Abstract Body: Background: Chronic psychosocial stressors, such as anticipated discrimination and adverse childhood experiences, have been shown to influence hypertension risk among stigmatized adults. Emerging research suggests that individuals exposed to adverse childhood experiences later report greater discrimination as adults. Researchers theorize that exposure to adverse childhood experiences likely moderate the association between discrimination and blood pressure (BP); however, this remains underexplored. Therefore, we sought to examine whether adverse childhood experiences moderated the associations of anticipated discrimination and BP in a diverse sample of adults.

Methods: Data were obtained from a 30-day online diary study of sexual and gender minority (SGM; e.g., gay/lesbian, bisexual, transgender) adults in the United States. Participants completed daily electronic diaries that assessed anticipated discrimination every morning. Home BP was assessed every day at awakening and before bedtime. Adverse childhood experiences, including childhood physical, emotional, and sexual abuse, were assessed at baseline using a validated questionnaire. Mixed-effects linear models, adjusted for demographic factors, estimated the associations between daily anticipated discrimination and BP and the moderating role of adverse childhood experiences.

Results: The sample included 31 SGM adults with a mean age of 27.1 years (±7.50). Approximately 83% of participants were Latinx and 49% were multiracial. We found that 39% of the sample reported exposure to 4 or more adverse childhood experiences. Results of mixed-effects linear models suggested that daily anticipated discrimination was not significantly associated with BP. However, we did find evidence that childhood physical abuse significantly strengthened the association between daily anticipated discrimination and morning diastolic BP (β(SE) = 2.36 (0.88), p = 0.01). Childhood emotional and sexual abuse were not significant moderators.

Conclusions: Our findings highlight the importance of considering the moderating effects of adverse childhood experiences on the association between daily anticipated discrimination and BP among SGM people. Future research is needed with larger samples to understand the role that adverse childhood experiences (particularly childhood physical abuse) may play in sensitizing individuals to greater exposure to psychosocial stress and subsequent hypertension risk in adulthood.