Examining the Association Between Adverse Childhood Experiences and Ambulatory Blood Pressure in Adulthood Among Black Women in Georgia Open Access
Tewfik, Ranni (Summer 2023)
Abstract
Adverse childhood experiences (ACEs) are potentially traumatic events that occur before age 18 and include witnessing or experiencing violence, abuse, or neglect in the home or community. Studies have shown that childhood adversity contributes to hypertension in adulthood, and Black American women have a heavier burden of ACEs and elevated blood pressure compared with other groups. Resting blood pressure methods have been used in most studies focusing on the association between ACEs and blood pressure, however, ambulatory blood pressure (ABP) monitoring is a more precise method and considered the gold standard. The purpose of this investigation was to investigate the relationship between ACEs and ABP in adulthood among Black women in Atlanta, Georgia, using baseline data from the Mechanisms Underlying Stress and Emotions in Heart Health (MUSE) study. To our knowledge, no studies have examined ACEs and ABP, and only one study has explored race, gender, aggregate ACEs, and elevated blood pressure. This was the first study to examine the association between cumulative ACEs and ABP, rather than resting blood pressure, and with a particular focus on Black women.
In the MUSE study, Black female adults aged 30-46 in Atlanta were enrolled from 2016 to 2019. ACEs were measured using a 10-item self-report questionnaire with subscales of abuse, neglect, and household dysfunction. The ACE composite score was categorized into four groups: no exposure, low exposure, moderate exposure, and severe exposure to ACEs. ABP was measured using a 48-hour monitoring device to record average daytime and nighttime systolic and diastolic blood pressure. The covariates used in the regression models for statistical analysis were age, education level, income level, smoking status, alcohol use status, BMI, and depression score. Logistic regression models were used to assess the association between ACE levels and the categorical measures of ABP, and linear regression models were used for the continuous measures of ABP. The results did not support the hypothesis that ACE exposure level is significantly associated with ABP. Across all comparison groups, there were no significant associations between exposure to ACEs at any level and any ABP outcome measure, even after adjusting for covariates.
Table of Contents
Introduction 1
Methods 5
Results 8
Discussion 14
References 20
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