Experiencing high levels of mental stress at any point in life—even if only in childhood—may raise the risk for heart disease, stroke or diabetes in adulthood, a new study suggests.
“The most striking and perhaps sobering finding in our study is that high levels of childhood distress predicted heightened adult disease risk, even when there was no evidence that these high levels of distress persisted into adulthood,” said study author Ashley Winning, a post-doctoral research fellow in the Harvard T.H. Chan School of Public Health in Boston.
“Greater attention must be paid to psychological distress in childhood,” Winning said. “It is an important issue in its own right and may also set up a trajectory of risk of poor health as people age.”
The findings were reported online Sept. 28 in the Journal of the American College of Cardiology.
Researchers tracked more than 6,700 people from age 7 through age 42 and assessed their levels of psychological stress six different times. At 7, 11 and 16 years of age, teachers rated participants on symptoms of depression, restlessness, misbehavior, hostility, anxiety and related issues. Participants reported on their own mental health at ages 23, 33 and 42.
Then, at age 45, participants were tested for cholesterol, heart rate, blood pressure and other characteristics to gauge the state of their immune system, along with their heart and metabolic health.
The risk for heart disease and metabolic disorders was highest among those who experienced stress throughout their lives. But those who had psychological distress only as children or only as adults also had a higher risk than those who did not go through periods of emotional turmoil.
Researchers adjusted their findings to account for other things that could affect health, including socio-economic status, weight, early health problems, diet, exercise, smoking history and medication use.
Winning emphasized that experiencing stress in childhood does not guarantee a person will have a heart attack or stroke or develop diabetes. While the study showed an association, it did not prove that stress causes later heart woes.
She said several factors may contribute to the health risks of stress. They include physical changes stemming from stress and behaviors people adopt in response to extreme stress, such as smoking or inadequate physical activity.
“Focusing on early emotional development and helping children learn to regulate emotions effectively may be an important target for disease prevention and health promotion efforts,” Winning added.
Cardiologist Dr. David Freedman agreed that one way to counteract the risk is for people to develop effective stress management skills.
“Perhaps a proper behavioural management strategy in both early childhood and adulthood, as well as early cognitive retraining for those people who have distressed or traumatic personal issues, could lead to better cardiovascular outcomes,” suggested Freedman, who is chief of congestive heart failure services at North Shore-LIJ’s Franklin Hospital in Valley Stream, N.Y.
Developing resilience over time may also help, said Alison Holman, a researcher in the nursing science program at the University of California, Irvine.
“Many factors contribute to resilience,” she said. “Having a sense of control in one’s life, having a supportive adult such as a teacher, counsellor or coach available to help you, seeking out mastery in an area of life and general support from close others all will help to protect people when facing trauma.”
Parents can help children face adversity by being as loving, accepting, supportive and understanding as possible and showing them how to manage emotions without blaming, denying or attacking others, Holman said.
“Helping children learn how to manage their emotions when they come up is crucial,” Holman said. “Nurturing them and inculcating healthy habits that support emotional balance is a good idea as well. For example, helping them learn how to eat well and incorporate exercise into their lives is really important as these will impact how they feel and respond to the stress around them.”
As adults, realizing that the past can’t be changed is also important, Holman added.
“You can only control what you do from here on out, so, don’t fret over it and just take whatever steps you can now to live a healthy, nurturing life,” she advised.
Published in Journal of the American College of Cardiology