Black Americans who survive a myocardial infarction (MI) face an elevated risk for adverse outcomes. Childhood trauma is associated with reduced cardiovascular reactivity, but its contribution to racial disparities in stress physiology is unclear. We investigated whether childhood trauma contributes to lower cardiovascular reactivity among Black compared with White MI survivors.
Methods:
Using a cross-sectional design, we assessed childhood trauma and heart rate and blood pressure responses (HRR, SBPR, DBPR) to public speaking in 183 White (30% female) and 311 Black (53% female) MI survivors [Mage (SD): 51 (7)]. Multiple linear regression tested the interaction between race and childhood trauma on cardiovascular reactivity, adjusting for resting values and relevant covariates. When no significant interaction was found, models were refitted to examine main effects. A 4-level race-trauma variable was used to assess group differences, with White participants with low trauma (n=115) as the reference group.
Results:
Black participants were more likely to report high childhood trauma (49% vs. 37%, p=.012) and showed significantly lower heart rate (HRR) and systolic (SBPR) and diastolic (DBPR) blood pressure reactivity to mental stress compared with White participants. High childhood trauma was independently associated with lower HRR and SBPR. No significant race × trauma interaction was observed, but additive effects were evident: Black participants with high trauma had the lowest HRR (β=−8.2; 95% CI: [−11.2, −5.2]), SBPR (β=−7.7; 95% CI: [−11.9, −3.5]), and DBPR (β=−2.9; 95% CI: [−5.4, −0.4]) relative to White participants with low trauma.
Conclusions:
Black MI survivors were more likely to report high childhood trauma and exhibit reduced cardiovascular responses to stress. Although no interaction was found, additive effects suggest trauma contributes to racial disparities. Addressing childhood trauma may help mitigate cardiovascular risk in Black Americans.