Abstract 19007: Impact of Childhood Adversities on Blood Pressure Regulation in Real Life: Results From a 23-Year Longitudinal Study Through Childhood to Young Adulthood

Background: Adverse environments in early life have been consistently associated with the increased risk of hypertension in later life. Recently, we have shown that exposure to adverse childhood experiences (ACEs) was associated with a faster increase of blood pressure (BP) in adulthood, measured by the casual BP. Twenty-four-hour ambulatory blood pressure (24h ABP) is considered as a better predictor of organ damage and cardiovascular events, as it can assess not only the BP levels in nighttime, but also the BP variability (BPV) in real life. How childhood adversities influence BP regulation in real life during the transition period from childhood to adulthood is not clear. Objective: We aim to examine the impact of ACEs on ABP levels and BPV in 24 hours, as well as in daytime and nighttime, using longitudinal data obtained from a youth cohort followed up through childhood to young adulthood. Methods: Twenty-four-hour ABP was measured up to 15 times over a 23-year period in 373 subjects aged 7 to 38 years old. BPV was indexed by the weighted 24h (as well as daytime and nighttime) standard deviation of ABP recordings. ACEs were assessed in three categories: childhood maltreatment (abuse or neglect), household dysfunction, and low socioeconomic status, with a summary score (0-3) indicating the level of adverse environments in early life. Individual growth curve modeling within a multilevel framework was used to examine the relation of ACE scores with 24h, daytime and nighttime ABP levels, as well as BPV. Results: A positive association was found between ACE scores and DBP levels in nighttime (β=0.52, p=0.02), but not in daytime (β=0.34, p=0.23). Individuals with high ACE scores also showed increased SBP variability over 24-hour period (β=0.16, p=0.001) and in daytime (β=0.18, p=0.002), but not in nighttime (β=0.06, p=0.40). There was no interaction with age, suggesting that the patterns of ACEs in relation to BP regulation in daytime and nighttime are similar through childhood to young adulthood. Conclusion: Using the ABP data collected over 23 years, we found that individuals exposed to ACEs showed altered BP regulation in real life, with increased BPV in daytime and remained high BP levels during nighttime, and these impacts may occur through childhood to young adulthood.