title: Child Abuse, Resting Blood Pressure, and Blood Pressure Reactivity to Psychosocial Stress.
abstract: OBJECTIVE
  Childhood trauma is associated with hypertension in adults. It is unknown whether childhood trauma predicts elevated blood pressure earlier in development. We investigated whether the trauma of child abuse was associated with blood pressure in adolescents.
  
  
  METHODS
  The sample included 145 adolescents aged 13-17 years, 40% with exposure to child abuse. The mean age of participants was 14.93 years (SD = 1.33); 58% were female. The majority self-identified as non-Hispanic White (43%), with the remainder identifying as non-Hispanic Black (17%), Hispanic (17%), or other/mixed race (23%). We used established age/sex/height-specific cutoffs to determine the prevalence of prehypertension and hypertension in the sample. We used two-sample t tests to examine associations of abuse with resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) and blood pressure reactivity to the Trier Social Stress Test and a frustration task. We used linear regression to adjust for potential confounders including sociodemographic variables, body mass index, smoking, and psychopathology.
  
  
  RESULTS
  Mean resting SBP and DBP were 114.07 mmHg and 61.35 mmHg in those with a history of abuse and 111.39 mmHg and 56.89 mmHg in those without a history of abuse. This difference was significant for DBP only. Twelve percent of participants met criteria for prehypertension or hypertension based on resting blood pressure values; this did not differ between those with and without an abuse history. Child abuse was associated with lower DBP and SBP reactivity to laboratory stress tasks and reduced DBP reactivity to frustration. These associations were robust to adjustment for potential confounders.
  
  
  CONCLUSIONS
  Child abuse is associated with higher resting DBP and blunted DBP and SBP reactivity to laboratory stress in adolescence. These findings suggest a potential pathway by which child abuse leads to hypertension.
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, holly.gooding@childrens.harvard.edu.
authors.forename: Holly C
authors.initials: HC
authors.lastname: Gooding
authors.affiliation: Clinical Research Center, Boston Children's Hospital.
authors.forename: Carly E
authors.initials: CE
authors.lastname: Milliren
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Department of Social and Behavioral Sciences, Harvard School of Public Health.
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
authors.affiliation: Department of Pediatrics, Harvard Medical School, Division of Developmental Medicine, Boston Children's Hospital, and.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Sheridan
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: Katie A
authors.initials: KA
authors.lastname: McLaughlin
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D016014:Linear Models; D008297:Male; D013315:Stress, Psychological / Q000503:physiopathology*
keywords: adolescent; child abuse/psychology; public health