The Relationship Between Forms of Childhood Maltreatment and Vascular Function Indices in Black Men and Women

Examine the association between types of childhood maltreatment and surrogate markers of vascular function, and to test whether sex modifies these relationships.

Childhood maltreatment and indices of vascular function were assessed in a cohort of healthy Black adults without known CVD (n=404). Maltreatment (physical, sexual, emotional, and general trauma) domains were assessed using the Early Trauma Inventory Short Form. A trauma severity index score was calculated by summing the indexes for each domain. Outcomes of central augmentation index (cAIx) corrected for a heart rate of 75 bpm, and carotid femoral pulse wave velocity were measured as indices of wave reflections and arterial stiffness, respectively, and central pulse pressure (CPP). Associations between each domain and outcomes were assessed using multivariate-adjusted (demographics, clinical, health behaviors, and depressive symptoms) and sex-stratified linear regression models.

The cohort had a mean age of 53±10.3 years, and 61% were women. After adjustments, emotional abuse (2.68 [95% CI: -4.78, -0.58, P =.013]) and physical abuse (-2.38 [-4.26, -0.50, P =<.001]) were associated with cAIx in the overall cohort. Significant sex interactions were identified for emotional ( P= .009) and physical abuse ( P= .001) with cAIx and for emotional abuse with CPP ( P =.021). Among women, physical abuse was associated with a higher cAIx (2.22 [95% CI: 0.70, 3.73, P =.004]), and among men, a lower cAIx (-2.59 [95% CI: -4.98, -0.19, P =.035]). Emotional abuse was also associated with higher CPP measures among women (1.31 [95% CI: 0.15, 2.46, P =.027]) with no associations identified in men.

Physical and emotional abuse was associated with higher cAIx and CPP in women, but not men, suggesting sex-specific effects of early trauma on vascular function.