Background: The American Heart Association defines ideal cardiovascular health (iCVH) based on seven cardiovascular metrics. Adverse childhood events (ACEs) have been associated with negative health behaviors including smoking and binge drinking, and with negative health outcomes including as depression, cancer, and hypertension.

Objective: To determine if having <3 ACEs is associated with better iCVH in adulthood?

Methods: Data from the 2019 Behavioral Risk Factor Surveillance System were used to explore ACEs and iCVH among 143,691 adults aged ≥18 years from 20 states. Having at least 6 of 7 metrics (normal weight, not smoking, ≥5 fruits and vegetables daily, physical activity ≥150 minutes weekly, no diabetes, no high blood pressure, and no high cholesterol) defined iCVH. Number of ACEs (11 questions on child abuse, neglect, and household challenges) was categorized into 0,1,2, and ≥3 events. A multivariate logistic regression analysis estimated the association between iCVH and ACEs accounting for age, race, sex, and educational level.

Results: Overall, only 4.3%(95%CI:4.1-4.6%) reported iCVH, 36.7%(36.1-37.2) reported no ACE, 23.2%(22.7-23.6) reported one, 13.4%(13.0-13.8) reported two, and 26.8%(26.3-27.3) reported ≥3 ACEs. Those who reported none (AOR=1.53; 95%CI=1.28-1.83), one (1.44; 1.18-1.76), and two (1.30; 1.02-1.66) were significantly more likely to have iCVH compared to those who reported ≥3 ACEs.

Conclusion: Ideal CVH occurred in less than 1 in 20 adults, ACEs were reported in nearly two-thirds of adults, and having 0,1,or 2 ACEs were positively associated with iCVH. Understanding the context of iCVH and ACEs may help identify interventions to improve overall cardiovascular health.