Relationship of early life stress and psychological functioning to blood pressure in the CARDIA study.

OBJECTIVE Low childhood socioeconomic status (CSES) and a harsh early family environment have been linked with health disorders in adulthood. In this study, the authors present a model to help explain these links and relate the model to blood pressure change over a 10-year period in the Coronary Artery Risk Development in Young Adults sample. DESIGN Participants (N = 2,738) completed measures of childhood family environment, parental education, health behavior, and adult negative emotionality. MAIN OUTCOME MEASURES These variables were used to predict initial systolic and diastolic blood pressure (SBP and DBP, respectively) and the rate of blood pressure change over 10 years. RESULTS Structural equation modeling indicated that family environment was related to negative emotions, which in turn predicted baseline DBP and SBP and change in SBP. Parental education directly predicted change in SBP. Although African American participants had higher SBP and DBP and steeper increases over time, multiple group comparisons indicated that the strength of most pathways was similar across race and gender. CONCLUSION Low CSES and harsh family environments help to explain variability in cardiovascular risk. Low CSES predicted increased blood pressure over time directly and also indirectly through associations with childhood family environment, negative emotionality, and health behavior.