# Childhood Maltreatment and Cardiovascular Health: Role of Sex and Life’s Essential 8 in the U.K. Biobank

## TL;DR

Childhood maltreatment is linked to worse cardiovascular health, but maintaining healthy lifestyle habits can reduce this risk, especially for women.

## Contribution

This study explores how Life’s Essential 8 lifestyle factors moderate the cardiovascular risks of childhood maltreatment in a large U.K. population.

## Key findings

- Childhood maltreatment is associated with lower Life’s Essential 8 scores, with stronger effects for higher cumulative exposure.
- Moderate-to-high Life’s Essential 8 scores significantly reduce cardiovascular disease risk for individuals with childhood maltreatment.
- Women with low Life’s Essential 8 scores and cumulative maltreatment show higher vulnerability to myocardial infarction.

## Abstract

Childhood maltreatment (CM) may increase cardiovascular disease (CVD) risk through behavioral and health pathways; while maintaining cardiovascular health, Life’s Essential 8 (LE8) may modify this association.

The objective of the study was to examine the link between CM and LE8, and to quantify the potential moderating role of LE8 scores in CM-related CVD risk for men and women.

We included 153,399 participants aged ≥40 years at baseline in the U.K. Biobank. CM was assessed using the online Childhood Trauma Screener. LE8 scores were calculated based on 8 behavioral and health factors. Incident CVDs were identified through linkage to patient and death registers up to 2022. Linear and Cox regressions were used.

All CM events were significantly associated with lower LE8 scores in both sexes, with stronger associations observed with increasing cumulative CM exposure (β1CM = −0.58, 95% CI: −0.72 to −0.44; β2CM = −1.17, 95% CI: −1.36 to −0.97; β≥3CM = −2.26, 95% CI: −2.47 to −2.05). Compared to individuals with no CM exposure and low LE8 scores, those maintaining moderate-to-high LE8 scores demonstrated a substantial reduction in risk for all CVD events, regardless of the number of CM events experienced. However, among participants with low total LE8 scores, women appeared more vulnerable than men to myocardial infarction when exposed to cumulative CM events.

The impact of early-life adversities can be offset by adopting good lifelong lifestyle practices. This study underscores the need to identify individuals, particularly women, with experiences of cumulative CM events and support interventions to improve their opportunity, capability, and motivation to enhance LE8.