Sex-specific associations between potentially traumatic events and cardiovascular disease in middle-aged and older...

Potentially traumatic events (PTEs) are associated with cardiovascular disease (CVD) in aging populations. Despite sex differences in PTE exposure and CVD incidence, no study has examined sex-specific associations between PTEs and CVD in the same sample of middle-aged and older adults. Using data from the Health and Retirement Study, we examined lifetime exposure to 18 PTEs across three domains: early life adversity, lifetime trauma, and perceived discrimination and CVD (stroke or heart disease). We used Cox proportional hazards regression to calculate crude and adjusted (race/ethnicity, age, and educational attainment) hazard ratios (aHRs) and 95% confidence intervals (CI). Among 12,272 HRS participants, nearly 80% reported experiencing at least one PTE. Within domains, child abuse and serious accident or illness had the strongest associations with CVD for men, aHR = 1.26, 95% CI [1.04, 1.52], aHR = 1.68, 95% CI [1.53, 1.85], respectively, and women, aHR = 1.35, 95% CI [1.17, 1.56], aHR = 1.80, 95% CI [1.64, 1.97], respectively. Sex differences were noted for perceived discrimination-for men, the strongest association was between being prevented from moving into other housing and CVD, aHR = 1.52, 95% CI [1.08, 2.14], and for women, the strongest association was between being denied health care and CVD, aHR = 1.43, 95% CI [1.08, 1.90]. For both sexes, experiencing a higher number of PTEs was associated with an increased rate of CVD. Differences among men and women in these results offer insight into opportunities for prevention and targeted clinical interventions in this age group.