Sex differences in the association between childhood maltreatment and cardiovascular disease in the UK Biobank

Heart. 2020 Sep;106(17):1310-1316. doi: 10.1136/heartjnl-2019-316320. Epub 2020 Jul 14.

Abstract

Objectives: To assess and compare associations between childhood maltreatment and cardiovascular disease (CVD) in men and women in the UK. In secondary analyses, we also explored possible age differences and associations with early onset CVD (<50 years).

Methods: We included 157 311 participants from the UK Biobank who had information on physical, sexual or emotional abuse, emotional or physical neglect. CVD outcomes were defined as any CVD, hypertensive disease, ischaemic heart disease (IHD) and cerebrovascular disease. These were extracted from self-report, blood pressure measurements, hospital register and death register. The associations between maltreatment and CVD were assessed using Poisson regression with robust variance to estimate risk ratios, stratified by sex and adjusted for socioeconomic and demographic factors.

Results: All types of maltreatment were associated with increased risk of CVD and IHD in both sexes. Additionally, in women all types of maltreatment were associated with higher risk of hypertensive disease, and all, except emotional neglect, were associated with cerebrovascular disease. In men, all but sexual abuse, were associated with higher risk of hypertensive disease, and all, except physical and sexual abuse, were associated with cerebrovascular disease. Associations were generally stronger in women, and individuals who were younger at baseline had stronger associations of childhood maltreatment with any CVD and IHD, but age differences were less evident when only early onset CVD was considered.

Conclusions: Childhood maltreatment was consistently associated with CVD and stronger associations were generally observed in women and seemed to be stronger for early onset CVD.

Keywords: cardiac risk factors and prevention; epidemiology; heart disease.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Adult Survivors of Child Abuse*
  • Age of Onset
  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Child
  • Child Abuse*
  • Child Abuse, Sexual
  • Emotional Abuse
  • Female
  • Health Status
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / epidemiology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • United Kingdom / epidemiology