Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Post Box 2099, 1014 Copenhagen, Denmark.
Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark.
Eur Heart J. 2023 Feb 14;44(7):586-593. doi: 10.1093/eurheartj/ehac607.
To examine the effect of childhood adversity on the development of cardiovascular disease (CVD) between ages 16 and 38, specifically focusing on ischaemic heart disease and cerebrovascular disease.
Register data on all children born in Denmark between 1 January 1980 and 31 December 2001, who were alive and resident in Denmark without a diagnosis of CVD or congenital heart disease until age 16 were used, totalling 1 263 013 individuals. Cox proportional hazards and Aalen additive hazards models were used to estimate adjusted hazard ratios (HRs) and adjusted hazard differences of CVD from ages 16 to 38 in five trajectory groups of adversity experienced between ages 0 and 15. In total, 4118 individuals developed CVD between their 16th birthday and 31 December 2018. Compared with those who experienced low levels of adversity, those who experienced severe somatic illness and death in the family (men: adjusted HR: 1.6, 95% confidence interval: 1.4-1.8, women: 1.4, 1.2-1.6) and those who experienced very high rates of adversity across childhood and adolescence (men: 1.6, 1.3-2.0, women: 1.6, 1.3-2.0) had a higher risk of developing CVD, corresponding to 10-18 extra cases of CVD per 100 000 person-years in these groups.
Individuals who have been exposed to childhood adversity are at higher risk of developing CVD in young adulthood compared to individuals with low adversity exposure. These findings suggest that interventions targeting the social origins of adversity and providing support for affected families may have long-term cardio-protective effects.
探讨儿童期逆境对 16 至 38 岁人群心血管疾病（CVD）发展的影响，特别是关注缺血性心脏病和脑血管疾病。
本研究使用了丹麦在 1980 年 1 月 1 日至 2001 年 12 月 31 日期间出生的所有儿童的登记数据，这些儿童在 16 岁之前存活并居住在丹麦，没有 CVD 或先天性心脏病的诊断，总计 1263013 人。使用 Cox 比例风险和 Aalen 加法风险模型来估计 16 岁至 38 岁期间五个逆境轨迹组的 CVD 调整后风险比（HR）和调整后风险差异。共有 4118 人在 16 岁生日至 2018 年 12 月 31 日期间发生 CVD。与经历低水平逆境的人相比，经历严重躯体疾病和家庭死亡的人（男性：调整后的 HR：1.6，95%置信区间：1.4-1.8，女性：1.4，1.2-1.6）和经历儿童期和青春期高逆境率的人（男性：1.6，1.3-2.0，女性：1.6，1.3-2.0）发生 CVD 的风险更高，这些组每 10 万人年发生 CVD 的额外病例数为 10-18 例。
与低逆境暴露的个体相比，暴露于儿童期逆境的个体在年轻成年时发生 CVD 的风险更高。这些发现表明，针对逆境的社会起源进行干预并为受影响的家庭提供支持可能具有长期的心脏保护作用。
