Abstract Body: Introduction: Early life stress (ELS), including child abuse and neglect, household dysfunction, poverty, or exposure to violence or trauma, has been associated with increased risk of hypertension and cardiovascular disease in adulthood. However, the impact of ELS on cardiovascular outcomes, particularly vascular dysfunction and hypertension, remains understudied in adolescence – a key age window near the time of ELS exposure that is usually free of comorbidities.

Hypothesis: We tested the hypothesis that ELS is associated with surrogates of future cardiovascular disease in adolescents: vascular dysfunction and abnormal ambulatory blood pressure (BP).

Methods: This was an interim analysis of a prospective cross-sectional study in 141 adolescents (ages 13–18) recruited from outpatient clinics at Children’s of Alabama. ELS was assessed using the Adverse Childhood Experiences (ACEs) survey and categorized as ACE = 0 or ACE ≥ 1. The primary outcome was vascular stiffness, assessed by aortic augmentation index. Secondary outcomes were carotid-femoral pulse wave velocity and analysis, clinic BP, and ambulatory BP patterns. Group differences were analyzed using independent t-tests or Mann-Whitney U tests, based on non-normal distribution of the outcomes.

Results: Adolescents with ACE ≥1 displayed a trend toward higher central diastolic BP (74 ± 11 vs. 70 ± 8 mmHg; p=0.07), daytime diastolic BP (73 mmHg ± 8 vs. 70 ± 6; p =0.06), and 24-hour mean diastolic BP (68 ± 8 vs. 66 ± 5 mmHg; p=0.07). Nighttime diastolic BP was significantly higher in the ACE ≥1 group (61 ± 8 vs. 57 ± 6 mmHg; p < 0.05). No significant differences were observed in vascular stiffness or other ambulatory BP patterns.

Conclusions: ELS was associated with elevated diastolic BP in adolescents, indicating a potential long-term impact on cardiovascular health during critical developmental years. Future research should investigate the mechanisms through which ELS influences BP regulation. Additionally, studies should identify potential mediators that could help mitigate its effects during adolescence, a critical age window for preventive measures to reduce future cardiovascular risk.