Childhood maltreatment and adult blood pressure-based outcomes: age- and sex-specific associations in the German National Cohort (NAKO)

Thielcke, Tara Alissa; Klinger-König, Johanna; Stracke, Sylvia; Berger, Klaus; Castell, Stefanie; Greiser, Karin Halina; Harth, Volker; Heier, Margit; Karch, André; Keil, Thomas; Krist, Lilian; Leitzmann, Michael; Lerch, Seraina; Markus, Marcello Ricardo Paulista; Meinke-Franze, Claudia; Mikolajczyk, Rafael; Moreno Velásquez, Ilais; Obi, Nadia; Pischon, Tobias; Schmidt, Carsten Oliver; Schipf, Sabine; Siewert-Markus, Ulrike; Völzke, Henry; Woeckel, Margarethe; Grabe, Hans J.; Ittermann, Till; Töpfer, Philipp

Childhood maltreatment and adult blood pressure-based outcomes: age- and sex-specific associations in the German National Cohort (NAKO)

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Item Type:	Article
Title:	Childhood maltreatment and adult blood pressure-based outcomes: age- and sex-specific associations in the German National Cohort (NAKO)
Creators:	Thielcke, Tara Alissa, Klinger-König, Johanna, Stracke, Sylvia, Berger, Klaus, Castell, Stefanie, Greiser, Karin Halina, Harth, Volker, Heier, Margit, Karch, André, Keil, Thomas, Krist, Lilian, Leitzmann, Michael, Lerch, Seraina, Markus, Marcello Ricardo Paulista, Meinke-Franze, Claudia, Mikolajczyk, Rafael, Moreno Velásquez, Ilais ORCID: https://orcid.org/0000-0001-6058-8983, Obi, Nadia, Pischon, Tobias ORCID: https://orcid.org/0000-0003-1568-767X, Schmidt, Carsten Oliver, Schipf, Sabine, Siewert-Markus, Ulrike, Völzke, Henry, Woeckel, Margarethe, Grabe, Hans J., Ittermann, Till and Töpfer, Philipp
Abstract:	BACKGROUND: Childhood maltreatment (CM) is associated with adult cardiovascular disease (CVD) risk. Systolic (SBP) and diastolic (DBP) blood pressure (BP), key markers of CVD risk, exhibit age- and sex-dependent variability, which was insufficiently accounted for in previous studies on the CM-BP relationship. This study therefore aimed to assess age- and sex-specific associations between CM and adult BP-based outcomes and hypertension using cross-sectional data from the population based German National Cohort (NAKO). METHODS: Complete data were available for 150,983 participants (49.3% female), who took part in the baseline assessment between 2014 and 2019. CM was assessed via the Childhood Trauma Screener (CTS). Resting BP was assessed using a standardized procedure. Hypertension was defined as either SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or intake of antihypertensive medication. Age- and sex-stratified multivariable regression models estimated age- and sex-specific associations between CM and BP-based markers and sex-stratified logistic regression models were calculated for hypertension as the outcome. RESULTS: A pattern of inverse associations between CTS sum score (CTS) and BP markers emerged. Compared to their non-exposed counterparts, females (OR = 0.87, 95%-CI: 0.80; 0.94) but not males (OR = 1.01, 95%-CI: 0.91; 1.13) with high cumulative CM exposure (i.e., ≥ 3 CM categories) had lower odds of hypertension. Age-dependent inverse associations between CTS and BP markers revealed sex-specific patterns. The age- and sex-dependent inverse associations of CM with BP markers were more consistent for the abuse vs. neglect subscales. CONCLUSIONS: The association between CM and BP revealed age- and sex-dependent patterns, highlighting the complexity of physical consequences in adulthood associated with CM.
Keywords:	Child Maltreatment, Risk Factors, Blood Pressure, Cardiometabolic Risk Factors, Sex Factors, Age Factors
Source:	BMC Public Health
ISSN:	1471-2458
Publisher:	BioMed Central
Volume:	26
Number:	1
Page Range:	2698
Date:	29 September 2026
Official Publication:	https://doi.org/10.1186/s12889-026-29019-z
PubMed:	View item in PubMed

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