Gymnastik- och idrottshögskolan, GIH

BACKGROUND Childhood maltreatment (CM) may increase cardiovascular disease (CVD) risk through behavioral and health pathways; while maintaining cardiovascular health, Life's Essential 8 (LE8) may modify this association. OBJECTIVES The objective of the study was to examine the link between CM and LE8, and to quantify the potential moderating role of LE8 scores in CM-related CVD risk for men and women. METHODS We included 153,399 participants aged >= 40 years at baseline in the U.K. Biobank. CM was assessed using the online Childhood Trauma Screener. LE8 scores were calculated based on 8 behavioral and health factors. Incident CVDs were identified through linkage to patient and death registers up to 2022. Linear and Cox regressions were used. RESULTS All CM events were significantly associated with lower LE8 scores in both sexes, with stronger associations observed with increasing cumulative CM exposure (beta 1CM =-0.58, 95% CI:-0.72 to-0.44; beta 2CM =-1.17, 95% CI:-1.36 to-0.97; beta >= 3CM =-2.26, 95% CI:-2.47 to-2.05). Compared to individuals with no CM exposure and low LE8 scores, those maintaining moderate-to-high LE8 scores demonstrated a substantial reduction in risk for all CVD events, regardless of the number of CM events experienced. However, among participants with low total LE8 scores, women appeared more vulnerable than men to myocardial infarction when exposed to cumulative CM events. CONCLUSIONS The impact of early-life adversities can be offset by adopting good lifelong lifestyle practices. This study underscores the need to identify individuals, particularly women, with experiences of cumulative CM events and support interventions to improve their opportunity, capability, and motivation to enhance LE8. (JACC Adv. 2026;5:102483) (c) 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).