Associations between adverse childhood family environments and blood pressure differ between men and women

Autoři: Hannah M. C. Schreier aff001;  Emily J. Jones aff001;  Sibel Nayman aff002;  Joshua M. Smyth aff001
Působiště autorů: Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America aff001;  Department of Psychology, University of Mannheim, Mannheim, Germany aff002;  Center of Psychological Psychotherapy, Mannheim, Germany aff003
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0225544



It is unclear how adverse childhood family environments differentially impact adult health outcomes among men and women. This brief communication reports on the independent and joint effects of adverse childhood family environments and sex on indicators of health in adulthood.

Methods & Results

213 18-55-year olds reported on their childhood family environment (Risky Families Questionnaire (RFQ); Family Environment Scale (FEStotal)) and their current perceived stress and depressive and anxious affect. Resting systolic (SBP) and diastolic blood pressure (DBP), and heart rate (HR) were taken during a laboratory visit, and total cortisol output was measured in saliva samples collected at home. Exposure to childhood adversity did not vary by sex. Women had lower SBP, DBP, and total cortisol output, but higher HR, than men (ps < .05). Sex moderated the association between childhood family environment and SBP (RFQ: B = -.316; SE = .120; p = .009; FEStotal: B = -.274; SE = .117; p = .021) and DBP (FEStotal: B = -.193; SE = .094; p = .041), such that exposure to greater childhood adversity was linked to lower BP in women only. Results were largely unchanged after adjusting for concurrent perceived stress and depressive and anxious affect. Separate effects of individual FES subscales are also discussed.


Contrary to expectations, exposure to adverse childhood family environments was associated with lower resting BP among women, perhaps indicative of basal cardiovascular hypoactivation, whereas early adversity was not linked to BP among men.

Klíčová slova:

Adults – Blood pressure – Cortisol – Depression – Heart rate – Human families – Child health – Psychological stress


1. Repetti RL, Taylor SE, Seeman TE. Risky families: Family social environments and the mental and physical health of offspring. Psychol Bull. 2002;128:330–66. doi: 10.1037/0033-2909.128.2.330 11931522

2. Nusslock R, Miller GE. Early-life adversity and physical and emotional health across the lifespan: A neuroimmune network hypothesis. Biol Psychiatry. 2016;80:23–32. doi: 10.1016/j.biopsych.2015.05.017 26166230

3. Danese A, McEwen BS. Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol Behav. 2012;106:29–39. doi: 10.1016/j.physbeh.2011.08.019 21888923

4. Shonkoff JP, Garner AS, Siegel BS, Dobbins MI, Earls MF, Garner AS, et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129:e232–e246. doi: 10.1542/peds.2011-2663 22201156

5. Dedovic K, Wadiwalla M, Engert V, Pruessner JC. The role of sex and gender socialization in stress reactivity. Dev Psychol. 2009; 45:45–55. doi: 10.1037/a0014433 19209989

6. Murphy MO, Loria AS. Sex-specific effects of stress on metabolic and cardiovascular disease: are women at higher risk? Am J Physiol Regul Integr Comp Physiol. 2017; 313:R1–R9. doi: 10.1152/ajpregu.00185.2016 28468942

7. Epperson CN, Bale TL. Sex differences and stress across the lifespan. Nat Neuroscience. 2015;18:1413–20. doi: 10.1038/nn.4112 26404716

8. Kudielka BM, Buske-Kirschbaum A, Hellhammer DH, Kirschbaum C. Differential heart rate reactivity and recovery after psychosocial stress (TSST) in healthy children, younger adults, and elderly adults: The impact of age and gender. Int J Behav Med. 2004;11: 116–121. doi: 10.1207/s15327558ijbm1102_8 15456681

9. Cohen S, Murphy MLM, Prather AA. Ten surprising facts about stressful life events and disease risk. Annu Rev Psychol. 2018;70:577–97. doi: 10.1146/annurev-psych-010418-102857 29949726

10. Chida Y, Steptoe A. Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: A meta-analysis of prospective evidence. Hypertension. 2010;55:1026–1032. doi: 10.1161/HYPERTENSIONAHA.109.146621 20194301

11. Chen E, Turiano NA, Mroczek DK, Miller GE. Association of reports of childhood abuse and all-cause mortality rates in women. JAMA Psychiatry. 2016;73:920–927. doi: 10.1001/jamapsychiatry.2016.1786 27540997

12. Suglia SF, Clark CJ, Boynton-jarrett R, Kressin NR, Koenen KC. Child maltreatment and hypertension in young adulthood. BMC Public Health. 2014;14:1149. doi: 10.1186/1471-2458-14-1149 25374338

13. Pulkki-Råback L, Elovainio M, Hakulinen C, Lipsanen J, Hintsanen M, Jokela M et al. Cumulative effect of psychosocial factors in youth on ideal cardiovascular health in adulthood. Circulation. 2015;131:245–253. doi: 10.1161/CIRCULATIONAHA.113.007104 25583139

14. Hakulinen C, Pulkki-Råback L, Elovainio M, Kubzansky L, Jokela M, Hintsanen M et al. Childhood psychosocial cumulative risks and carotid intima-media thickness in adulthood: The Cardiovascular Risk in Young Finns Study. Psychosom Med. 2016;78:171–181. doi: 10.1097/PSY.0000000000000246 26809108

15. Juonala M, Pulkki-Råback L, Elovainio M, Hakulinen C, Magnussen CG, Sabin MA et al. Childhood psychosocial factors and coronary artery calcification in adulthood: The Cardiovascular Risk in Young Finns Study. JAMA Pediatr. 2016;170:466–472. doi: 10.1001/jamapediatrics.2015.4121 26974359

16. Cooney MT, Vartiainen E, Laakitainen T, Juolevi A, Dudina A, Graham IM. Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women. Am Heart J. 2010;159: 612–619. doi: 10.1016/j.ahj.2009.12.029 20362720

17. Kannel WB. Blood pressure as a cardiovascular risk factor: Prevention and treatment. JAMA. 1996;275:1571–1576. 8622248

18. Girod JP, Brotman DJ. Does altered glucocorticoid homeostasis increase cardiovascular risk? Cardiovasc Res. 2004; 64: 217–226. doi: 10.1016/j.cardiores.2004.07.006 15485680

19. Walker BR. Glucocorticoids and cardiovascular disease. Eur J Endocrinol. 2007;157: 545–559. doi: 10.1530/EJE-07-0455 17984234

20. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med. 1998;14:245–58. doi: 10.1016/s0749-3797(98)00017-8 9635069

21. Crosswell AD, Bower JE, Ganz PA. Childhood adversity and inflammation in breast cancer survivors. Psychosom Med. 2014;76:208–214. doi: 10.1097/PSY.0000000000000041 24632893

22. Winer JP, Powers SI, Pietromonaco PR. Early pubertal timing and childhood family adversity interact to predict newlywed women’s anxiety symptoms. J Child Fam Stud. 2017;26:591–602. doi: 10.1007/s10826-016-0575-6 28458501

23. Moos RH. Conceptual and empirical approaches to developing family-based assessment procedures: Resolving the case of the Family Environment Scale. Fam Process. 1990;29:199–208. doi: 10.1111/j.1545-5300.1990.00199.x 2373215

24. Dressendörfer RA, Kirschbaum C, Rohde W, Stahl F, Strasburger CJ. Synthesis of a cortisol-biotin conjugate and evaluation as a tracer in an immunoassay for salivary cortisol measurement. J Steroid Biochem Mol Biol. 1992;43:683–692. doi: 10.1016/0960-0760(92)90294-s 1472460

25. Pruessner JC, Kirschbaum C, Meinlschmid G, Hellhammer DH. Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology. 2003;28:916–31. doi: 10.1016/s0306-4530(02)00108-7 12892658

26. Cohen S, Kamarck T, Mermelstein R. A Global Measure of Perceived Stress. J Health Soc Behav. 1983;24:385–396. 6668417

27. Winzeler K, Voellmin A, Hug E, Kirmse U, Helmig S, Princip M, et al. Adverse childhood experiences and autonomic regulation in response to acute stress: the role of the sympathetic and parasympathetic nervous systems. Anxiety Stress Coping. 2017;30:145–154. doi: 10.1080/10615806.2016.1238076 27653030

28. Su S, Wang X, Kapuku GK, Treiber FA, Pollock DM, Harshfield GA, et al. Adverse childhood experiences are associated with detrimental hemodynamics and elevated circulating endothelin-1 in adolescents and young adults. Hypertension. 2014;64:201–207. doi: 10.1161/HYPERTENSIONAHA.113.02755 24777980

29. Joyner MJ, Charkoudian N, Wallin BG. Sympathetic nervous system and blood pressure in humans: Individualized patterns of regulation and their implications. Hypertension. 2010;56:10–16. doi: 10.1161/HYPERTENSIONAHA.109.140186 20497993

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2019 Číslo 12