Childhood trauma increases incidence of heart disease in Black women, study finds

New research from Emory University indicates that childhood trauma physically alters the hearts of Black women.

The study, which examined the relationship between childhood exposure to trauma and vascular dysfunction among more than 400 Black adults in Atlanta aged 30 to 70, found that women who experienced childhood trauma had worse vascular function, a preclinical marker of heart disease, while men had none. In addition, the findings show women may be more vulnerable to a larger cumulative stress burden, eliciting varying physiological stress responses.

“Heart disease is still the number one killer of women,” says Telisa Spikes, RN, Ph.D., and lead author of the study, published in the Journal of the American Heart Association.

“We have already heard that stress kills, but until recently, few studies have investigated stressors, especially socially derived, and how they impact cardiovascular outcomes. We are beginning to quantify what type of effect stress has—and we are seeing now that stress does get under the skin to have a detrimental impact on cardiovascular health, especially for Black women,” adds Spikes, a professor at Emory University’s Nell Hodgson Woodruff School of Nursing.

The study, conducted at the Morehouse-Emory Cardiovascular Center for Health Equity, revealed that childhood trauma in women can cause arterial stiffness, or impaired artery function of the cardiovascular system, contributing to major cardiac events, such as stroke and heart attack.

It also contributes to heart disease, high blood pressure, and a malfunctioning small blood vessel system, which could damage tissues in the kidneys or brain.

Numerous study participants reported experiencing childhood trauma, defined as distressing experiences that threaten the bodily, familial, or social safety of someone under the age of 18. For the study, researchers used a 27-item self-report questionnaire to assess participants’ experience with trauma in four domains: general trauma, and emotional, sexual, and physical abuse.

While men and women reported similar levels of trauma in the study, men in the group did not experience any of the vascular dysfunction observed among women. Other similarities among men and women included marital status, education, and income levels, with almost half of the participants making less than $25,000 annually.

Additionally, both cohorts had similar levels of blood pressure, glucose, triglycerides, diabetes, and hypertension. Despite the similarities, the prevalence of atrial stiffness among only female participants suggests that trauma has a different biological impact on women.

According to the study, women may experience stress differently because they are exposed to different forms of trauma, and it may be more chronic. For example, “Evidence shows that girls are more likely to be exposed to sexual abuse, whereas boys are more likely to report physical abuse.”

Additionally, the study suggests women may be more vulnerable to a larger cumulative stress burden, eliciting varying physiological stress responses. It also adds that there was an overall higher prevalence of childhood maltreatment among Black populations, compounded by adverse social stressors, which may create an increased risk of resorting to unhealthy coping mechanisms.

“What was an interesting takeaway was that both the men and women in this group had a low cardiovascular risk burden, meaning that it was a healthy population,” says Spikes, suggesting a correlation between arterial stiffness and traumatic experiences.

“This exposure to trauma had a more consequential effect on the cardiovascular health of Black women over Black men, and that was very eye-opening. This may explain why we are seeing such an increased burden of high blood pressure in Black women, and why it’s happening earlier in life compared to women from other racial-ethnic backgrounds.”

Concluding the study, Spikes emphasizes that clinicians could consider adding a trauma-informed assessment as part of the patient intake process to help prevent and mitigate the risk of cardiovascular disease.

“It is widely known that women process and appraise stressors differently and are more impacted by that neurobiological process,” says Spikes.

“Depression and cardiovascular disease are synergistic—they go hand-in-hand. Mental well-being has a profound impact on physical health outcomes, and adding a psychosocial questionnaire for the patients could be an important clinical screening tool for risk assessment.”

New research from Emory University indicates that childhood trauma physically alters the hearts of Black women.

The study, which examined the relationship between childhood exposure to trauma and vascular dysfunction among more than 400 Black adults in Atlanta aged 30 to 70, found that women who experienced childhood trauma had worse vascular function, a preclinical marker of heart disease, while men had none. In addition, the findings show women may be more vulnerable to a larger cumulative stress burden, eliciting varying physiological stress responses.

“Heart disease is still the number one killer of women,” says Telisa Spikes, RN, Ph.D., and lead author of the study, published in the Journal of the American Heart Association.

“We have already heard that stress kills, but until recently, few studies have investigated stressors, especially socially derived, and how they impact cardiovascular outcomes. We are beginning to quantify what type of effect stress has—and we are seeing now that stress does get under the skin to have a detrimental impact on cardiovascular health, especially for Black women,” adds Spikes, a professor at Emory University’s Nell Hodgson Woodruff School of Nursing.

The study, conducted at the Morehouse-Emory Cardiovascular Center for Health Equity, revealed that childhood trauma in women can cause arterial stiffness, or impaired artery function of the cardiovascular system, contributing to major cardiac events, such as stroke and heart attack.

It also contributes to heart disease, high blood pressure, and a malfunctioning small blood vessel system, which could damage tissues in the kidneys or brain.

Numerous study participants reported experiencing childhood trauma, defined as distressing experiences that threaten the bodily, familial, or social safety of someone under the age of 18. For the study, researchers used a 27-item self-report questionnaire to assess participants’ experience with trauma in four domains: general trauma, and emotional, sexual, and physical abuse.

While men and women reported similar levels of trauma in the study, men in the group did not experience any of the vascular dysfunction observed among women. Other similarities among men and women included marital status, education, and income levels, with almost half of the participants making less than $25,000 annually.

Additionally, both cohorts had similar levels of blood pressure, glucose, triglycerides, diabetes, and hypertension. Despite the similarities, the prevalence of atrial stiffness among only female participants suggests that trauma has a different biological impact on women.

According to the study, women may experience stress differently because they are exposed to different forms of trauma, and it may be more chronic. For example, “Evidence shows that girls are more likely to be exposed to sexual abuse, whereas boys are more likely to report physical abuse.”

Additionally, the study suggests women may be more vulnerable to a larger cumulative stress burden, eliciting varying physiological stress responses. It also adds that there was an overall higher prevalence of childhood maltreatment among Black populations, compounded by adverse social stressors, which may create an increased risk of resorting to unhealthy coping mechanisms.

“What was an interesting takeaway was that both the men and women in this group had a low cardiovascular risk burden, meaning that it was a healthy population,” says Spikes, suggesting a correlation between arterial stiffness and traumatic experiences.

“This exposure to trauma had a more consequential effect on the cardiovascular health of Black women over Black men, and that was very eye-opening. This may explain why we are seeing such an increased burden of high blood pressure in Black women, and why it’s happening earlier in life compared to women from other racial-ethnic backgrounds.”

Concluding the study, Spikes emphasizes that clinicians could consider adding a trauma-informed assessment as part of the patient intake process to help prevent and mitigate the risk of cardiovascular disease.

“It is widely known that women process and appraise stressors differently and are more impacted by that neurobiological process,” says Spikes.

“Depression and cardiovascular disease are synergistic—they go hand-in-hand. Mental well-being has a profound impact on physical health outcomes, and adding a psychosocial questionnaire for the patients could be an important clinical screening tool for risk assessment.”