Abstract P227: Adverse Childhood Environment And Cardiovascular Health Score Across The Lifecourse: The Coronary Artery Risk Development In Young Adults (CARDIA) Study

Background: Childhood adversity has been associated with poor health outcomes including cardiovascular disease (CVD) and mortality across the lifecourse. In contrast, ideal cardiovascular health (CVH) inclusive of seven lifestyle-related target metrics, has demonstrated protection from morbidity and mortality. While the relationship between adversity and CVD is hypothesized to be in part due to poor lifestyle, few studies have directly tested this. Purpose: To examine potential associations between childhood risky family environment (RFE) and CVH. Methods: The analyses included 1,987 CARDIA participants without CVD at baseline with complete data. The RFE questionnaire assessed adversities including caregiver abuse, affection, low support, substance use, household disorganization, and limited family engagement (score 0-28). CVH score was calculated as low (0-7), moderate (8-9), and high (10-14) based on AHA poor, intermediate, and ideal categories of smoking status, cholesterol, blood pressure, fasting glucose, body mass index, physical activity, and diet. We applied logistic regression for cross-sectional analyses at each year (0, 7, and 20) and logistic regression with random intercepts for longitudinal analyses across time (all years), adjusting for age, sex, income, and alcohol use. Results: The study sample was age 25.3 SD(3.5) years and 56% female at baseline. Average RFE score was 10 (IQR [8, 14], min 7, max 27). For every unit higher RFE score, the odds of high CVH decreased by 3% (OR=0.97, p=0.036) at year 0, 2% (OR=0.98, p=0.027) at year 7, and longitudinally over 20 years by 3% (OR=0.97, p=0.004). Conclusion: Adverse childhood environment is associated with sustained poor CVH across the lifecourse, suggesting that population health interventions mitigating RFE may improve lifecourse outcomes. Future work should explore if the identification of such environmental exposures may improve modifiable CVD risk factors in adulthood, even when childhood experiences may be long passed.