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Cited by 518Child Abuse and TraumaBirth, Development, and HealthObesity, Physical Activity, Diet

Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association

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Suglia, Shakira F., Koenen, Karestan C., Boynton-Jarrett, Renée, Chan, Paul S., Clark, Cari J., Danese, Andrea, Faith, Myles S., Goldstein, Benjamin I. +8 more·2018·Circulation
DOI 10.1161/cir.0000000000000536PMC PMC7792566
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Abstract

Adverse experiences in childhood and adolescence, defined as subjectively perceived threats to the safety or security of the child’s bodily integrity, family, or social structures, are known to be associated with cardiometabolic outcomes over the life course into adulthood. This American Heart Association scientific statement reviews the scientific literature on the influence of childhood adversity on cardiometabolic outcomes that constitute the greatest public health burden in the United States, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. This statement also conceptually outlines pathways linking adversity to cardiometabolic health, identifies evidence gaps, and provides suggestions for future research to inform practice and policy. We note that, despite a lack of objective agreement on what subjectively qualifies as exposure to childhood adversity and a dearth of prospective studies, substantial evidence documents an association between childhood adversity and cardiometabolic outcomes across the life course. Future studies that focus on mechanisms, resiliency, and vulnerability factors would further strengthen the evidence and provide much-needed information on targets for effective interventions. Given that childhood adversities affect cardiometabolic health and multiple health domains across the life course, interventions that ameliorate these initial upstream exposures may be more appropriate than interventions remediating downstream cardiovascular disease risk factor effects later in life.

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Crossref · 10.1161/cir.0000000000000536

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  • Stress-related hormones mediate the stress response to induce changes in heart rate, blood pressure, metabolism, and immune function.

    “These stress-related hormones mediate the stress response (92) to induce changes in heart rate, blood pressure, metabolism (93), and immune function (94).”

    From Epigenetic Modifications in Stress Response Genes Associated With Childhood Trauma (2019) · cites this paper as [93]

    The Mechanisms section (page unavailable) links stress responses to metabolic changes and higher blood pressure, and says prolonged stress affects glucocorticoid metabolism and likely alters immune function. It does not specifically report a change in heart rate or establish that stress-related hormones induce every listed change. The citing sentence places this citation after “metabolism”; its separate citations for the stress response and immune function are not assessed here. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Childhood maltreatment, social isolation, and socioeconomic disadvantage are linked to higher levels of inflammation and metabolic risk factors later in life.

    “Childhood maltreatment, social isolation, and socioeconomic disadvantage have been linked to higher levels of inflammation and metabolic risk factors later in life. 20,21”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [20]

    The Mechanisms section (page unavailable) links childhood adversity to elevated inflammatory biomarkers and later cardiometabolic risk factors, including blood pressure and body mass index; it specifically discusses childhood maltreatment and later BMI. The paper also identifies economic disadvantage as an adversity and discusses higher cardiometabolic risk in lower-SES households, but the passages do not establish the stated inflammation-and-metabolic-risk link for social isolation specifically. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Small clinical trials evaluating a gratitude intervention suggested improvements in blood pressure, sleep, inflammatory biomarkers, and heart rate variability.

    “Small clinical trials evaluating a gratitude intervention (eg, gratitude journaling) suggested improvements in blood pressure, sleep, inflammatory biomarkers, and heart rate variability. 19,20”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [20]

    The Future Directions > Interventions passage discusses early-childhood and family-oriented interventions for adversity, not gratitude interventions. Searches for gratitude journaling, clinical trials, and heart rate variability found no passage in our copy reporting the claimed improvements in blood pressure, sleep, inflammatory biomarkers, or heart rate variability. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 17

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Sorted by citations

Authors
Suglia, S. F., Koenen, K. C., Boynton-Jarrett, R., Chan, P. S., Clark, C. J., Danese, A., Faith, M. S., Goldstein, B. I., Hayman, L. L., Isasi, C. R., Pratt, C. A., Slopen, N., Sumner, J. A., Turer, A., Turer, C. B., & Zachariah, J. P.
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-01-30
Volume
137
Issue
5
Pages
e15-e28
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/cir.0000000000000536
PMC
PMC7792566
OpenAlex
W2780541235
Cited by
518
References
131
Citations by year
2026: 56 · 2025: 62 · 2024: 56 · 2023: 69 · 2022: 64 · 2021: 80 · 2020: 58 · 2019: 48 · 2018: 24
FWCI
5.46
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (K23HL118152, K23HL111335)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
childhood adversity, adolescent adversity, cardiometabolic outcomes, obesity, hypertension, type 2 diabetes, cardiovascular disease, life course epidemiology, resilience, vulnerability factors, upstream interventions
MeSH terms
Adverse Childhood Experiences, Adolescent, Adult, Age Factors, Aged, American Heart Association, Child, Diabetes Mellitus, Type 2, Female, Humans, Hypertension, Male, Middle Aged, Obesity, Prognosis, Risk Factors, United States, Risk Assessment, Metabolic Syndrome

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