Childhood adversities as predictors of incident coronary heart disease and cerebrovascular disease.
BACKGROUND
Studies suggest that childhood adversities are important determinants of various types of later illnesses as well as poor health behaviour. However, few large-scale prospective studies have examined the associations between childhood adversities and cardiovascular disease.


OBJECTIVE
To investigate whether childhood adversities are associated with increased risk of incident cardiovascular disease.


METHODS
Participants were 23 916 men and women in four age groups (20-24, 30-34, 40-44, and 50-54 years) from the Health and Social Support study, a longitudinal study on a random sample representative of the Finnish population. Data from national health registers on coronary heart disease and cerebrovascular disease during a mean follow-up of 6.9 years were linked to survey responses on childhood adversities. Cox proportional hazard models were adjusted for age group and potential mediators (education, health risk behaviours, diabetes and depression).


RESULTS
There was a significant linear trend between the number of childhood adversities and disease end points in women. The risk of incident cardiovascular disease was threefold among women exposed concurrently to three types of childhood adversities (financial difficulties, interpersonal conflicts and longstanding illness of a family member). Among men, increased risk was observed only among those with longstanding illness of a family member (HR=1.44; 95% CI 1.06 to 1.96).


CONCLUSIONS
In this prospective population-based sample, childhood adversities were associated with a significantly increased risk of objectively verified cardiovascular disease, especially among women but to a lesser extent among men. More studies with prospective settings are needed to confirm the association and possible mechanisms.
Korkeila
Jyrki
J
Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700 Turku, Finland. jyrki.korkeila@utu.fi
Vahtera
Jussi
J
Korkeila
Katariina
K
Kivimäki
Mika
M
Sumanen
Markku
M
Koskenvuo
Karoliina
K
Koskenvuo
Markku
M
D000328:Adult; D017677:Age Distribution; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D003327:Coronary Disease / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D055815:Young Adult