Exposure to interparental physical violence in early life associated with incidence of CVD in adulthood: JAMA
Researchers have established a strong correlation between witnessing physical violence during childhood and high risks for cardiovascular disease at adulthood. A population-based cohort of more than 10,000 participants elucidates this association as partly mediated through depressive symptoms that occur during later life. This study was recently published in JAMA Network Open conducted by Cancan C. and colleagues.
Childhood exposure to adversity, including witnessing violence between parents, has been linked to several adult health outcomes; however, the specific association of childhood witness to interparental violence with increased risk for cardiovascular disease and its underlying mechanisms has been poorly understood. Therefore, this study was established to assess the association of witness to interparental physical violence during childhood to later heart disease and stroke and to consider whether mediation occurs through depressive symptoms at an adult stage.
Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which enrolled participants aged 45 years or older. Participants were followed up for nine years, thus providing robust evidence of the long-term impact of early-life exposures on adult health outcomes. A cohort study based on CHARLS data from 2011 to 2020, with a follow-up period of nine years. 10,424 adults aged 45 years or older; mean age: 58.1 ± 9.0 years; 51.2% female. Early-life exposure to interparental physical violence assessed using a validated early-life exposure questionnaire. Self-reported and physician-diagnosed heart disease (including myocardial infarction, angina, coronary heart disease, and heart failure) and stroke.
Key findings
Exposure Prevalence:
Reported childhood exposure to interparental physical violence in 872 participants (8.4%)
Cardiovascular Risks:
Overall CVD risk: Hazard ratio (HR) 1.36 (95% CI: 1.20–1.55).
Risk of heart disease: HR 1.36 (95% CI: 1.17–1.57).
Risk of stroke: HR 1.28 (95% CI: 1.03–1.61).
Depressive Symptoms:
25.4% of exposed participants (2371 of 9335) reported depressive symptoms, as compared with non-exposed individuals.
Depressive symptoms mediated 11.0% of the association between interparental violence and CVD (HR 1.26; 95% CI: 1.09–1.45).
Experiences of interparental physical violence in childhood significantly increase the risk for adult-onset cardiovascular disease. These findings underscore an urgent need for comprehensive approaches aimed at addressing the social determinants of interparental violence and promoting mental health to reduce the long-term health consequences of childhood adversity.
Reference:
Cui C, Liu L, Li H, et al. Childhood Exposure to Interparental Physical Violence and Adult Cardiovascular Disease. JAMA Netw Open. 2024;7(12):e2451806. doi:10.1001/jamanetworkopen.2024.51806
