Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association

Shakira F Suglia, Karestan C Koenen, Renée Boynton-Jarrett, Paul S Chan, Cari J Clark, Andrea Danese, Myles S Faith, Benjamin I Goldstein, Laura L Hayman, Carmen R Isasi, Charlotte A Pratt, Natalie Slopen, Jennifer A Sumner, Aslan Turer, Christy B Turer, Justin P Zachariah, American Heart Association Council on Epidemiology and Prevention; Council on Cardiovascular Disease in the Young; Council on Functional Genomics and Translational Biology; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research, Shakira F Suglia, Karestan C Koenen, Renée Boynton-Jarrett, Paul S Chan, Cari J Clark, Andrea Danese, Myles S Faith, Benjamin I Goldstein, Laura L Hayman, Carmen R Isasi, Charlotte A Pratt, Natalie Slopen, Jennifer A Sumner, Aslan Turer, Christy B Turer, Justin P Zachariah, American Heart Association Council on Epidemiology and Prevention; Council on Cardiovascular Disease in the Young; Council on Functional Genomics and Translational Biology; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research

Abstract

Adverse experiences in childhood and adolescence, defined as subjectively perceived threats to the safety or security of the child's bodily integrity, family, or social structures, are known to be associated with cardiometabolic outcomes over the life course into adulthood. This American Heart Association scientific statement reviews the scientific literature on the influence of childhood adversity on cardiometabolic outcomes that constitute the greatest public health burden in the United States, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. This statement also conceptually outlines pathways linking adversity to cardiometabolic health, identifies evidence gaps, and provides suggestions for future research to inform practice and policy. We note that, despite a lack of objective agreement on what subjectively qualifies as exposure to childhood adversity and a dearth of prospective studies, substantial evidence documents an association between childhood adversity and cardiometabolic outcomes across the life course. Future studies that focus on mechanisms, resiliency, and vulnerability factors would further strengthen the evidence and provide much-needed information on targets for effective interventions. Given that childhood adversities affect cardiometabolic health and multiple health domains across the life course, interventions that ameliorate these initial upstream exposures may be more appropriate than interventions remediating downstream cardiovascular disease risk factor effects later in life.

Keywords: AHA Scientific Statements; adolescent; cardiovascular diseases; child; diabetes mellitus; hypertension; obesity; stress; trauma.

Conflict of interest statement

The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.

© 2017 American Heart Association, Inc.

Figures

Figure.
Figure.
Conceptual model of the relation between childhood adversities and cardiometabolic health.

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