Introduction: Mississippi ranks second for cardiovascular disease (CVD) deaths in the nation. Greater adverse childhood experiences (ACEs) have been implicated in risky behaviors, poor health behaviors and outcomes, however, the impacts of ACEs on CVD in Mississippi remains unexplored.

Objectives: This study aimed to examine the association between ACEs and cardiovascular outcomes among Mississippi adults.

Methods: We analyzed data from 2021 Mississippi BRFSS for 4,421 Mississippi adults. CVD was defined as having stroke or heart attack or angina. Aces were summed by number (0, 1, 2-3, 4 or more). Descriptive and bivariate statistics were computed. We used logistic regression to assess association between ACEs and CVD after adjusting for covariates like age, race, sex, income, education level, employment. SAS 9.4 proc survey procedure were used for all analysis to accommodate the complex design of BRFSS.

Results: 56% of adults Mississippians have experienced at least one ACE. Adult Mississippians with greater number of ACEs were more likely to have CVD compared to those who reported fewer or zero ACEs (Heart attack aOR = 1.96; 95% CI = 1.23-3.13; angina aOR = 1.88; 95% CI = 1.19-2.97; stroke aOR = 1.39; 95% CI = 0.84-2.31). Moreover, income level, educational attainment and employment status significantly contributed to these associations.

Conclusion: This study findings highlights the need for increased awareness about ACEs, deploying prevention efforts and to reduce occurrence of ACES. Addressing ACES could improve cardiovascular and other health outcomes among Mississippi adults who reported ACEs in the past.