Objectives: Although, the relationship between childhood physical abuse and adult heart disease has been documented, very few studies have controlled for many of the known risk factors for heart disease. The objective of the current study, therefore, was to investigate the association between childhood physical abuse and adult heart disease while controlling for the following established risk factors: (1) childhood stressors; (2) adult health behaviors; (3) adult stressors; (4) depression; and, (5) high pressure. Methods: Data was obtained from the 2005 Canadian Community Health Survey. The sample included 13,093 respondents from the Canadian provinces of Manitoba and Saskatchewan, of whom 7.4% (n = 1025) reported that they had been physically abused as a child by someone close to them and 4.4% (n = 850) reported that they had been diagnosed with heart disease by a health professional. The regional level response rate was 84%. Results: The age-gender-race adjusted odds ratio of heart disease among those who had reported childhood physical abuse was 1.57 (95% CI = 1.12, 2.20). When adjustments were made for all of the established risk factors the odds ratio declined to 1.45 (95% CI = 1.01, 2.08). Conclusions: The relationship between childhood physical abuse and heart disease persists even when controlling for five types of factors previously thought to mediate the relationship. Practice implications: Further research would benefit from a closer analysis of the potential mechanisms linking childhood physical abuse and heart disease. (Contains 2 tables and 1 figure.)