Abstract
BACKGROUND: Adverse childhood experiences (ACE) have been linked to various negative health outcomes in adulthood. However, their relationship with blood pressure remains inconclusive. We aimed to conduct a systematic review and meta-analysis to investigate this association. METHODS: We conducted a comprehensive search of PubMed, Cochrane Library, Scopus, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and VIP from the databases' inception until 1 July 2023. We assessed the quality of included cross-sectional and cohort studies using the Agency of Healthcare Research and Quality and Newcastle-Ottawa Scale criteria. We analysed the combined effect size for the diagnosis of hypertension and changes in systolic blood pressure and diastolic blood pressure from the included studies further explored these results based on geographical and age subgroups. RESULTS: We included a total of 19 cohort and 23 cross-sectional studies, comprising 754 146 participants and investigating 24 types of ACE. In addition to parental divorce or separation and group violence, exposure to domestic violence, physical neglect, and physical abuse were associated with an increased risk of hypertension, with the risk increasing with the number of exposures. This association was prominent in Europe and North America and in adults. However, the relationship varied among Asian populations and minors due to the type and degree of ACE. CONCLUSIONS: Our results provide evidence supporting the association between ACE and elevated blood pressure, suggesting that ACE may contribute to the development of hypertension in adulthood. Future studies should explore potential gender differences in this association. REGISTRATION: PROSPERO: CRD42023442287.