童年逆境与成年期高血压患病的研究进展

doi:10.12114/j.issn.1007-9572.2024.0193

中国全科医学 ›› 2025, Vol. 28 ›› Issue (03): 358-364.DOI: 10.12114/j.issn.1007-9572.2024.0193

所属专题：高血压最新文章合辑

• 论著·儿童健康专题研究 • 上一篇下一篇

童年逆境与成年期高血压患病的研究进展

姜申¹^,², 吴静¹, 周佳丽¹, 蒋德楠¹, 孙炜迪¹, 程思清¹, 朱思雨¹, 侯乐莹¹, 宋培歌¹^,³^,^*()

1．310058　浙江省杭州市，浙江大学公共卫生学院
2．365500　福建省三明市疾病预防控制中心免疫规划科
3．310006　浙江省杭州市，浙江大学医学院附属第二医院临床大数据与统计中心

收稿日期:2024-05-20 修回日期:2024-07-10 出版日期:2025-01-20 发布日期:2024-10-28
通讯作者: 宋培歌
作者贡献：
姜申、宋培歌负责文章的选题、构思与设计；姜申进行文献及资料的检索、收集与整理，并撰写论文；吴静、周佳丽、蒋德楠、孙炜迪、程思清、朱思雨、侯乐莹进行论文的修订；宋培歌负责文章的质量控制和审校，对文章整体负责。

Progress in the Study of the Association between Adverse Childhood Experiences and the Prevalence of Hypertension in Adulthood

JIANG Shen¹^,², WU Jing¹, ZHOU Jiali¹, JIANG Denan¹, SUN Weidi¹, CHENG Siqing¹, ZHU Siyu¹, HOU Leying¹, SONG Peige¹^,³^,^*()

1. School of Public Health, Zhejiang University, Hangzhou 310058, China
2. Department of Immunization Program, Sanming Center for Disease Control and Prevention, Sanming 365500, China
3. Center of Clinical Big Data and Analytics, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310006, China

Received:2024-05-20 Revised:2024-07-10 Published:2025-01-20 Online:2024-10-28
Contact: SONG Peige

摘要/Abstract

摘要： 童年逆境（ACEs）是指发生在儿童时期（18岁以前）的各种创伤事件或情况。长期并持续的ACEs可能对儿童身心健康造成终身影响。目前，欧美地区的多项研究证实了ACEs可增加个体成年期高血压的患病风险，然而不同分型的ACEs与成年期高血压的关联仍存在争议。本文对不同分型的ACEs与成年期高血压相关研究进行综述，探讨童年期不同分型逆境对成年期高血压患病的影响及其发生、发展机制，归纳总结两者间的研究现状并提出展望，为改善儿童早期发展环境、预防其成年期高血压研究提供依据。

关键词: 童年不良经历, 童年逆境, 成年期高血压, 高血压, 疾病负担, 综述

Abstract:

Adverse childhood experiences (ACEs) are traumatic events or situations that individuals may experience during their childhood. Children living with prolonged and persistent adverse experiences may have lifelong effects on their physical and mental health. Most studies in Europe and the United States confirm that ACEs increase the risk of hypertension in adulthood. However, the association between different types of ACEs and hypertension in adulthood remains controversial. This study provides a comprehensive review of studies on the association between different types of ACEs and hypertension, which explores the effects of ACEs on hypertension in adulthood and potential mechanisms. This study also summarizes the current status of studies on ACEs and hypertension. It presents a prospective view of providing a basis for improving the early childhood developmental environment and preventing hypertension in adulthood.

Key words: Adverse childhood experiences, Adverse childhood experiences, Hypertension in adulthood, Hypertension, Burden of disease, Review

中图分类号:

R 179

姜申,吴静,周佳丽,等. 童年逆境与成年期高血压患病的研究进展[J]. 中国全科医学, 2025, 28(03): 358-364. DOI: 10.12114/j.issn.1007-9572.2024.0193.
JIANG Shen,WU Jing,ZHOU Jiali, et al. Progress in the Study of the Association between Adverse Childhood Experiences and the Prevalence of Hypertension in Adulthood[J]. Chinese General Practice, 2025, 28(03): 358-364. DOI: 10.12114/j.issn.1007-9572.2024.0193.

参考文献 65

[1]	BERENS A E，JENSEN S K G，NELSON C A 3rd. Biological embedding of childhood adversity：from physiological mechanisms to clinical implications[J]. BMC Med，2017，15（1）：135. DOI：10.1186/s12916-017-0895-4.
[2]	American Centers for Disease Control and Prevention. Preventing Adverse Childhood Experiences[DB/OL]. [2024-03-13].
[3]	AFIFI T O，MACMILLAN H L，BOYLE M，et al. Child abuse and mental disorders in Canada[J]. CMAJ，2014，186（9）：E324-332. DOI：10.1503/cmaj.131792.
[4]	MERRICK M T，FORD D C，PORTS K A，et al. Prevalence of adverse childhood experiences from the 2011-2014 behavioral risk factor surveillance system in 23 states[J]. JAMA Pediatr，2018，172（11）：1038-1044. DOI：10.1001/jamapediatrics.2018.2537.
[5]	BERNARDI L，HUININK J，SETTERSTEN R A Jr. The life course cube：a tool for studying lives[J]. Adv Life Course Res，2019，41：100258. DOI：10.1016/j.alcr.2018.11.004.
[6]	Center on the Developing Child in Harvard University. Child，Excessive Stress Disrupts the Architecture of the Developing Brain：Working Paper 3[R/OL]. [2024-03-11].
[7]	World Health Organization. Hypertension[R/OL]. （2023-03-17）[2024-03-11].
[8]	World Health Organization. More than 700 million people with untreated hypertension[R/OL]. （2021-08-25）[2024-03-11].
[9]	中国高血压防治指南修订委员会，高血压联盟（中国，中华医学会心血管病学分会中国医师协会高血压专业委员会，等. 中国高血压防治指南（2018年修订版）[J]. 中国心血管杂志，2019，24（1）：24-56. DOI：10.3969/j.issn.1007-5410.2019.01.002.
[10]	World Health Organization. Report of the Consultation on Child Abuse Prevention，29-31 March 1999，WHO，Geneva[EB/OL]. [2024-03-12].
[11]	Hidden Hurt Domestic Abuse Information. Physical Abuse[R/OL]. [2024-03-12].
[12]	World Health Organization. Global status report on preventing violence against children 2020[R/OL]. （2020-06-18）[2024-03-12].
[13]	LEE H，KIM E. Global prevalence of physical and psychological child abuse during COVID-19：a systematic review and meta-analysis[J]. Child Abuse Negl，2023，135：105984. DOI：10.1016/j.chiabu.2022.105984.
[14]	Hidden Hurt Domestic Abuse Information. Sexual Abuse，Domestic Violence and Marital Rape[R/OL]. [2024-03-12].
[15]	World Health Organization. Child maltreatment[R/OL]. （2022-09-19）[2024-03-12].
[16]	Hidden Hurt Domestic Abuse Information. Emotional Abuse[R/OL]. [2024-03-12].
[17]	BROMFIELD N F，REZA H，BENNETT L W，et al. Adolescents in street situations in Bangladesh and their exposure to physical violence and emotional abuse[J]. Child Youth Serv Rev，2023，144：106714. DOI：10.1016/j.childyouth.2022.106714.
[18]	焦富勇. 防止虐待忽视儿童的医学处理[M]. 西安：第四军医大学出版社，2004.
[19]	U.S. Department of Health & Human Services，Administration for Children and Families，Administration on Children，Youth and families，Children's Bureau. Child maltreatment 2019[R]. Washington，2021.
[20]	SUGLIA S F，CLARK C J，BOYNTON-JARRETT R，et al. Child maltreatment and hypertension in young adulthood[J]. BMC Public Health，2014，14：1149. DOI：10.1186/1471-2458-14-1149.
[21]	胡春香，孔明. 儿童忽视对其独孤感的影响：自尊的中介作用[J]. 中国健康心理学杂志，2022，30（2）：223-227. DOI：10.13342/j.cnki.cjhp.2022.02.013.
[22]	MOUSAVI A S. Functional family therapy with a systemic approach[M]. Tehran：University Press，2004.
[23]	KAN M L，FEINBERG M E. Can a family-focused，transition-to-parenthood program prevent parent and partner aggression among couples with young children?[J]. Violence Vict，2014，29（6）：967-980. DOI：10.1891/0886-6708.vv-d-12-00162.
[24]	FLAHERTY E G，THOMPSON R，DUBOWITZ H，et al. Adverse childhood experiences and child health in early adolescence[J]. JAMA Pediatr，2013，167（7）：622-629. DOI：10.1001/jamapediatrics.2013.22.
[25]	BAKER E H. Socioeconomic status，definition[M]. Hoboken：John Wiley & Sons，Ltd，2014
[26]	RAKESH D，WHITTLE S，SHERIDAN M A，et al. Childhood socioeconomic status and the pace of structural neurodevelopment：accelerated，delayed，or simply different?[J]. Trends Cogn Sci，2023，27（9）：833-851. DOI：10.1016/j.tics.2023.03.011.
[27]	KARNEY B R. Socioeconomic status and intimate relationships[J]. Annu Rev Psychol，2021，72：391-414. DOI：10.1146/annurev-psych-051920-013658.
[28]	HOEBEL J，WALDHAUER J，BLUME M，et al. Socioeconomic status，overweight，and obesity in childhood and adolescence—secular trends from the nationwide German kiggs study[J]. Dtsch Arztebl Int，2022，119（49）：839-845. DOI：10.3238/arztebl.m²022.0326.
[29]	ASHIDA T，FUJIWARA T，KONDO K. Childhood socioeconomic status and social integration in later life：results of the Japan Gerontological Evaluation Study[J]. SSM Popul Health，2022，18：101090. DOI：10.1016/j.ssmph.2022.101090.
[30]	STEIN D J，SCOTT K，HARO ABAD J M，et al. Early childhood adversity and later hypertension：data from the World Mental Health Survey[J]. Ann Clin Psychiatry，2010，22（1）：19-28.
[31]	RILEY E H，WRIGHT R J，JUN H J，et al. Hypertension in adult survivors of child abuse：observations from the Nurses' Health Study Ⅱ[J]. J Epidemiol Community Health，2010，64（5）：413-418. DOI：10.1136/jech.2009.095109.
[32]	NGUYEN K A，KENGNE A P，ABRAHAMS N，et al. Associations of childhood maltreatment with hypertension in South African women：a cross-sectional study[J]. BMJ Open，2022，12（9）：e057436. DOI：10.1136/bmjopen-2021-057436.
[33]	GOODING H C，MILLIREN C，MCLAUGHLIN K A，et al. Child maltreatment and blood pressure in young adulthood[J]. Child Abuse Negl，2014，38（11）：1747-1754. DOI：10.1016/j.chiabu.2014.08.019.
[34]	PARRISH C，SURKAN P J，MARTINS S S，et al. Childhood adversity and adult onset of hypertension and heart disease in São Paulo，Brazil[J]. Prev Chronic Dis，2013，10：E205. DOI：10.5888/pcd10.130193.
[35]	ALASTALO H，RAIKKONEN K，PESONEN A K，et al. Cardiovascular health of Finnish war evacuees 60 years later[J]. Ann Med，2009，41（1）：66-72. DOI：10.1080/07853890802301983.
[36]	KEOGH T M，HOWARD S，GALLAGHER S. Early life adversity and blunted cardiovascular reactivity to acute psychological stress：the role of current depressive symptoms[J]. Psychosom Med，2022，84（2）：170-178. DOI：10.1097/PSY.0000000000001024.
[37]	SOARES A L G，HAMMERTON G，HOWE L D，et al. Sex differences in the association between childhood maltreatment and cardiovascular disease in the UK Biobank[J]. Heart，2020，106（17）：1310-1316. DOI：10.1136/heartjnl-2019-316320.
[38]	NIKULINA V，WIDOM C S. Do race，neglect，and childhood poverty predict physical health in adulthood? A multilevel prospective analysis[J]. Child Abuse Negl，2014，38（3）：414-424. DOI：10.1016/j.chiabu.2013.09.007.
[39]	INIGUEZ K C，STANKOWSKI R V. Adverse childhood experiences and health in adulthood in a rural population-based sample[J]. Clin Med Res，2016，14（3/4）：126-137. DOI：10.3121/cmr.2016.1306.
[40]	SCHREIER H M C，JONES E J，NAYMAN S，et al. Associations between adverse childhood family environments and blood pressure differ between men and women[J]. PLoS One，2019，14（12）：e0225544. DOI：10.1371/journal.pone.0225544.
[41]	ALLEN H，WRIGHT B J，VARTANIAN K，et al. Examining the prevalence of adverse childhood experiences and associated cardiovascular disease risk factors among low-income uninsured adults[J]. Circ Cardiovasc Qual Outcomes，2019，12（9）：e004391. DOI：10.1161/CIRCOUTCOMES.117.004391.
[42]	LEHMAN B J，TAYLOR S E，KIEFE C I，et al. Relationship of early life stress and psychological functioning to blood pressure in the CARDIA study[J]. Health Psychol，2009，28（3）：338-346. DOI：10.1037/a0013785.
[43]	EAST P，DOOM J，DELKER E，et al. Childhood socioeconomic hardship，family conflict，and young adult hypertension：the Santiago Longitudinal Study[J]. Soc Sci Med，2020，253：112962. DOI：10.1016/j.socscimed.2020.112962.
[44]	CAMPBELL T S，SÉGUIN J R，VITARO F，et al. Childhood socioeconomic position and blood pressure dipping in early adulthood：a longitudinal study[J]. Ann Behav Med，2013，46（2）：227-231. DOI：10.1007/s12160-013-9496-4.
[45]	CAMPBELL T S，KEY B L，IRELAND A D，et al. Early socioeconomic status is associated with adult nighttime blood pressure dipping[J]. Psychosom Med，2008，70（3）：276-281. DOI：10.1097/PSY.0b013e3181647e30.
[46]	POLLITT R A，ROSE K M，KAUFMAN J S. Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes：a systematic review[J]. BMC Public Health，2005，5：7. DOI：10.1186/1471-2458-5-7.
[47]	POOL L R，AGUAYO L，BRZEZINSKI M，et al. Childhood risk factors and adulthood cardiovascular disease：a systematic review[J]. J Pediatr，2021，232：118-126.e23. DOI：10.1016/j.jpeds.2021.01.053.
[48]	SU S Y，WANG X L，POLLOCK J S，et al. Adverse childhood experiences and blood pressure trajectories from childhood to young adulthood：the Georgia Stress and Heart Study[J]. Circulation，2015，131（19）：1674-1681. DOI：10.1161/CIRCULATIONAHA.114.013104.
[49]	PERVANIDOU P，CHROUSOS G P. Posttraumatic stress disorder in children and adolescents：neuroendocrine perspectives[J]. Sci Signal，2012，5（245）：pt6. DOI：10.1126/scisignal.2003327.
[50]	SEERY M D，HOLMAN E A，SILVER R C. Whatever does not kill us：cumulative lifetime adversity，vulnerability，and resilience[J]. J Pers Soc Psychol，2010，99（6）：1025-1041. DOI：10.1037/a0021344.
[51]	DANESE A，PARIANTE C M，CASPI A，et al. Childhood maltreatment predicts adult inflammation in a life-course study[J]. Proc Natl Acad Sci U S A，2007，104（4）：1319-1324. DOI：10.1073/pnas.0610362104.
[52]	EHRLICH K B，ROSS K M，CHEN E，et al. Testing the biological embedding hypothesis：is early life adversity associated with a later proinflammatory phenotype?[J]. Dev Psychopathol，2016，28（4pt2）：1273-1283. DOI：10.1017/S0954579416000845.
[53]	OBI I E，MCPHERSON K C，POLLOCK J S. Childhood adversity and mechanistic links to hypertension risk in adulthood[J]. Br J Pharmacol，2019，176（12）：1932-1950. DOI：10.1111/bph.14576.
[54]	刘晓萌，刘高卿，曹园圆，等. 炎症反应在原发性高血压病中作用的研究进展[J]. 中国医药，2024，19（2）：289-292.
[55]	OTTE C，NEYLAN T C，POLE N，et al. Association between childhood trauma and catecholamine response to psychological stress in police academy recruits[J]. Biol Psychiatry，2005，57（1）：27-32. DOI：10.1016/j.biopsych.2004.10.009.
[56]	FLOMENBAUM M A，WARNER R C. Morphologic markers of acute and chronic stress in child abuse[J]. Am J Clin Pathol，2022，157（6）：823-835. DOI：10.1093/ajcp/aqab204.
[57]	HUANG Z H，ZHANG Y L，MA X H，et al. Photobiomodulation attenuates oligodendrocyte dysfunction and prevents adverse neurological consequences in a rat model of early life adversity[J]. Theranostics，2023，13（3）：913-930. DOI：10.7150/thno.78777.
[58]	FOX B M，BECKER B K，LORIA A S，et al. Acute pressor response to psychosocial stress is dependent on endothelium-derived endothelin-1[J]. J Am Heart Assoc，2018，7（4）：e007863. DOI：10.1161/JAHA.117.007863.
[59]	SU S Y，WANG X L，KAPUKU G K，et al. Adverse childhood experiences are associated with detrimental hemodynamics and elevated circulating endothelin-1 in adolescents and young adults[J]. Hypertension，2014，64（1）：201-207. DOI：10.1161/HYPERTENSIONAHA.113.02755.
[60]	ARISTIZABAL M J，ANREITER I，HALLDORSDOTTIR T，et al. Biological embedding of experience：a primer on epigenetics[J]. Proc Natl Acad Sci U S A，2020，117（38）：23261-23269. DOI：10.1073/pnas.1820838116.
[61]	FUJII R，SATO S，TSUBOI Y，et al. DNA methylation as a mediator of associations between the environment and chronic diseases：a scoping review on application of mediation analysis[J]. Epigenetics，2022，17（7）：759-785. DOI：10.1080/15592294.2021.1959736.
[62]	LUSSIER A A，ZHU Y W，SMITH B J，et al. Association between the timing of childhood adversity and epigenetic patterns across childhood and adolescence：findings from the Avon Longitudinal Study of Parents and Children（ALSPAC） prospective cohort[J]. Lancet Child Adolesc Health，2023，7（8）：532-543. DOI：10.1016/S2352-4642(23)00127-X.
[63]	WANG W J，YAO J，LI W L，et al. Epigenome-wide association study in Chinese monozygotic twins identifies DNA methylation loci associated with blood pressure[J]. Clin Epigenetics，2023，15（1）：38. DOI：10.1186/s13148-023-01457-1.
[64]	KUH D. Life course epidemiology[J]. J Epidemiol Community Health，2003，57（10）：778-783. DOI：10.1136/jech.57.10.778.
[65]	DE SOUSA ANDRADE D R，CAMELO L V，DOS REIS R C，et al. Life course socioeconomic adversities and 10-year risk of cardiovascular disease：cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health[J]. Int J Public Health，2017，62（2）：283-292. DOI：10.1007/s00038-016-0928-3.

童年逆境与成年期高血压患病的研究进展

Progress in the Study of the Association between Adverse Childhood Experiences and the Prevalence of Hypertension in Adulthood

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 65

相关文章 15

编辑推荐

Metrics

留言

[1]	周小娅, 王卫凯, 刘倩, 李建华, 孙波, 王燕侠. 孕期睡眠质量与褪黑素受体1B基因多态性交互作用对妊娠期高血压的影响研究[J]. 中国全科医学, 2026, 29(21): 2975-2981.
[2]	冯宇茜, 王津津, 蔡一, 朱润芝, 朱勤. 乳酸化修饰在肾脏疾病中的研究进展[J]. 中国全科医学, 2026, 29(21): 3056-3063.
[3]	李文萍, 陈建华, 许家培, 金雪, 潘子涵, 迟春花. 数智化健康管理平台赋能社区老年人健康服务的范围综述[J]. 中国全科医学, 2026, 29(21): 2938-2949.
[4]	张泽宇, 李春晖. 1990—2021年中国归因于二手烟的缺血性心脏病疾病负担分析[J]. 中国全科医学, 2026, 29(20): 2903-2912.
[5]	吴一璇, 肖亮满, 刘鑫, 严梓萁, 王毓婷, 林舒敏, 庄礼兴. 1990—2021年中国与全球帕金森病的疾病负担分析与未来趋势预测[J]. 中国全科医学, 2026, 29(20): 2895-2902.
[6]	热伊莱·麦麦提, 周燚然, 武云, 刘稹诚, 卢耀勤, 吴海燕. 高血压患者新型肥胖指标与心血管疾病发病风险的关联研究[J]. 中国全科医学, 2026, 29(20): 2836-2845.
[7]	程玉, 韩士尧, 孙平, 向娟, 杨辉, 李东泽, 郑莉, 廖晓阳. 慢性病管理中的社会经济与人口学挑战分析[J]. 中国全科医学, 2026, 29(20): 2800-2807.
[8]	张小娟, 刘阳, 彭博, 叶媛, 朱坤. 基层医疗卫生机构高血压和糖尿病防治现状研究[J]. 中国全科医学, 2026, 29(19): 2614-2620.
[9]	陈义萍, 张剑梅, 厉彦虎, 李睿, 张瑞平, 杨萍. COVID-19后遗症心肌损伤的诊疗进展[J]. 中国全科医学, 2026, 29(18): 2585-2592.
[10]	张明悦, 侯艳. 呼出气、肺泡气一氧化氮在间质性肺疾病中的研究进展[J]. 中国全科医学, 2026, 29(18): 2571-2576.
[11]	苗境杰, 张晋雯, 吴千豪, 韩佩佩. 间歇性禁食对心血管代谢疾病影响的研究进展[J]. 中国全科医学, 2026, 29(18): 2538-2545.
[12]	马晓雨, 马晓梅, 武国智, 郑亚, 郭庆红. 中性粒细胞外陷阱在胃癌中的研究进展[J]. 中国全科医学, 2026, 29(17): 2425-2432.
[13]	李佳威, 葛奥淇, 高欣怡, 李娟娟, 袁蓓蓓. 医防融合的概念内涵和实现路径：一项系统综述研究[J]. 中国全科医学, 2026, 29(16): 2156-2166.
[14]	汪洋, 金花, 杨森, 杨辉, 于德华. 中国基本医疗服务功能特征及其对卫生服务结局的影响路径：一项15年的混合方法系统综述[J]. 中国全科医学, 2026, 29(16): 2140-2155.
[15]	徐萍, 马艳, 黄莉, 何梅亮, 侯云凤, 王德旺, 孙盼盼, 刘峥, 郭艳芳, 徐英. 社区成年人体重调整腰围指数与高血压、糖尿病和血脂异常共病的关联研究[J]. 中国全科医学, 2026, 29(16): 2198-2204.