Gooding Holly C, Milliren Carly E, Austin S Bryn, Sheridan Margaret A, McLaughlin Katie A
Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School,
Clinical Research Center, Boston Children's Hospital.
J Pediatr Psychol. 2016 Jan-Feb;41(1):5-14. doi: 10.1093/jpepsy/jsv040. Epub 2015 May 15.
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.
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.
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.
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.
童年创伤与成年人高血压有关。童年创伤是否会在发育早期预测血压升高尚不清楚。我们调查了儿童期虐待创伤是否与青少年血压有关。
样本包括145名13 - 17岁的青少年，40%曾遭受过儿童期虐待。参与者的平均年龄为14.93岁（标准差 = 1.33）；58%为女性。大多数人自我认定为非西班牙裔白人（43%），其余为非西班牙裔黑人（17%）、西班牙裔（17%）或其他/混合种族（23%）。我们使用既定的年龄/性别/身高特定临界值来确定样本中高血压前期和高血压的患病率。我们使用双样本t检验来检验虐待与静息收缩压（SBP）、舒张压（DBP）以及对特里尔社会应激测试和挫折任务时血压反应性之间的关联。我们使用线性回归来调整潜在的混杂因素，包括社会人口统计学变量、体重指数、吸烟和精神病理学。
有虐待史者的静息SBP和DBP均值分别为114.07 mmHg和61.35 mmHg，无虐待史者分别为111.39 mmHg和56.89 mmHg。仅DBP的这种差异具有统计学意义。12%的参与者根据静息血压值符合高血压前期或高血压标准；有虐待史和无虐待史者之间没有差异。儿童期虐待与对实验室应激任务时较低的DBP和SBP反应性以及对挫折时较低的DBP反应性有关。这些关联在调整潜在混杂因素后依然显著。
儿童期虐待与青少年较高的静息DBP以及对实验室应激时DBP和SBP反应性减弱有关。这些发现提示了儿童期虐待导致高血压的潜在途径。
