Childhood Exposure to Multiple Types of Violence and Adult Cardiovascular Disease

Abstract Aims To explore the associations between childhood experience of violence from parents, siblings, and peers and the subsequent risk of cardiovascular disease (CVD) and to examine whether adult depressive symptoms modify these associations. Methods and results This population-based cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS). Childhood exposures to violence from parents, siblings, and peers were assessed through a life history questionnaire. Depressive symptoms were measured using the validated 10-item Center for Epidemiologic Studies Depression Scale. The primary outcome was self-reported, physician-diagnosed CVD. Multivariate Cox proportional hazards models with age as the time scale were used. The study included 11,398 participants, with a mean (SD) age of 58 (9) years, of whom 5622 (49.3%) were men. Among participants, 1101 (9.7%) reported frequent childhood violence exposure, including violence from parents (623, 5.5%), siblings (117, 1.0%), and peers (515, 4.5%). Frequent exposures to violence from parents, siblings, peers, or any type were associated with increased risks of CVD, with hazard ratios (HRs) of 1.23 (95% CI: 1.04–1.45), 1.24 (0.87–1.75), 1.25 (1.05–1.49), and 1.22 (1.06–1.40), respectively. The associations were consistent across subgroups and multiple sensitivity analyses. Adult depressive symptoms mediated 23.0% of the association between frequent exposure to violence and CVD (P for mediation = 0.03). Conclusion Childhood exposure to violence from parents, siblings, and peers is associated with an elevated risk of adult-onset CVD. Addressing mental health may help mitigate the long-term CVD risk linked to childhood violence exposure.