during adolescence. This study included 78 male and female adolescents (median age=16, range=13-18) recruited from Children’s of Alabama hospital. Exclusion criteria included cardiovascular or renal disease and antihypertensive medication. An oscillometric blood pressure (BP) monitor was used to measure 24-h ambulatory BP. ACE exposure was measured with the Adolescent Life Change Event (ALCES) questionnaire and was prevalent, with 65% (51 of 78) of participants experiencing 1 ACEs. The mean cumulative ACE score was 1.4±0.2. ACE exposure was not correlated with gender, race, age, or body mass index (BMI). Linear regression models were utilized to link ACE exposure (0 versus 1 ACEs) with 24-h mean arterial pressure (MAP), systolic BP (SBP), diastolic BP (DBP), and pulse wave velocity (PWV). Race and gender were included as covariates. Mean 24-h DBP was significantly (p=0.04) higher in participants with ACE exposure (65.9±0.7 mmHg, n=51) compared to those with no ACE exposure (64.1±0.9 mmHg, n=27); this association was independent of covariates. Since BMI was significantly correlated with SBP, PWV, and MAP, additional models included BMI as a covariate. Both ACE exposure (p= 0.02) and BMI (p<0.001) were associated with increased PWV, while the interaction between ACE exposure and BMI was negatively associated with PWV (p=0.02). Mean 24-h SBP and MAP were not significantly associated with ACE exposure. The finding that ACE exposure is associated with elevated DBP and PWV and not with SBP is in accordance with previously reported results in young adults and suggests that ACEs may alter autonomic pathways leading to CVD and hypertension. Interventions targeted at individuals with ACE exposure early in life could lower the risk of arterial stiffness and in turn the cascade of events leading to CVD.