Table 3.
Associations of adverse childhood experiences (ACEs) with incident cardiovascular disease (CVD) and mediation proportion of the associations attributed to adverse adulthood experiences (AAEs)
| HR (95% CI)a | Mediation proportion (%) (95% CI) | ||
|---|---|---|---|
| Unadjusted for AAEs | Adjusted for AAEs | ||
| Cardiovascular disease | |||
| ACEs indicatorsb (1-unit per increasing) | 1.11 (1.08–1.14) | 1.09 (1.03–1.16) | 17.7 (8.2–34.2) |
| No. of ACEs indicators | |||
| 0 | 1.00 (reference) | 1.00 (reference) | - |
| ≥ 1 | 1.38 (1.12–1.70) | 1.36 (1.10–1.68) | 4.6 (1.3–15.4) |
| Heart disease | |||
| ACEs indicatorsb (1-unit per increasing) | 1.06 (1.02–1.10) | 1.04 (0.98–1.08) | 36.7 (4.0–89.0) |
| No. of ACEs indicators | |||
| 0 | 1.00 (reference) | 1.00 (reference) | - |
| ≥ 1 | 1.32 (1.16–1.51) | 1.30 (1.14–1.49) | 5.6 (1.0–26.1) |
| Stroke | |||
| ACEs indicatorsb (1-unit per increasing) | 1.17 (1.13–1.20) | 1.15 (1.11–1.18) | 10.9 (4.5–24.0) |
| No. of ACEs indicators | |||
| 0 | 1.00 (reference) | 1.00 (reference) | - |
| ≥ 1 | 1.51 (1.34–1.70) | 1.49 (1.32–1.68) | 3.3 (0.9–11.9) |
Abbreviations: ACEs Adverse childhood experiences, AAEs Adverse adulthood experiences, HR Hazard ratio, 95% CI, 95% confidence interval
aModels were adjusted for age, sex, residence, marital status, educational level, health behaviors (physical activity, smoking status, and alcohol consumption), health status variables (BMI; history of diabetes, hypertension, dyslipidemia, and chronic kidney disease; use of diabetes medications, hypertension medications, and lipid-lowering therapy; and depressive symptoms), and young adulthood social support
bContinuous variable