Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Heart. 2020 Sep;106(17):1310-1316. doi: 10.1136/heartjnl-2019-316320. Epub 2020 Jul 14.
To assess and compare associations between childhood maltreatment and cardiovascular disease (CVD) in men and women in the UK. In secondary analyses, we also explored possible age differences and associations with early onset CVD (<50 years).
We included 157 311 participants from the UK Biobank who had information on physical, sexual or emotional abuse, emotional or physical neglect. CVD outcomes were defined as any CVD, hypertensive disease, ischaemic heart disease (IHD) and cerebrovascular disease. These were extracted from self-report, blood pressure measurements, hospital register and death register. The associations between maltreatment and CVD were assessed using Poisson regression with robust variance to estimate risk ratios, stratified by sex and adjusted for socioeconomic and demographic factors.
All types of maltreatment were associated with increased risk of CVD and IHD in both sexes. Additionally, in women all types of maltreatment were associated with higher risk of hypertensive disease, and all, except emotional neglect, were associated with cerebrovascular disease. In men, all but sexual abuse, were associated with higher risk of hypertensive disease, and all, except physical and sexual abuse, were associated with cerebrovascular disease. Associations were generally stronger in women, and individuals who were younger at baseline had stronger associations of childhood maltreatment with any CVD and IHD, but age differences were less evident when only early onset CVD was considered.
Childhood maltreatment was consistently associated with CVD and stronger associations were generally observed in women and seemed to be stronger for early onset CVD.
评估和比较英国男性和女性中儿童期虐待与心血管疾病（CVD）之间的关联。在二次分析中，我们还探讨了可能的年龄差异以及与早发性 CVD（<50 岁）的关联。
我们纳入了英国生物库中 157311 名参与者，这些参与者有身体、性或情感虐待、情感或身体忽视的信息。CVD 结局定义为任何 CVD、高血压疾病、缺血性心脏病（IHD）和脑血管疾病。这些结局是通过自我报告、血压测量、医院登记和死亡登记提取的。使用泊松回归和稳健方差来评估虐待与 CVD 之间的关联，以估计风险比，按性别分层，并调整社会经济和人口统计学因素。
所有类型的虐待都与男女 CVD 和 IHD 风险增加有关。此外，在女性中，所有类型的虐待都与高血压疾病风险增加有关，除情感忽视外，所有类型的虐待都与脑血管疾病有关。在男性中，除性虐待外，所有类型的虐待都与高血压疾病风险增加有关，除身体和性虐待外，所有类型的虐待都与脑血管疾病有关。在女性中，这些关联通常更强，在基线时年龄更小的个体中，儿童期虐待与任何 CVD 和 IHD 的关联更强，但当仅考虑早发性 CVD 时，年龄差异不太明显。
儿童期虐待与 CVD 密切相关，在女性中观察到的关联通常更强，并且似乎与早发性 CVD 的关联更强。
