A rocky childhood could be bad for your heart

Traumatic childhood experiences may have a lasting effect on your heart health.

A review published online Dec. 2, 2020, by JAMA Cardiology found that adults who had multiple adverse childhood experiences (ACEs) — like being neglected; suffering physical, sexual, or emotional abuse; or witnessing violence at home — had double the risk of cardiovascular disease and an early death compared with people who didn’t face any ACEs at all.

The findings are not surprising, says Jill Goldstein, a professor of psychiatry and medicine at Harvard Medical School. Past research has found strong links between traumatic childhood events and the development of physical and mental health problems. This is likely due, in some part, to the effects of stress on the body.

“Stress affects almost every chronic disease that we know of,” says Goldstein, who also serves as executive director of the Innovation Center on Sex Differences in Medicine at Massachusetts General Hospital. And stressful events that occur in childhood have been linked to all sorts of conditions, including depression, psychoses and other psychiatric disorders, and cardiometabolic disease.

“Childhood is a really critical period of development, so when these ACEs occur, they can have long-lasting effects on the body’s systems, including the vascular system,” she says.

Childhood stress and heart disease

Many studies have shown a link between ACEs and cardiovascular disease. Research published more than 20 years ago found that people who had experienced four or more ACEs had a higher risk of heart attack and stroke.

Different ACEs might have different effects on the body depending on the severity of the event or how the individual sees the event.

Potential risk triggers

In the JAMA Cardiology review, authors identified three main reasons why disturbing childhood events might be linked to future heart and blood vessel problems.

Behavioral changes resulting from trauma. “These events are psychologically traumatic,” says Goldstein. “They can produce addictive behaviors that result from people trying to self-medicate, by smoking or using alcohol and drugs,” she says. In addition, people who have residual stress from distressing incidents may also be more prone to unhealthy lifestyle habits, such as poor eating or lack of exercise.

Physical changes to the body. There may also be stress-induced physical changes that affect risk. When you find yourself in a dangerous situation, your brain and heart team up to help get you out of trouble, pumping out chemicals that can energize your body to flee from danger. But while these organs can work well together in perilous moments, the link between them may compound the damage when psychologically harmful events occur. “The brain and heart are connected physiologically, through things like stress hormones and our immune responses. They are also linked electrically through nerve connections, like the vagus nerve, which also connects to the gut,” says Goldstein.

Moreover, chronic exposure to stress and the hormones it produces can affect the developing brain, changing how it processes fear, emotion, and even memory, said review authors. It may also set off a cascade of physical changes that can lead to diabetes, high blood pressure, high cholesterol, inflammation, and weight gain in the midriff — all of which are dangerous for heart health.

Emotional changes. Past research has shown a clear connection between ACEs and an increased risk of psychiatric disorders, including anxiety, depression, and post-traumatic stress disorder, among others. These conditions, and in some cases the medications used to treat them, can themselves raise the risk for cardiovascular disease.

Helping a child at riskWhile adverse childhood experiences can have a huge effect on an individual, they also take a societal toll. Authors of a review published online Dec. 2, 2020, by JAMA Cardiology said that one past analysis found that if adverse childhood experiences were eliminated in North America, there would be a 40% drop in depression, a 30% reduction in anxiety, a 28% reduction in respiratory disease, a 20% drop in cardiovascular disease, and a 10% reduction in cancer. If you think a child in your life may be experiencing trauma, there are things you can do to help. Because many of these situations involve tricky family situations, it’s not always possible to intervene. However, you can still make a difference. Simply being a trusted adult in a child’s life can mitigate damage. “You hear about it all the time. You ask someone, ‘You grew up in this really horrendous situation, how did you ever survive it?’ And they usually tell you something about a grandmother, a mother, a teacher, a priest, or a minister,” says Dr. Jill Goldstein, a professor of psychiatry at Harvard Medical School. “As children, these people found a trusted adult as a role model to help them move forward psychologically and realize their potential in other ways.”For information on how to report childhood abuse or neglect, visit the U.S. Department of Health and Human Services Child Welfare Information Gateway at www.childwelfare.gov.

Getting help

If you had difficulties in your childhood, you’re not alone. In one study noted by JAMA Cardiology authors, 52% of 13,000 people polled said that they experienced at least one ACE, and more than 6% of people lived through four or more. If you did face childhood adversity, however, it doesn’t mean that you are destined to develop heart and blood vessel problems. Some people who had ACEs avoid long-term health effects. This may reflect several factors, says Dr. Goldstein:

  • Some people have a genetic susceptibility to cardiovascular problems, which could make these events more harmful than they are for people who don’t have the same underlying tendency.
  • The timing of the traumatic events may have an influence.
  • Gender could play a role. In some cases, women and men show varying susceptibility to ill effects from different types of ACEs.
  • Some people might have personality traits or life experiences that make them more resilient in the face of trauma.

Whatever your childhood was like, there are still things you can do to reduce your risk. Over 90% of cardiovascular disease is believed to be preventable, says Goldstein. Here are some strategies that can help:

Seek professional help. While there are many strategies that you can use on your own, there’s no substitute for a good psychologist or psychiatrist to help you work through serious trauma, says Goldstein. If you’ve experienced ACEs, seeing a mental health specialist can be highly beneficial she says.

Change your daily habits. “Although behavioral changes are very difficult to make, simple lifestyle changes can have a major effect on your risk for cardiovascular disease,” says Goldstein. These include managing your stress load (when possible), maintaining a healthy diet and body weight, and increasing your physical activity. Whenever possible, select exercises and lifestyle changes that you enjoy. And be consistent.

Treat your mind. Behavioral changes may be even more difficult if someone is struggling from past trauma, so emphasize practices that address your mental health as well. Keep your brain active. Try new activities, change your daily walking route, take up a new hobby, or just read more. A healthy mindset is crucial to maintaining good physical health.

Manage stress. “This is a huge challenge for all of us,” says Goldstein. Start by trying mindfulness meditation, a practice that encourages self-awareness and a focus on the sensations you feel in the present. There are numerous apps and online resources you can use to get started. “Try them out. Some people find that some apps work better for them than others,” says Goldstein.

Or sign up for a class, such as Pilates or yoga. These focus on both the mind and the body, and can help to reduce stress.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

 “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.” – Philippians 4:8

 “Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.” – Mark 11:24

 “Anxiety weighs down the heart, but a kind word cheers it up.” – Proverbs 12:25

 “Who of you by worrying can add a single hour to your life?” – Luke 12:25

 “For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.” – Jeremiah 29:11

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11

 “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22

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