Structured, Progressive Exercise Training Improves Cardiovascular Psychophysiological Outcomes in Young Adult Women with a History of Adverse Childhood Experiences.

Adverse childhood experiences (ACEs) represent psychosocial stressors that occur during critical developmental periods and are associated in a dose-dependent manner with adverse cardiovascular outcomes in emerging adults, including greater age-related increases in blood pressure (BP) and increased circulating endothelin-1 (ET-1), a psychosocial stress-responsive, endothelium-derived peptide and potent vasoconstrictor. ACEs have also been linked to lower resilience and hope, which is a motivational state based on goal-directed energy (agency) and goal planning (pathways). Importantly, resilience and hope are each stable psychological traits that may protect against adversity. We examined the effects of a structured, progressive exercise training program on hope agency, hope pathways, resilience, BP, and circulating ET-1 in young adult women with a history of moderate-to-severe (e.g., 4 or more) adverse childhood experiences (ACEs). We hypothesized that exercise training would increase resilience and hope, but lower systolic BP (SBP), diastolic BP (DBP), and circulating ET-1. We further hypothesized that changes in hope and resilience would be associated with changes in BP and ET-1 across the intervention period in the young women with ACEs. Forty-two otherwise healthy young adult women with either four or more (ACE+) or with no ACEs (ACE-) were recruited and completed this study. Participants with ACEs (ACE+) were randomly assigned to either an exercise (n=14) or non-exercise (n=14) control group, whereas women without a history of ACEs (ACE-) were assigned to a non-exercise control (e.g., negative control group; n=14). Statistical analyses included two-way mixed (group x time) effects and bivariate correlational analyses. Changes are reported as means ± SE. Agency did not change in any group (p = 0.14), but pathways improved only in the ACE+ exercise group (+1.6 ± 0.74 au; p = 0.03). ET-1 decreased in the ACE+ exercise group only (-0.31 ± 0.29 pg/ml, p= 0.04). While the interactions for resilience and SBP did not reach significance (p = 0.06 and 0.05, respectively), forced post-hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, p = 0.01) and SBP tended to improve (-4.0 ± 2.0 mmHg; p = 0.05) in the ACE+ exercise group only. DBP did not change in any group (p = 0.43). There were significant inverse associations between changes in pathways and SBP (ρ = -0.43, p= 0.02) and pathways and ET-1 (ρ = -0.56, p= 0.003), and a significant direct association between changes in SBP and ET-1 (ρ = 0.49; p = 0.01) in the ACE+ young women. Associations among resilience and BP and ET-1 were weaker and non-significant (ρ = -0.17-0.29, p≥ 0.13). Our results suggest that structured, progressive exercise training promotes improvements in positive psychological factors, SBP, and circulating ET-1 levels in young adults with a history of ACEs. Further, changes in pathways were related to changes in SBP and ET-1 across the intervention period, suggesting a potential psychophysiological relationship between positive psychological traits and cardiovascular risk factors in young women with ACEs.