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Updated: Aug 9, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Less than ideal cardiovascular health among adults is associated with experiencing adverse childhood events: BRFSS
Donald K Hayes1, Jennifer L Wiltz2, Jing Fang1
1Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control & Prevention, United States of America.
Insights
Adverse childhood events (ACEs) are linked to poorer cardiovascular health (CVH). Higher numbers of ACEs increase the likelihood of having intermediate or poor CVH, highlighting the need for early intervention.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Health Research
Background:
- Ideal cardiovascular health (CVH) is crucial for preventing heart disease and stroke.
- Adverse childhood events (ACEs) are associated with detrimental health behaviors and conditions impacting CVH.
Purpose of the Study:
- To investigate the association between the number of ACEs and levels of CVH in adults.
- To identify risks for poor and intermediate CVH based on ACEs exposure.
Main Methods:
- Utilized 2019 Behavioral Risk Factor Surveillance System data from 86,584 adults across 20 states.
- Defined CVH based on seven indicators (weight, diet, activity, smoking, hypertension, cholesterol, diabetes).
- Employed a generalized logit model to assess the relationship between ACEs count and CVH categories (poor, intermediate, ideal).
Main Results:
- Only 10.9% of adults achieved ideal CVH; 16.7% had poor CVH.
- Individuals with 1 or more ACEs were significantly more likely to report poor CVH compared to those with zero ACEs.
- A dose-response relationship was observed, with increasing ACEs associated with higher odds of intermediate and poor CVH.
Conclusions:
- ACEs are significantly associated with reduced cardiovascular health.
- Preventing and mitigating ACEs, alongside addressing social determinants, is vital for improving population cardiovascular health.
- Interventions targeting early life adversity may reduce the burden of cardiovascular disease.
Abstract:
Ideal cardiovascular health (CVH) is associated with a lower risk of heart disease and stroke while adverse childhood events (ACEs) are related to health behaviors (e.g., smoking, unhealthy diet) and conditions (e.g., hypertension, diabetes) associated with CVH. Data from the 2019 Behavioral Risk Factor Surveillance System was used to explore ACEs and CVH among 86,584 adults ≥18 years from 20 states. CVH was defined as poor (0-2), intermediate (3-5), and ideal (6-7) from summation of survey indicators (normal weight, healthy diet, adequate physical activity, not smoking, no hypertension, no high cholesterol, and no diabetes). ACEs was summed by number (0,1, 2, 3, and ≥4). A generalized logit model estimated associations between poor and intermediate CVH (ideal as referent) and ACEs accounting for age, race/ethnicity, sex, education, and health care coverage. Overall, 16.7% (95% Confidence Interval[CI]:16.3-17.1) had poor, 72.4% (95%CI:71.9-72.9) had intermediate, and 10.9% (95%CI:10.5-11.3) had ideal CVH. Zero ACEs were reported for 37.0% (95%CI:36.4-37.6), 22.5% (95%CI:22.0-23.0) reported 1, 12.7% (95%CI:12.3-13.1) reported 2, 8.5% (95%CI:8.2-8.9) reported 3, and 19.3% (95%CI:18.8-19.8) reported ≥4 ACEs. Those with 1 (Adjusted Odds Ratio [AOR] = 1.27;95%CI = 1.11-1.46), 2 (AOR = 1.63;95%CI:1.36-1.96), 3 (AOR = 2.01;95%CI:1.66-2.44), and ≥ 4 (AOR = 2.47;95%CI:2.11-2.89) ACEs were more likely to report poor (vs. ideal) CVH compared to those with 0 ACEs. Those who reported 2 (AOR = 1.28;95%CI = 1.08-1.51), 3 (AOR = 1.48;95%CI:1.25-1.75), and ≥ 4 (AOR = 1.59;95%CI:1.38-1.83) ACEs were more likely to report intermediate (vs. ideal) CVH compared to those with 0 ACEs. Preventing and mitigating the harms of ACEs and addressing barriers to ideal CVH, particularly social and structural determinants, may improve health.
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