Positive relationships boost heart health: Study
The Sector > Research > Positive relationships with caregivers boosts heart health for children later in life

Positive relationships with caregivers boosts heart health for children later in life

by Freya Lucas

January 29, 2024

Positive, warm relationships between caregivers and children were associated with higher odds of attaining ideal heart health at multiple points across a 20-year span of adulthood, a new study from New York University has found. 


On the flip side, the findings also suggested that lower income in adulthood may introduce additional adversity in the life course and may potentially amplify the broader experience of a difficult childhood in such a way that it made the relationship between caregiver-child adversity and heart health difficult to see.


Published in American Heart Association journal Circulation: Cardiovascular Quality and Outcomes, the study also noted that experiencing childhood adversity such as abuse was associated with a lower chance of reaching optimal cardiovascular health in adulthood.


“While it is known that early childhood health lays the foundation for health later in life, we found how children interact with adults in their lives may also be impactful,” lead author Dr Robin Ortiz explained.


“Supporting adults in a way that may promote safe, stable and nurturing relationships with children in their care may be important in creating healthy habits in childhood that carry through adulthood. Health care professionals should consider the health and well-being of the household when addressing cardiovascular health at any age.”


The study is believed to be the first to identify a link between childhood family environment and cardiovascular health at different times throughout the course of adult life, which was a 20-year follow-up period.


Using data from a long-term study about cardiovascular disease and risk factors among Black and white adults aged between 18 and 30 years, researchers aimed to quantify the association between adverse childhood experiences and caregiver warmth on cardiovascular health from early to later adulthood. They also explored whether the association differed based on income levels.


The study used the framework of the American Heart Associations’ Life’s Simple Seven metrics (recently updated to Life’s Essential 8™ to include sleep) for improving and maintaining cardiovascular health (controlling cholesterol, blood pressure and blood sugar; managing healthy diet, weight and physical activity, and avoiding smoking) to calculate cardiovascular health scores at the start of the study and again at year 7 and year 20. 


Information on adverse childhood experiences was collected at year 15 with the Risky Family Environment Questionnaire. This questionnaire assesses childhood experiences before the age of 18 years, such as emotional and physical abuse, substance use in the home and adult affection.


At the 20-year mark, researchers observed:


  • A one-unit higher score on the risky family environment questionnaire was associated with nearly 4 per cent lower odds of reaching a high cardiovascular health score. Abuse, in particular, was associated with about 13 per cent decreased odds of attaining a high heart-health score.
  • Positive, warm experiences between caregiver and child were associated with about 12 per cent higher odds of reaching the highest cardiovascular health score.
  • While the relationship between childhood exposures and adult heart health remained unchanged for those with highest annual income – above $35,000 – in adulthood, lower annual income — $35,000 or less — in adulthood may confound the effects of early adversity.


Researchers expected to find that having experienced high caregiver warmth would be protective against the relationship between childhood abuse and low cardiovascular health scores in adulthood.


“However, it turns out that those with high caregiver warmth who also experienced high abuse were still more likely to have lower cardiovascular health scores,” Dr Ortiz said. “This suggests that the lack of stability in a caregiver relationship, in other words the potential to experience abuse and warmth with unpredictability for either, may be as harmful as exposure to high rates of abuse without protective factors.”


Researchers, she continued, were surprised at the impact of adult income.


“We interpret this to suggest that people with low income in adulthood may have faced adversity in both early and later life beyond family relationship experiences, and perhaps also socioeconomic hardships or structural adversity,” she said. “As we look at primordial prevention of cardiovascular disease, healthy and stable childhood relationships and life-long economic equity may play a crucial role in the equitable opportunity for all to attain cardiovascular health across the life course.”


Access the study in full here

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