Childhood trauma in Black women can hurt their heart, Emory study finds

The stressors of childhood trauma may cause stiffness or hardening of the arteries, or otherwise impair how they function, contributing to heart attacks and strokes, according to the study conducted through the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity and released at the tail end of American Heart Month.

The study analyzed previous MECA clinical research involving slightly more than 400 Black adults in Atlanta ages 30 to 70 with a mean age of 53. About 60% of the study participants were women. That research explored the impact of individual, environmental and biological factors that predispose Black Americans to either increased risk or resilience from cardiovascular disease.

Credit: Emory University

Credit: Emory University

The new research, which began in late 2023, focused on Black women to learn: Does early life trauma in childhood have any relationship to arterial stiffness and vascular dysfunction, considered preliminary indicators for cardiovascular disease?

Arterial stiffness is believed to lead to hypertension, or high blood pressure, because when the arteries don’t expand and contract as they are supposed to, this results in increased pressure which the heart must pump against to move blood throughout the body, explained Telisa Spikes, lead author of the new study and a nurse and professor in Emory’s nursing school. Her research primarily focuses on cardiovascular health in reproductive-age and early midlife Black women.

“This particular group of women has an increased risk of cardiovascular morbidity and mortality, and we don’t know why,” said Spikes.

“Diet and activity does not fully account for the growing disparity in this particular group with increased hypertension in Black women compared to Black men. A precursor for hypertension might be related to psychosocial stressors,” such as childhood trauma, she said.

Participants in the original MECA study, recruited from 2016 to 2019, were considered healthy without a known history of preexisting cardiovascular or other chronic diseases, among other limitations.

As part of that research, participants reported to clinical researchers at Emory and Morehouse about experiencing childhood trauma, defined as distressing incidents that threaten the body, family, or social safety or security of someone under 18.

The experiences were emotionally painful or distressful, often resulting in negative mental and physical health consequences. The trauma might include the divorce of a parent or death of a close contact, Spikes said.

While men and women in the study reported similar levels of trauma, the men didn’t experience vascular complications. Women tend to be exposed to different forms of trauma, so their reactions may be more chronic, the new research revealed.

“Evidence shows that girls are more likely to be exposed to sexual abuse, whereas boys are more likely to report physical abuse,” according to the study. “Findings suggest that men and women have disparate clinical CVD (cardiovascular disease) outcomes such that men have an earlier age onset of CVD whereas women experience higher CVD mortality in adulthood.”

The study also found that “women experience a greater burden of cumulative stress than men,” and it’s possible that exposure to traumatic childhood events “may prove more consequential for cardiovascular risk for women than men.”

Spikes attributed the increased stress of Black women to their tendency to be single moms supporting their families with wage disparities from their male and white counterparts. “It places them in a prone position to be disproportionately impacted by various stresses.”

For balanced comparisons, the men and women in the study had the same marital status, education and income levels, with almost half the participants making less than $25,000 annually. Participants from both sexes also had similar levels of blood pressure, glucose, triglycerides, diabetes and hypertension.

Credit: Cardiovascular Research Institute

Credit: Cardiovascular Research Institute

Spikes worked with researchers from MECA, including cardiologists and psychologists, some of whom were involved in the original study. Among them, MECA Director Herman Taylor said the new research is another example of how the intense challenges Black people tend to face, including childhood trauma and deprivation, have health consequences.

“In general, it suggests that it’s so important for people, especially women, to focus on their lifestyle and make adjustments now so they can reduce their risks,” said Taylor, a cardiologist, professor at Morehouse School of Medicine and director of its Cardiovascular Research Institute.

Among the findings of the new study, the higher proportion of mistreated children in Black communities, compounded by negative social stressors, may increase their risks for resorting to unhealthy coping mechanisms that can lead to cardiovascular disease.

Researchers hope the results of the latest study will convince clinicians to consider childhood trauma and other psychosocial stressors among more typical clinical assessments such as checking blood pressure, lipid levels, and lifestyle behaviors when determining a patient’s risk of heart disease and how to help reduce it.

Clinicians, particularly primary care providers, should better understand the cardiovascular risks of African American women who come to their practice, especially if their blood pressure is borderline, Spikes said. She added that clinicians should refer such patients to mental health therapists.

Taylor agreed. “I think it’s important, and research and clinical experience repeatedly show the close relationship between state of mind and heart health. So much of mental health is communicated into the heart and the vascular systems. Life stressors and mental health challenges … can have important implications for your overall health, including heart health.”

He explained that doctors ask their patients about their “medical, family and what we call ‘social history,’” to help judge disease risk. “Telisa’s work suggests knowing about a history of adverse childhood events — trauma, personal loss, even abuse — could be just as important to the prediction of disease.”

Taylor believes that one of the lessons learned from the latest research should be that all patients, even young ones who seem healthy, may have experienced a trauma earlier in life that affects their health later on.

Roni Robbins has been a journalist for 37 years. This is her second stint as a freelance reporter for the AJC. She also freelances for Medscape, where she was an editor. Her writing has appeared in WebMD, HuffPost, Forbes, NY Daily News, BioPharma Dive, MNN, Adweek, Healthline and others. She’s also the author of the award-winning Hands of Gold: One Man’s Quest to Find the Silver Lining in Misfortune.