Childhood maltreatment, genetic risk, and subsequent risk of arrhythmias: a prospective cohort study

Figures & data

Table 1. Characteristics of participants at baseline in the UK Biobank study.

Characteristics	Total (N = 151,741)	No types of maltreatment (N = 101,192)	1–2 types of maltreatment (N = 42,500)	3–5 types of maltreatment (N = 8,049)
Age (years)	55.8 (7.7)	56.1 (7.7)	55.6 (7.8)	54.1 (7.7)
Sex, male (%)	65,789 (43.4)	45,109 (44.6)	18,159 (42.7)	2,521 (31.3)
Ethnicity, White (%)	147,441 (97.2)	99,158 (98.0)	40,857 (96.1)	7,426 (92.3)
Assessment centre (%)
England	135,941 (89.6)	90,355 (89.3)	38,250 (90.0)	7,336 (91.1)
Scotland	10,204 (6.7)	7,049 (7.0)	2,720 (6.4)	435 (5.4)
Wales	5,596 (3.7)	3,788 (3.7)	1,530 (3.6)	278 (3.5)
Currently employed (%)	97,439 (64.2)	64,271 (63.5)	27,786 (65.4)	5,382 (66.9)
College or university degree (%)	69,571 (45.8)	47,502 (46.9)	18,845 (44.3)	3,224 (40.1)
Townsend Deprivation Index^a	−1.71 (2.83)	−1.89 (2.73)	−1.47 (2.93)	−0.77 (3.26)
Current smokers (%)	10,994 (7.2)	6,317 (6.2)	3,615 (8.5)	1,062 (13.2)
Alcohol consumption status (%)
Abstainer	12,364 (8.1)	7,357 (7.3)	3,907 (9.2)	1,100 (13.7)
Light or moderate drinker	104,994 (69.2)	71,036 (70.2)	28,727 (67.6)	5,231 (65.0)
Heavy or abusive drinker	34,383 (22.7)	22,799 (22.5)	9,866 (23.2)	1,718 (21.3)
Physical activity, METs (summed days)	10.49 (4.67)	10.50 (4.63)	10.45 (4.72)	10.70 (4.97)
Healthy diet score, median [IQR]	3 [2–4]	3 [2–4]	3 [2–4]	3 [2–4]
Insomnia (%)
Never/rarely	39,373 (25.9)	27,839 (27.5)	9,976 (23.5)	1,558 (19.4)
Sometimes	72,800 (48.0)	49,074 (48.5)	20,130 (47.4)	3,596 (44.7)
Usually	39,568 (26.1)	24,279 (24.0)	12,394 (29.2)	2,895 (36.0)
Body mass index (kg/m^2)	26.75 (4.55)	26.59 (4.41)	26.96 (4.69)	27.70 (5.24)
Grip strength (kg)	31.21 (10.69)	31.45 (10.69)	31.01 (10.72)	29.16 (10.36)
Hypertension (%)	34,202 (22.5)	22,441 (22.2)	9,833 (23.1)	1,928 (24.0)
Hypercholesterolemia (%)	18,221 (12.0)	12,154 (12.0)	5,101 (12.0)	966 (12.0)
Diabetes mellitus (%)	4,651 (3.1)	2,925 (2.9)	1,400 (3.3)	326 (4.1)
Anxiety or depression (%)	50,839 (33.5)	28,995 (28.7)	17,322 (40.8)	4,522 (56.2)
Structural heart disease (%)	391 (0.3)	252 (0.2)	115 (0.3)	24 (0.3)
Ischemic heart disease (%)	3,427 (2.3)	2,145 (2.1)	1,038 (2.4)	244 (3.0)
Heart failure (%)	183 (0.1)	118 (0.1)	54 (0.1)	11 (0.1)
Stroke (%)	445 (0.3)	276 (0.3)	134 (0.3)	35 (0.4)

Note. Data are mean (SD) unless otherwise indicated.

IQR, interquartile range; MET, metabolic equivalent of task; SD, standard deviation.

^a Positive values of the index will indicate areas with high material deprivation whereas those with negative values will indicate relative affluence.

Figure 1. Relationship between childhood maltreatment and AF (A), VA (B), and BA (C). HRs were adjusted for age, sex, ethnicity, assessment centre, employment status, education level, Townsend Deprivation Index, smoking status, alcohol consumption status, physical activity, and healthy diet score. AF, atrial fibrillation; BA, bradyarrhythmia; HR, hazard ratio; VA, ventricular arrhythmias.

Table 2. Associations of childhood maltreatment with subsequent risk for AF, VA, and BA.

	N	Cases/ Person-Years	Model 1^a HR (95% CI)	Model 2^b HR (95% CI)	Model 3^c HR (95% CI)
AF as outcome
Cumulative types of childhood maltreatment
0	101,192	4,361/1,219,712	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
1–2	42,500	1,896/511,101	1.10 (1.04–1.16)	1.09 (1.03–1.15)	1.08 (1.02–1.14)
3–5	8,049	331/96,731	1.28 (1.15–1.43)	1.27 (1.13–1.42)	1.23 (1.09–1.37)
VA as outcome
Cumulative types of childhood maltreatment
0	101,192	483/1,238,980	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
1–2	42,500	212/519,214	1.10 (0.93–1.29)	1.06 (0.91–1.25)	1.05 (0.89–1.23)
3–5	8,049	47/98,019	1.60 (1.18–2.16)	1.47 (1.09–1.99)	1.39 (1.03–1.89)
BA as outcome
Cumulative types of childhood maltreatment
0	101,192	1,388/1,233,995	1.00 [Reference]	1.00 [Reference]	1.00 [Reference]
1–2	42,500	594/517,255	1.08 (0.98–1.19)	1.07 (0.98–1.18)	1.06 (0.96–1.17)
3–5	8,049	111/97,673	1.42 (1.17–1.72)	1.38 (1.14–1.68)	1.32 (1.09–1.61)

Note. AF, atrial fibrillation; BA, bradyarrhythmia; CI, confidence interval; HR, hazard ratio; VA, ventricular arrhythmias.

^a Model 1 adjusted for age and sex;

^b Model 2 additionally adjusted for socioeconomic factors including ethnicity, assessment centre, employment status, education level, and Townsend Deprivation Index;

^c Model 3 additionally adjusted for lifestyle factors including smoking status, alcohol consumption status, physical activity, and healthy diet score.

Figure 2. Joint associations of cumulative types of childhood maltreatment and genetic risk for AF with subsequent risk of incident AF. HRs were adjusted for age, sex, ethnicity, assessment centre, employment status, education level, Townsend Deprivation Index, smoking status, alcohol consumption status, physical activity, and healthy diet score. AF, atrial fibrillation; CI, confidence interval; HR, hazard ratio.

Data availability statement

Individual-level data from the UK Biobank are not publicly available due to their policy, but the data will be made available after the application of the UK Biobank (https://www.ukbiobank.ac.uk/).