Adverse Childhood Experiences and Blood Pressure in Women in the United States: A Systematic Review.
Jewel Scott, Jacquelyn McMillian-Bohler, Ragan Johnson and 1 others
PMID 33576175WHAT IT FOUND
In adult women, adverse childhood experiences were not consistently linked to hypertension.
Half of the studies found positive associations, including childhood sexual abuse, but blood pressure results from objective measurements were less consistent.
Key findings
01Half of the included studies found a significant positive association between adverse childhood experiences and elevated blood pressure in women.
02Four studies found a positive association between childhood sexual abuse and hypertension in women.
03Only two of the seven studies that measured blood pressure objectively found a positive association with adverse childhood experiences.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No included study met all quality metrics. Common quality gaps were limited description of participants and setting, failure to address prior hypertension diagnosis and medication use, failure to address missing data, and failure to include strategies to address confounding. Self-reported hypertension is less precise than objective blood pressure measurement, and studies using self-report were more likely to find positive associations. Most studies measured adverse childhood experiences retrospectively, so current well-being and cultural norms may affect reports. The review included only nonpregnant women in the United States, so it does not address blood pressure during pregnancy or after childbirth. Only 5 of the 12 sex-stratified studies also stratified by race and sex, limiting conclusions about racial and ethnic subgroups. Generalizability is limited because some samples were mostly white adults.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that adverse childhood experiences cause hypertension in women. The review found inconsistent associations, and only two of seven studies with objectively measured blood pressure showed a positive association.