Childhood trauma in Black women increases incidence of cardiovascular disease, Emory study finds

New research from Emory University indicates that childhood trauma physically alters the hearts of Black women.

The study, which examines the relationship between childhood exposure to trauma and vascular dysfunction among more than 400 Black adults in Atlanta ages 30 to 70, found that women who experienced childhood trauma had a worse vascular function, a preclinical marker of heart disease, while men had none. In addition, the findings show women may be more vulnerable to a larger cumulative stress burden, eliciting varying physiological stress responses.

“Heart disease is still the number one killer of women,” says Telisa Spikes, RN, PhD, and lead author of the study, published in the Journal of the American Heart Association.

Numerous study participants reported experiencing childhood trauma, defined as distressing experiences that threaten the bodily, familial, or social safety of someone under the age of 18. For the study, researchers used a 27-item self-report questionnaire to assess participants’ experience with trauma in four domains: general trauma, and emotional, sexual and physical abuse.

While men and women reported similar levels of trauma in the study, men in the group did not experience any of the vascular dysfunction observed among women. Other similarities among men and women included marital status, education and income levels, with almost half of the participants making less than $25,000 annually. Additionally, both cohorts had similar levels of blood pressure, glucose, triglycerides, diabetes and hypertension. Despite the similarities, the prevalence of atrial stiffness among only female participants suggests that trauma has a different biological impact on women. 

According to the study, women may experience stress differently because they are exposed to different forms of trauma, and it may be more chronic. For example, “Evidence shows that girls are more likely to be exposed to sexual abuse, whereas boys are more likely to report physical abuse.” Additionally, the study suggests women may be more vulnerable to a larger cumulative stress burden, eliciting varying physiological stress responses. It also adds that there was an overall higher prevalence of childhood maltreatment among Black populations, compounded by adverse social stressors, which may create an increased risk of resorting to unhealthy coping mechanisms.

says Spikes, suggesting a correlation between arterial stiffness and traumatic experiences. “This exposure to trauma had a more consequential effect on the cardiovascular health of Black women over Black men, and that was very eye-opening. This may explain why we are seeing such an increased burden of high blood pressure in Black women, and why it’s happening earlier in life compared to women from other racial-ethnic backgrounds.”

Concluding the study, Spikes emphasizes that clinicians could consider adding a trauma-informed assessment as part of the patient intake process to help prevent and mitigate the risk of cardiovascular disease.

“It is widely known that women process and appraise stressors differently and are more impacted by that neurobiological process,” says Spikes. “Depression and cardiovascular disease are synergistic — they go hand-in-hand. Mental wellbeing has a profound impact on physical health outcomes, and adding a psychosocial questionnaire for the patients could be an important clinical screening tool for risk assessment.”

CITATION: Effect of Early Life Trauma Exposure on Vascular Dysfunction in Black Men and Women. (2024) T. Spikes, R. J. Thorpe, S. B. Dunbar, V. Michopoulos, J. Pelkmans, W. Wharton, Harris, L.K., Mehta, P.K., Searles, C.D., Pemu, P., Taylor, H., Quyyumi, A. Journal of American Heart Association.  (in-press). DOI: 10.1161/JAH3.10387