Results
Table 1 shows the distribution of child maltreatment, socio-demographics, as well as study covariates. The sample comprises mostly of White (66%) men and women who were 29 years of age on average (SD 1.7, Range 25–34) at the time of the Wave 4 (2007–2008) assessment (Table 1). Twenty-eight percent of men had high blood pressure, as did 14% of women (Table 1). Cardiovascular risk factors were highly present in this sample, 36% of men and 38% of women were obese, and 27% of men and 22% of women were current smokers. Child maltreatment was also common, 14% of men and 8% of women reported ever experiencing neglect, 28% of men and 27% women reported experiencing physical maltreatment and 5% of both men and women reported experiencing sexual abuse as a child. In addition 4% of men and 5% of women reported their family being investigated by social services.
The prevalence of hypertension by child maltreatment status and social services visitation is presented in Figure 1. Men who experienced neglect (31% vs. 28%), sexual abuse (30% vs. 28%) or whose families were investigated by social services (32% vs. 28%) had a higher prevalence of hypertension compared to those who did not endorse those experiences, however these were not statistically significant differences. Women who experienced sexual abuse had a non-statistically significant higher prevalence of hypertension (17% vs. 14%) compared to those who did not. In contrast those who experienced physical abuse (12% vs. 15%) or whose families were involved with social services (12% vs. 14%) had a lower prevalence of hypertension compared to those who did not endorse those experiences, however these differences were not statistically significant.
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Figure 1.
Weighted prevalence of hypertension by type of child maltreatment and involvement with social services stratified by sex, Add Health Study N = 11384. Hypertension was defined as having an elevated systolic blood pressure > = 140 mmHg or diastolic > = 90 mmHg or reported using antihypertensive medications. No statistically significant differences were noted between type of child maltreatment and hypertension.
In models adjusted for socio-demographic factors, and other forms of maltreatment, women who experienced sexual abuse in early childhood had a significantly higher prevalence of hypertension (PR 1.43 95% CI 1.00, 2.05) compared to women who did not experience sexual abuse (Table 2). Among men, experiencing sexual abuse in early childhood was not associated with higher prevalence of hypertension (PR 0.98 95% CI 0.72, 1.32). Experiencing neglect, physical abuse or having visitations by social services at home during childhood was not associated with hypertension among either women or men. While the effect estimates did not substantially change upon inclusion of other covariates, their statistical significance did change. After adjustment for physical activity, current smoking, obesity, alcohol use and depressive symptomatology, women experiencing sexual abuse had a higher prevalence of hypertension (PR 1.35 95% CI 0.92, 1.96) albeit this was no longer statistically significant.