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Linking childhood abuse and hypertension: sleep disturbance and inflammation as mediators

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Abstract

The indirect association of childhood abuse with prevalent hypertension in adulthood through sleep disturbance and pro-inflammatory biomarkers was investigated in 589 community-dwelling, middle-aged adults. Participants completed the Childhood Trauma Questionnaire and self-reported current sleep disturbance and medical diagnoses including hypertension. Blood pressure was taken and blood samples were analyzed for C-reactive protein, interleukin-6, and fibrinogen. Hypertension was present in 41.3 % of the sample. In the full multiple mediation model, tested using structural equation modeling, all hypothesized pathways were significant (p’s < 0.05). Childhood abuse was significantly related to both body mass index and sleep disturbance, which, both in turn, were significantly associated with inflammation, which was subsequently associated with hypertension status. The model demonstrated good fit [χ2 (122) = 352.0, p < 0.001, CFI = 0.918, RMSEA = 0.057] and the indirect effect of all mediators was significant (indirect effect: 0.02, 95 % CI 0.005–0.03, p = 0.001). Sleep disturbance, body mass, and inflammation may be independent, intermediate steps between childhood abuse and subsequent hypertension that may be amenable to biobehavioral interventions.

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Funding

This work is supported by a grant from the National Institute on Aging: “Resilience and Health in Communities and Individuals” (R01 AG 026006), Alex Zautra (PI), John Hall (Co-PI).

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Authors and Affiliations

  1. College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd Street, Phoenix, AZ, 85004, USA

    Megan E. Petrov & Michael J. Belyea

  2. Department of Psychology, Arizona State University, Phoenix, AZ, USA

    Mary C. Davis & Alex J. Zautra

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  1. Megan E. Petrov
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  2. Mary C. Davis
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Correspondence to Megan E. Petrov.

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Megan E. Petrov, Mary C. Davis, Michael J. Belyea and Alex J. Zautra declare that they do not have any conflict of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Petrov, M.E., Davis, M.C., Belyea, M.J. et al. Linking childhood abuse and hypertension: sleep disturbance and inflammation as mediators. J Behav Med 39, 716–726 (2016). https://doi.org/10.1007/s10865-016-9742-x

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  • DOI: https://doi.org/10.1007/s10865-016-9742-x

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