{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:50:05Z","timestamp":1789102205609,"version":"build-2803163510"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>This study aimed to quantify the association between childhood family environment and longitudinal cardiovascular health (CVH) in adult CARDIA (Coronary Artery Risk Development in Young Adults) Study participants. We further investigated whether the association differs by adult income.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We applied the CVH framework from the American Heart Association including metrics for smoking, cholesterol, blood pressure, glucose, body mass index, physical activity, and diet. CVH scores (range, 0\u201314) were calculated at years 0, 7, and 20 of the study. Risky Family environment (range, 7\u201328) was assessed at year 15 retrospectively, for childhood experiences of abuse, caregiver warmth, and family or household challenges. Complete case ordinal logistic regression and mixed models associated risky family (exposure) with CVH (outcome), adjusting for age, sex, race, and alcohol use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>The sample (n=2074) had a mean age of 25.3 (\u00b13.5) years and 56% females at baseline. The median risky family was 10 with ideal CVH (\u226512) met by 288 individuals at baseline (28.4%) and 165 (16.3%) at year 20. Longitudinally, for every 1-unit greater risky family, the odds of attaining high CVH (\u226510) decreased by 3.6% (OR, 0.9645 [95% CI, 0.94\u20130.98]). Each unit greater child abuse and caregiver warmth score corresponded to 12.8% lower and 11.7% higher odds of ideal CVH (\u226510), respectively (OR, 0.872 [95% CI, 0.77\u20130.99]; OR, 1.1165 [95% CI, 1.01\u20131.24]), across all 20 years of follow-up. Stratified analyses by income in adulthood demonstrated associations between risky family environment and CVH remained significant for those of the highest adult income (&gt;$74k), but not the lowest (&lt;$35k).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Although risky family environmental factors in childhood increase the odds of poor longitudinal adult CVH, caregiver warmth may increase the odds of CVH, and socioeconomic attainment in adulthood may contextualize the level of risk. Toward a paradigm of primordial prevention of cardiovascular disease, childhood exposures and economic opportunity may play a crucial role in CVH across the life course.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.122.009794","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T10:00:44Z","timestamp":1706004044000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Evidence for the Association Between Adverse Childhood Family Environment, Child Abuse, and Caregiver Warmth and Cardiovascular Health Across the Lifespan: The Coronary Artery Risk Development in Young Adults (CARDIA) Study"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0957-5850","authenticated-orcid":true,"given":"Robin","family":"Ortiz","sequence":"first","affiliation":[{"name":"Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine (R.O.)."},{"name":"Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-6397","authenticated-orcid":true,"given":"Kiarri N.","family":"Kershaw","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL (K.N.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songzhu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6183-3303","authenticated-orcid":true,"given":"David","family":"Kline","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (D.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5317-079X","authenticated-orcid":true,"given":"Guy","family":"Brock","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Jaffee","sequence":"additional","affiliation":[{"name":"Department of Psychology, The University of Pennsylvania, Philadelphia (S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherita H.","family":"Golden","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (S.H.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gbenga","family":"Ogedegbe","sequence":"additional","affiliation":[{"name":"Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)."},{"name":"Department of Medicine, New York University, Grossman School of Medicine (G.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Carroll","sequence":"additional","affiliation":[{"name":"The University of California, Los Angeles, David Geffen School of Medicine, Jane and Terri Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences (J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa E.","family":"Seeman","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles 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