title: Adverse childhood experiences and blood pressure trajectories from childhood to young adulthood: the Georgia stress and Heart study.
abstract: BACKGROUND
  The purposes of this study were to assess the long-term effect of adverse childhood experiences (ACEs) on blood pressure (BP) trajectories from childhood to young adulthood and to examine whether this relation is explained by childhood socioeconomic status (SES) or risk behaviors that are associated with ACEs.
  
  
  RESULTS
  Systolic and diastolic BPs were measured up to 16 times (13 times on average) over a 23-year period in 213 African Americans and 181 European Americans 5 to 38 years of age. Retrospective data on traumatic experiences before 18 years of age were collected, including abuse, neglect, and household dysfunction. Individual growth curve modeling within a multilevel framework was used to examine the relation between exposure to ACEs and BP development. No main effect of ACEs on average BP levels was found. However, a significant interaction of ACE score with age(3) was observed (systolic BP, P=0.033; diastolic BP, P=0.017). Subjects who experienced multiple traumatic events during childhood showed a faster rise in BP levels after 30 years of age than those without ACEs. As expected, a graded association of ACEs with childhood socioeconomic status and negative health behaviors was observed (P<0.001). The ACE-systolic BP relation was not explained by these factors, whereas the ACE-diastolic BP relation was partially mediated by illicit drug use.
  
  
  CONCLUSIONS
  In this novel longitudinal study, we observed that participants who were exposed to multiple ACEs displayed a greater increase in BP levels in young adulthood compared with their counterparts without ACEs.
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.). ssu@gru.edu.
authors: Shaoyong
authors: S
authors: Su
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: Xiaoling
authors: X
authors: Wang
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: Jennifer S
authors: JS
authors: Pollock
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: Frank A
authors: FA
authors: Treiber
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: Xiaojing
authors: X
authors: Xu
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: Harold
authors: H
authors: Snieder
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: W Vaughn
authors: WV
authors: McCall
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: Michael
authors: M
authors: Stefanek
authors: From Georgia Prevention Institute, Medical College of Georgia (S.S., X.W., X.X., G.A.H.), Department of Psychiatry and Health Behavior (W.V.M.), and Department of Psychological Sciences, College of Science and Mathematics (M.S.), Georgia Regents University, Augusta; Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham (J.S.P.); Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston (F.A.T.); and Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands (H.S.).
authors: Gregory A
authors: GA
authors: Harshfield
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001794:Blood Pressure; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002675:Child, Preschool; D054541:Family Conflict; D005260:Female; D005500:Follow-Up Studies; D005845:Georgia / Q000453:epidemiology; D006130:Growth Disorders / Q000453:epidemiology / Q000503:physiopathology; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000503:physiopathology; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: blood pressure; ethnic groups; life stress; longitudinal studies; youth