Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr:169:107457.
doi: 10.1016/j.ypmed.2023.107457. Epub 2023 Feb 20.

Less than ideal cardiovascular health among adults is associated with experiencing adverse childhood events: BRFSS 2019

Donald K Hayes  1 , Jennifer L Wiltz  2 , Jing Fang  3 , Fleetwood Loustalot  4
Affiliations

Less than ideal cardiovascular health among adults is associated with experiencing adverse childhood events: BRFSS 2019

Donald K Hayes et al. Prev Med. 2023 Apr.

Abstract

Ideal cardiovascular health (CVH) is associated with a lower risk of heart disease and stroke while adverse childhood events (ACEs) are related to health behaviors (e.g., smoking, unhealthy diet) and conditions (e.g., hypertension, diabetes) associated with CVH. Data from the 2019 Behavioral Risk Factor Surveillance System was used to explore ACEs and CVH among 86,584 adults ≥18 years from 20 states. CVH was defined as poor (0-2), intermediate (3-5), and ideal (6-7) from summation of survey indicators (normal weight, healthy diet, adequate physical activity, not smoking, no hypertension, no high cholesterol, and no diabetes). ACEs was summed by number (0,1, 2, 3, and ≥4). A generalized logit model estimated associations between poor and intermediate CVH (ideal as referent) and ACEs accounting for age, race/ethnicity, sex, education, and health care coverage. Overall, 16.7% (95% Confidence Interval[CI]:16.3-17.1) had poor, 72.4% (95%CI:71.9-72.9) had intermediate, and 10.9% (95%CI:10.5-11.3) had ideal CVH. Zero ACEs were reported for 37.0% (95%CI:36.4-37.6), 22.5% (95%CI:22.0-23.0) reported 1, 12.7% (95%CI:12.3-13.1) reported 2, 8.5% (95%CI:8.2-8.9) reported 3, and 19.3% (95%CI:18.8-19.8) reported ≥4 ACEs. Those with 1 (Adjusted Odds Ratio [AOR] = 1.27;95%CI = 1.11-1.46), 2 (AOR = 1.63;95%CI:1.36-1.96), 3 (AOR = 2.01;95%CI:1.66-2.44), and ≥ 4 (AOR = 2.47;95%CI:2.11-2.89) ACEs were more likely to report poor (vs. ideal) CVH compared to those with 0 ACEs. Those who reported 2 (AOR = 1.28;95%CI = 1.08-1.51), 3 (AOR = 1.48;95%CI:1.25-1.75), and ≥ 4 (AOR = 1.59;95%CI:1.38-1.83) ACEs were more likely to report intermediate (vs. ideal) CVH compared to those with 0 ACEs. Preventing and mitigating the harms of ACEs and addressing barriers to ideal CVH, particularly social and structural determinants, may improve health.

Keywords: Adverse childhood events; BRFSS; Epidemiology; Ideal cardiovascular health; Population survey.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.
Overall Distribution of Adverse Childhood Experiences Components of Household Challenges (denoted by fill of dots), Verbal Abuse (horizontal fill lines), Physical Abuse (vertical fill lines) and Sexual Abuse (waves fill pattern) among adults, 2019 BRFSS. Note: 95% Confidence Intervals shown.
Fig. 2.
Fig. 2.
Overall Distribution of Cardiovascular Health Components of Reported Behaviors (square) and Chronic Conditions (diagonal lines) among adults, 2019 BRFSS. Note: 95% Confidence Intervals shown.
Fig. 3.
Fig. 3.
Adjusted Odd Ratios of Poor and Intermediate Cardiovascular Health (referent: Ideal) by Number of Adverse Childhood Events among Adults. Notes: Odds ratio shown are Adjusted for Age, Race/Ethnicity, Sex, Educational Level, and Health Care Coverage. 95% Confidence Intervals are shown.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Anda RF, Brown DW, 2010. Adverse childhood experiences and population health in Wasthington: The face of a chronic public health disaster. In: Results from the 2009 Behavioral Risk Factor Surveillance System (BRFSS). Washington State Family Policy Council, Washington. http://www.legis.state.wv.us/senate1/majority/poverty/ACEsinWashington20... (Accessed September 29, 2014).
    1. Arteaga SS, Gillman MW, 2020. Promoting ideal cardiovascular health through the life span. Pediatrics 145. 10.1542/peds.2020-0159. - DOI - PMC - PubMed
    1. Bellis MA, Hughes K, Ford K, Ramos Rodriguez G, Sethi D, Passmore J, 2019. Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. Lancet Public Health 4. 10.1016/S2468-2667(19)30145-8 e517–e28. - DOI - PMC - PubMed
    1. Fang N, Jiang M, Fan Y, 2016. Ideal cardiovascular health metrics and risk of cardiovascular disease or mortality: a meta-analysis. Int. J. Cardiol. 214, 279–283. 10.1016/j.ijcard.2016.03.210. - DOI - PubMed
    1. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS, 1998. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am. J. Prev. Med. 14, 245–258. - PubMed