Associations between adverse childhood experiences and vascular health outcomes: assessing mediating and moderating factors

Traditional research assessing the risk of cardiovascular disease (CVD) has commonly focused on physiological risk factors such as type 2 diabetes, elevated cholesterol and high blood pressure. However, the potentially crucial role of early life social and environmental factors such as adverse childhood experiences (ACEs), i.e. exposure to abuse or violence, and relationships with CVD are less well documented. Additionally, measures of vascular health indicative of early changes in structure and function, and progression of CVD, are less well studied in relation to these types of early-life exposures. The American Heart Association highlighted that there is a particular need for research using prospective data, including measurement of possible mechanisms linking ACEs to health outcomes in later life.
Considering the above, the present project aims to assess how ACEs may be associated with vascular health in adolescence and early adulthood, as well as CVD risk factors in later life. This will be carried out using birth cohort data obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). The project will build upon existing research by assessing the extent that factors such as mental health and health risk behaviours during childhood (i.e. smoking or low levels of physical activity) might affect or explain these relationships. Further, we will also address potential physiological mechanisms, such as biomarkers of inflammation, that might contribute to the associations between ACEs and vascular health or CVD risk. It is also important to consider whether socio-demographic factors such as ethnicity and sex, social class or neighbourhood deprivation could alter the strength of associations, which will also be considered in our analyses. Dependent upon the results of these initial findings, we aim to follow up this secondary data analysis with primary research which would more closely assess any potential biological mechanisms underpinning our findings.