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. 2010 Feb;22(1):19-28.

Early childhood adversity and later hypertension: data from the World Mental Health Survey

Dan J Stein  1 , Kate Scott, Josep M Haro Abad, Sergio Aguilar-Gaxiola, Jordi Alonso, Matthias Angermeyer, Koen Demytteneare, Giovanni de Girolamo, Noboru Iwata, José Posada-Villa, Viviane Kovess, Carmen Lara, Johan Ormel, Ronald C Kessler, Michael Von Korff
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Early childhood adversity and later hypertension: data from the World Mental Health Survey

Dan J Stein et al. Ann Clin Psychiatry. 2010 Feb.

Abstract

Background: Although many studies have indicated that psychosocial factors contribute to hypertension, and that early childhood adversity is associated with long-term adverse mental and physical health sequelae, the association between early adversity and later hypertension is not well studied.

Method: Data from 10 countries participating in the World Health Organization (WHO) World Mental Health (WHM) Surveys (N = 18,630) were analyzed to assess the relationship between childhood adversity and adult-onset hypertension, as ascertained by self-report. The potentially mediating effect of early-onset depression-anxiety disorders, as assessed by the WHM Survey version of the International Diagnostic Interview (WMH-CIDI), on the relationship between early adversity and hypertension was also examined.

Results: Two or more early childhood adversities, as well as early-onset depression-anxiety, were significantly associated with hypertension. A range of specific childhood adversities, as well as early-onset social phobia and panic/agoraphobia, were significantly associated with hypertension. In multivariate analyses, the presence of 3 or more childhood adversities was associated with hypertension, even when early-onset depression-anxiety or current depression-anxiety was included in the model.

Conclusions: Although caution is required in the interpretation of self-report data on adult-onset hypertension, the results of this study further strengthen the evidence base regarding the role of psychosocial factors in the pathogenesis of hypertension.

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Figures

FIGURE 1
FIGURE 1
Kaplan-Meier curve for the cumulative percentage of onset of hypertension by age for persons with 0, 1, or 2+ childhood adversities
FIGURE 2
FIGURE 2
Kaplan-Meier curve for the cumulative percentage of hypertension onset by age for persons with vs without early-onset depression-anxiety disorders
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