It’s common to think of heart disease as being completely due to diet and lifestyle. I mean, most people know that if our diets are poor and we don’t exercise or engage in other forms of physical activity very often, we’ll likely develop high cholesterol. From there, if we don’t change something, we may even suffer from complications such as heart attack or stroke. But what if that isn’t the entire story? What if something that took place in our lives decades before heart disease was even on our radar sort of set the stage for its development? What if I told you that something that took place in our childhood—specifically traumatic events, also known as adverse childhood experiences or ACEs—increased our risk for being diagnosed with high blood pressure, heart disease, atherosclerosis, peripheral artery disease, heart attack, stroke, and other cardiovascular concerns?
Well, I’m here to tell you that research demonstrates that childhood trauma continues to affect our physical health in adulthood. As survivors of adverse childhood experiences, it’s in our best interest to understand how trauma increases our risk for chronic disease so that we can be proactive about our health and live our healthiest and best lives now, in spite of our past experiences. Allow me to explain.
What Counts as a Traumatic Event During Childhood?
First of all, let’s make sure we’re on the same page. When I say childhood trauma, adverse childhood experiences, traumatic occurrences during childhood or any similar phrase, I’m actually referring to any experience that takes place between your time in your mother’s uterus and adolescence that activates what is known as your stress response. Examples of these traumatic events include:
- your parents being separated or divorced;
- seeing your mother or another caregiver treated violently;
- having a depressed or otherwise mentally ill household member;
- experiencing physical, sexual, or verbal abuse;
- having a household member who is incarcerated;
- having a household member who struggles with substance abuse or addiction;
- not having enough clothes, food, or other necessities;
- and not feeling that you are loved and protected by your family.
Although these are the most commonly researched forms of childhood trauma, there has been research done that has demonstrated links between chronic health concerns like cardiovascular disease and other forms of trauma, including:
- having a parent or sibling die,
- being raised in foster care,
- being chronically ill during childhood,
- and more.
How Does Trauma Increase Our Risk For Heart Attack, Stroke, Heart Failure, and Other Cardiovascular Concerns?
Research demonstrates that, compared to those who were raised in more favorable family environments, people who were exposed to less favorable family environments (e.g. experiences of abuse, neglect) were 129% to 153% more likely to experience a cardiovascular event. This includes heart attack, stroke, heart failure, coronary artery disease, peripheral artery disease, and other cardiovascular disease events.
So how exactly do adverse childhood experiences increase our risk for cardiovascular disease?
What Exactly Happens in the Body When We Experience ACEs?
To explain how childhood trauma increases our risk for hypertension, high cholesterol, heart failure, coronary artery disease, heart attack, stroke, peripheral artery disease, and other forms of cardiovascular concerns, I need to explain what happens within your body when you experience stress as a child. When we experience childhood trauma, our stress response, which is controlled by the sympathetic division of our autonomic nervous system and by our hypothalamic-pituitary-adrenal (HPA) axis, is activated.
If this sounds complicated, I’ll prove to you that you actually already know part of what I’m talking about. The “fight-or-flight” response, which I’m sure you’ve heard of before, is the part of our stress response that is activated when we are exposed to short-term stressors. This would be like if you lose your balance or if someone scares you in the dark. The other part of the stress response, specifically the part that is controlled by the HPA axis and that takes over when we are exposed to repeated or otherwise chronic stress, is the part that is most relevant to our discussion on childhood trauma.
When we experience ACEs, our stress response is activated. Through a cascade of events, our adrenal glands begin to secrete the stress hormone cortisol. Because our brains are still being developed during childhood, elevations in cortisol actually rewire our brains and bodies. This leads to us becoming hyper-reactive to stress. In other words, now our bodies begin to over-produce cortisol both at baseline and when we are exposed to anything remotely stressful. This includes when we encounter physiological, psychological, and environmental stressors.
The Role of Inflammation and the Immune System
To add to the unfortunate nature of this picture I’m painting, your body activates your immune response whenever your stress response is activated. Because of the immune system changes that take place when we are exposed to childhood stressors, an inflammatory process begins. This inflammatory process damages the integrity of our arteries and plaque begins to build up in our blood vessels. We refer to this as atherosclerosis.
The interesting thing is that this plaque build-up actually begins in the teens and twenties for most people. It then takes place for years before we begin to see changes on our blood cholesterol tests. This means even if you have perfect cholesterol levels, there could be an underlying inflammatory process taking place in your cardiovascular system. And this process could be setting the stage for cardiovascular concerns. This includes hypertension, heart attack, stroke, heart failure, and other cardiovascular concerns. AND… all of this could have begun with the trauma you experienced during childhood.
What Can I Do to Decrease My Risk of Developing Cardiovascular Disease as a Survivor of Adverse Childhood Experiences?
Understanding the link between ACEs and cardiovascular disease is a crucial first step to reducing your risk and being proactive about your health. We see a dose-response relationship between ACEs and chronic disease. This means that the higher your ACE score, the higher your risk tends to be. Because of this, I recommend that ACE survivors know their ACE score and understand what it means for them personally. This is crucial to know because if you’ve experienced at least one type of adverse childhood experience, you carry an increased risk for not only cardiovascular concerns like heart attack, heart failure, and stroke, but a host of other health concerns, such as mental health concerns like anxiety, depression, bipolar disorder, schizophrenia, and PTSD, autoimmune diseases, reproductive concerns, and more.
The good news, however, is that experiencing ACEs does not mean you’ll definitely experience cardiovascular disease in your lifetime. Yes, you’ve experienced childhood trauma that has changed your brain and body and increased your risk for multiple health concerns. But there are things we can do to support our HPA axes and to support our bodies. By implementing a few crucial changes, we can reduce our accumulated risk and live our healthiest lives now. Our past does not have to control us any longer.
If you’re a survivor of adverse childhood experiences, I encourage you to be proactive about your health. Take the ACE Assessment to find out your ACE score. When you do, I’ll send you a document that contains important information about how your score can affect your risk for cardiovascular disease, mental health concerns, autoimmune conditions, reproductive concerns, and other health concerns. I’ll also share important tips you can implement right away to help you minimize your risk for these concerns.