Matthews Timothy A, Zhu Yifang, Robbins Wendie, Rezk-Hanna Mary, Macey Paul M, Song Yeonsu, Li Jian
Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA.
School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA.
Life (Basel). 2022 Sep 27;12(10):1507. doi: 10.3390/life12101507.
Hypertension is a key driver of cardiovascular diseases. However, how stressors contribute to the development of hypertension remains unclear. The objective of this study was to examine prospective associations of adverse childhood experiences (ACEs) and adulthood psychosocial disadvantages (APDs) with incident hypertension. Data were from the Mid-life in the United States (MIDUS) study, a national, population-based, prospective cohort study. ACEs were examined via retrospective reports, and APDs including work stress and social isolation were assessed using survey measures. Incident hypertension was defined based on self-reported physician diagnosis. Baseline data were collected in 1995, with follow-up in 2004-2006 and 2013-2014. Cox proportional hazards regression was applied to assess prospective associations of ACEs and APDs with incident hypertension in 2568 workers free from hypertension at baseline. After adjustment for covariates, baseline APDs were associated with increased incident hypertension (aHR and 95% CI = 1.48 [1.09, 2.01]) during a 20-year follow-up, whereas ACEs showed null associations. Moreover, a moderating effect by ACEs was observed-the effect of APDs on risk of hypertension was stronger when ACEs were present (aHR and 95% CI = 1.83 [1.17, 2.86]). These findings underscore the importance of psychosocial stressors as nontraditional risk factors of cardiometabolic disorders.
高血压是心血管疾病的关键驱动因素。然而，应激源如何导致高血压的发生仍不清楚。本研究的目的是探讨童年不良经历（ACEs）和成年期心理社会劣势（APDs）与高血压发病之间的前瞻性关联。数据来自美国中年（MIDUS）研究，这是一项基于全国人口的前瞻性队列研究。通过回顾性报告来研究ACEs，并使用调查方法评估包括工作压力和社会孤立在内的APDs。根据自我报告的医生诊断来定义高血压发病情况。1995年收集基线数据，2004 - 2006年和2013 - 2014年进行随访。应用Cox比例风险回归来评估2568名基线时无高血压的工作者中ACEs和APDs与高血压发病的前瞻性关联。在对协变量进行调整后，在20年的随访期间，基线APDs与高血压发病增加相关（调整后风险比和95%置信区间 = 1.48 [1.09, 2.01]），而ACEs则无关联。此外，观察到ACEs具有调节作用——当存在ACEs时，APDs对高血压风险的影响更强（调整后风险比和95%置信区间 = 1.83 [1.17, 2.86]）。这些发现强调了心理社会应激源作为心脏代谢紊乱非传统风险因素的重要性。
