美国一项新纵向研究表明，童年期有过不良经历(如多次创伤性事件等)者在成年后早期血压的升高情况较童年期无不良经历者更明显。相关研究论文4月9日在线发表于《循环》(Circulation)杂志。
该研究旨在评估童年期有过不良经历对相应受试者至成年期血压的长期影响，以及这种相关性是否可被童年社会经济学状态和/或其童年期不良经 历相关的行为风险所解释。纳入213例非裔美国人和181例欧裔美国人，年龄在5至38岁之间，在23年期间对其收缩压和舒张压评估高达16次(平均13 次)。收集受试者18岁以前的不良经历数据，包括受虐、被忽视或在非正常家庭环境中成长。利用多级结构的个体成长曲线模型评估童年期无不良经历与血压进展 的关系。
结果，研究者未发现童年期无不良经历对平均血压水平有重要影响，但却发现，童年期不良经历与年龄间存在相互作用(收缩压和舒张压的P值分 别为0.033和0.017)。与童年期无不良经历者相比，童年期经历过多次创伤事件的受试者30岁以后的血压水平升高的更快。不出所料，童年期不良经历 与其社会经济学状态和消极健康行为存在分级相关性(P<0.001)。这些因素并不能解释童年不良经历与收缩压的相关性，而违禁药品的使用可间接部 分解释童年不良经历与舒张压的相关性。
参考文献：
Shaoyong Su,et al. CIRCULATION AHA.114.013104Published online before print April 9, 2015,doi: 10.1161/CIRCULATIONAHA.114.013104
Adverse Childhood Experiences and Blood Pressure Trajectories
from Childhood to Young Adulthood: The Georgia Stress and Heart Study
1. Shaoyong Su1*;
2. Xiaoling Wang1;
3. Jennifer S. Pollock2;
4. Frank A. Treiber3;
5. Xiaojing Xu1;
6. Harold Snieder4;
7. W. Vaughn McCall1;
8. Michael Stefanek1;
9. Gregory A. Harshfield1
-Author Affiliations
1. 1Georgia Regents University, Augusta, GA
2. 2University of Alabama at Birmingham, Birmingham, AL
3. 3Medical University of South Carolina, Charleston, SC
4. 4University of Groningen, University Medical Center Groningen, The Netherlands
1. ?* Georgia Prevention Institute, Medical College of Georgia, Georgia
Regents University, 1120 15th Street, HS 1721, Augusta, GA 30912
ssu@gru.edu
Abstract
Background—The purpose of this study was to assess the long-term effect
of adverse childhood experiences (ACEs) on blood pressure (BP)
trajectories from childhood to young adulthood and to examine whether
this relation is explained by childhood socioeconomic status (SES)
and/or risk behaviors that are associated with ACEs.
Methods and Results—Systolic and diastolic blood pressure (SBP and DBP)
were measured up to 16 times (13 times on average) over a 23-year
period in 213 African Americans (AAs) and 181 European Americans (EAs)
aged 5 to 38 years. Retrospective data on traumatic experiences prior to
age 18 were collected, including abuse, neglect and household
dysfunction. Individual growth curve modeling within a multilevel
framework was used to examine the relation between exposure to ACEs and
BP development.
No main effect of ACEs on average BP levels was found. However, a
significant interaction of ACE score with age3 was observed (SBP:
p=0.033; DBP: p=0.017). Subjects who experienced multiple traumatic
events during childhood showed a faster rise of BP levels after age of
30 years than those without ACEs. As expected, a graded association of
ACEs with childhood SES and negative health behaviors was observed
(p<0.001). The ACE-SBP relation was not explained by these factors,
while the ACE-DBP relation was partially mediated by illicit drug use.
Conclusions—In this novel longitudinal study, we observed that
participants who were exposed to multiple ACEs displayed a greater
increase of BP levels in young adulthood compared to their counterparts
without ACEs.
