Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Childhood Adversity & Cardiometabolic Outcomes

Circulation; ePub 2017 Dec 18; Suglia, et al

The American Heart Association (AHA) has issued a scientific statement on adverse experiences in childhood and adolescence, which are known to be associated with cardiometabolic outcomes over the life course into adulthood. The statement reviews scientific literature on the influence of childhood adversity on cardiometabolic outcomes that constitute the greatest public health burden in the US, including obesity, hypertension, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD). It also outlines pathways linking adversity to cardiometabolic health, identifies evidence gaps, and provides suggestions for future research. Among the statement’s conclusions:

  • Evidence suggests that childhood adversity is associated with adverse health behaviors that increase risk of cardiometabolic disease, including smoking, overeating, and inactivity.
  • Cardiometabolic health outcomes and adverse experiences are strongly patterned by sex, race/ethnicity, socioeconomic status, and nativity.
  • 3 pathways are identified to explain how childhood adversity may increase risk of cardiometabolic, as well as others, diseases: behavioral, mental health, and biological.
  • Interventions that ameliorate upstream exposures may be more appropriate than remediating downstream CVD risk factor effects later in life.


Suglia SF, Koenen KC, Chan PS, et al. Childhood and adolescent adversity and cardiometabolic outcomes. A scientific statement from the American Heart Association. [Published online ahead of print December 18, 2017]. Circulation. doi:10.1161/CIR.0000000000000536.

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