title: Early childhood adversity and later hypertension: data from the World Mental Health Survey.
abstract: BACKGROUND
  Although many studies have indicated that psychosocial factors contribute to hypertension, and that early childhood adversity is associated with long-term adverse mental and physical health sequelae, the association between early adversity and later hypertension is not well studied.
  
  
  METHODS
  Data from 10 countries participating in the World Health Organization (WHO) World Mental Health (WHM) Surveys (N = 18,630) were analyzed to assess the relationship between childhood adversity and adult-onset hypertension, as ascertained by self-report. The potentially mediating effect of early-onset depression-anxiety disorders, as assessed by the WHM Survey version of the International Diagnostic Interview (WMH-CIDI), on the relationship between early adversity and hypertension was also examined.
  
  
  RESULTS
  Two or more early childhood adversities, as well as early-onset depression-anxiety, were significantly associated with hypertension. A range of specific childhood adversities, as well as early-onset social phobia and panic/agoraphobia, were significantly associated with hypertension. In multivariate analyses, the presence of 3 or more childhood adversities was associated with hypertension, even when early-onset depression-anxiety or current depression-anxiety was included in the model.
  
  
  CONCLUSIONS
  Although caution is required in the interpretation of self-report data on adult-onset hypertension, the results of this study further strengthen the evidence base regarding the role of psychosocial factors in the pathogenesis of hypertension.
authors.affiliation: Department of Psychiatry, University of Cape Town, Groote Schur Hospital, Anzio Road, Cape Town, South Africa. dan.stein@uct.ac.za
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Kate
authors.initials: K
authors.lastname: Scott
authors.forename: Josep M
authors.initials: JM
authors.lastname: Haro Abad
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Matthias
authors.initials: M
authors.lastname: Angermeyer
authors.forename: Koen
authors.initials: K
authors.lastname: Demytteneare
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Noboru
authors.initials: N
authors.lastname: Iwata
authors.forename: José
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess
authors.forename: Carmen
authors.initials: C
authors.lastname: Lara
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D015984:Causality; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000523:psychology; D008016:Life Change Events; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology; D010698:Phobic Disorders / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D012650:Self Disclosure; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult