Support in childhood linked to better heart health in adulthood 

Supportive and stable caregiving during childhood significantly improves cardiovascular health in adulthood, according to a new study led by NYU Grossman School of Medicine and The Ohio State University Wexler Medical Center. 

The research marks a pivotal shift in understanding the long-term impacts of early childhood environments on heart health.

Early adversity and heart health

The connection between childhood adversity – such as abuse, neglect, and household substance use – and deteriorating heart health in later life has been well-documented. However, the new study provides a fresh perspective by highlighting the protective role of positive childhood experiences.

The researchers said the findings are the first to frame adversity and protective factors across a large group when it comes to cardiovascular health over time.

Mitigating risk factors

Study lead author Dr. Robin Ortiz is a professor in the Departments of Pediatrics and Population Health at NYU Langone. 

“We know that mitigating risk factors for cardiovascular disease must begin in childhood,” said Dr. Ortiz. “At the same time, our findings show that adversity in early childhood does not equal destiny.” 

“While adverse childhood family environments were associated with lower odds of cardiovascular health in adulthood, our findings suggest that supportive and, importantly, stable caregiving may have a stronger influence on later heart health than early adversity.”

How the study was conducted

The researchers analyzed data from over 2,000 participants in the CARDIA study, a long-term project tracking cardiovascular disease risks in more than 5,000 adults. This cohort was examined at the baseline average age of 25 and followed up at seven and 20-year intervals.

The team used scales to measure childhood adversity, such as child abuse and caregiver warmth. 

Critical new insights 

The experts discovered that for each increase in overall family environment adversity and child abuse, there was a corresponding 3.6% and 12.8% lower likelihood of achieving ideal cardiovascular health (CVH), respectively. Conversely, each increase in caregiver warmth was linked to an 11.7% higher chance of better heart health.

Exposure to caregiver warmth in childhood was associated with the highest cardiovascular health scores in adults. 

Stability and consistency 

What was most unique about the findings, said Dr. Ortiz, was that of all adults with high levels of child abuse exposure, those who also reported high levels of caregiver warmth exposure had lower CVH scores than those with high child abuse but low levels of caregiver warmth exposure. 

According to Dr. Ortiz, this suggests that while having a supportive caregiver is crucial to a life course of health, the stability and consistency of that support and warmth in childhood is just as important of a predictor of heart health in later life.

Study implications 

Dr. Ortiz noted that individuals who have experienced both abuse and warmth in childhood might face the inability to predict the presence of support overall in their childhood environment. 

The results suggest that an unpredictable or unstable relational environment may be associated with poor heart health later in life, while predictable support in childhood may optimize physiology and behavior to result in greater cardiovascular health later in life.

Future research 

Dr. Ortiz said the hope is that this study offers insight into how supportive and stable caregiving relationships in childhood can offer greater attainment of cardiovascular health at a population level. Future research will focus on the complex relationship between cardiovascular health and economic hardship.  

“We have to address healthy caregiver relationships as well as address socioeconomic hardship,” said Dr. Ortiz. “We need policies and programs that support both caregivers and children in order to achieve greater health equity.”

The study is published in the journal Circulation Cardiovascular Quality and Outcomes.

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