Increased Cardiometabolic and Mortality Risk Following Childhood Maltreatment in the United Kingdom

TY - JOUR

T1 - Increased Cardiometabolic and Mortality Risk Following Childhood Maltreatment in the United Kingdom

AU - Chandan, Joht Singh

AU - Okoth, Kelvin

AU - Margadhamane Gokhale, Krishna

AU - Bandyopadhyay, Siddhartha

AU - Taylor, Julie

AU - Nirantharakumar, Krishnarajah

PY - 2020/5/18

Y1 - 2020/5/18

N2 - Background Childhood maltreatment remains a significant public health issue associated with a number of poor health outcomes. This study explores the association between childhood maltreatment and the subsequent development of cardiometabolic disease and all-cause mortality. Methods and Results Using a UK primary care database between January 1, 1995 and December 31, 2018, we conducted a population-based open retrospective cohort study. We matched 80 657 adult patients with a historic recording of childhood maltreatment or maltreatment-related concerns (exposed group) to 161 314 unexposed patients. Outcomes of interest were the development of cardiovascular disease, hypertension, type 2 diabetes mellitus, and risk of all-cause mortality. During the study period there were 243 new diagnoses of cardiovascular disease (incidence rate 8.3 per 10 000 person-years) in the exposed group compared with 254 in the unexposed group (incidence rate 4.6 per 10 000 person-years). Following adjustment for key covariates, this translated to an adjusted incidence rate ratio of 1.71 (95% CI 1.42-2.06). Additionally, the exposed group had an increased risk of hypertension (adjusted incidence rate ratio 1.42; 95% CI, 1.26-1.59), type 2 diabetes mellitus (adjusted incidence rate ratio 2.13; 95% CI, 1.86-2.45) and all-cause mortality (adjusted incidence rate ratio 1.75; 95% CI, 1.52-2.02) during the study period compared with the unexposed group. Conclusions Considering the high prevalence of exposure to childhood maltreatment, we have demonstrated the substantial associated burden of preventable cardiometabolic disease. There is a clear need to ensure that public health approaches are implemented to prevent the adverse consequences following exposure to childhood maltreatment.

AB - Background Childhood maltreatment remains a significant public health issue associated with a number of poor health outcomes. This study explores the association between childhood maltreatment and the subsequent development of cardiometabolic disease and all-cause mortality. Methods and Results Using a UK primary care database between January 1, 1995 and December 31, 2018, we conducted a population-based open retrospective cohort study. We matched 80 657 adult patients with a historic recording of childhood maltreatment or maltreatment-related concerns (exposed group) to 161 314 unexposed patients. Outcomes of interest were the development of cardiovascular disease, hypertension, type 2 diabetes mellitus, and risk of all-cause mortality. During the study period there were 243 new diagnoses of cardiovascular disease (incidence rate 8.3 per 10 000 person-years) in the exposed group compared with 254 in the unexposed group (incidence rate 4.6 per 10 000 person-years). Following adjustment for key covariates, this translated to an adjusted incidence rate ratio of 1.71 (95% CI 1.42-2.06). Additionally, the exposed group had an increased risk of hypertension (adjusted incidence rate ratio 1.42; 95% CI, 1.26-1.59), type 2 diabetes mellitus (adjusted incidence rate ratio 2.13; 95% CI, 1.86-2.45) and all-cause mortality (adjusted incidence rate ratio 1.75; 95% CI, 1.52-2.02) during the study period compared with the unexposed group. Conclusions Considering the high prevalence of exposure to childhood maltreatment, we have demonstrated the substantial associated burden of preventable cardiometabolic disease. There is a clear need to ensure that public health approaches are implemented to prevent the adverse consequences following exposure to childhood maltreatment.

KW - cardiovascular diseases

KW - childhood maltreatment

KW - hypertension

KW - type 2 diabetes mellitus

UR - http://www.scopus.com/inward/record.url?scp=85084786874&partnerID=8YFLogxK

U2 - 10.1161/JAHA.119.015855

DO - 10.1161/JAHA.119.015855

M3 - Article

C2 - 32410481

VL - 9

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 10

M1 - 015855

ER -