Adverse childhood experiences (ACEs) are associated with reduced vascular endothelial function in young adult females

Vascular endothelial function is a marker of various cardiovascular diseases (CVD). Evidence suggests that adverse childhood experiences (ACEs) are associated with both reduced endothelial function and increased risk of CVD. This pilot study investigated the effect of ACEs on the flow mediated dilation (FMD) response in a cohort of healthy young females, a group mostly absent in the literature. We hypothesized that young adult females with high ACEs will have a lower endothelial function compared to those with low ACEs. Eight healthy female adults (22 ± 3 years; mean ± SD) were analyzed. ACEs were assessed (Childhood Trust Events Survey 2.0) and participants were dichotomized comparing those with high ACEs (≥ 4, n=4; mean 4.8 ± 1.0) to low ACEs (< 4, n=4; mean 2.0 ± 1.2). Heart rate (HR; ECG), mean arterial pressure (MAP; Finometer), brachial artery diameter and blood flow velocity (Doppler ultrasound; EchoPac) were measured during a FMD protocol including a 5-minute baseline, a 5-minute period of cuff occlusion distal to the right elbow, and a 5-minute post occlusion period. Shear rate (SR) was calculated as the quotient of brachial artery blood flow velocity and brachial artery diameter and expressed as peak SR response (SR peak ). FMD was expressed as the relative change of artery diameter from baseline to peak FMD response (FMD % ). Area under-the-curve (AUC) analyses were performed for SR and FMD responses over the course of cuff release and expressed as arbitrary units (au). Independent sample one sided t -tests assessed differences in FMD parameters between high and low ACEs groups. Females with high ACEs demonstrated nonsignificant lower FMD% (6.4 ± 1.3% vs. 10.0 ± 5.2%, P = 0.116, Cohens d = 0.93) and smaller absolute diameter change (0.20 ± 0.03mm vs. 0.28 ± 0.2mm, P = 0.186, Cohens d = 0.68) compared to females with low ACEs, despite no differences in baseline brachial artery diameter (0.32 ± 0.02mm vs. 0.31 ± 0.03mm, P = 0.291, Cohens d = -0.41) and SR peak (1120.0 ± 387.6s -1 vs. 1096.9 ± 122.8s -1 , P = 0.457, Cohens d = -0.08). FMD AUC was lower in high ACEs versus low ACEs group (295.9 ± 74.3au vs. 616.2 ± 181.8au, P = 0.02) despite similar SR AUC between groups (54996 ± 12010au vs. 58764 ± 5852au, P = 0.59). While underpowered as a pilot study, these findings suggest that young adult females with high ACEs have a blunted FMD response, indicating early signs of endothelial dysfunction. The lower FMD despite similar SR AUC in the high ACEs group expands evidence that endothelium impairment is occurring, which is associated with future CVD risk. This study was supported by funding from the Brock University Advancement – Fund Explore Program and the Canadian Institutes of Health Research This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.