Complex traumatization and physical health. Association between child maltreatment and coronary artery disease

Abstract

Trauma in childhood, which is considered to be the "prototype" of complex traumatization, is associated with numerous physical diseases, in particular with coronary artery disease (CAD). In this review we present the current state of research on this issue. Despite inconsistencies in details between reported findings, numerous studies consistently show a clear relationship between childhood maltreatment and CAD. This association holds not only for clinical endpoints, e.g. myocardial infarct and angina pectoris but also for subclinical markers of CAD. In this article three distinct etiopathogenetic pathways are defined linking childhood maltreatment to CAD, namely mental alterations, behavioral alterations, such as harmful health behavior and pathophysiological changes including somatic comorbidities. Methodology critical aspects and future research issues as well as the clinical implications of these findings are briefly discussed.