Cardiovascular disease risk factors in autistic adults: The impact of sleep quality and antipsychotic medication use.

This study looked at heart health risks in 545 autistic adults. They found very high rates of health problems: nearly 3 out of 4 people were overweight, almost half had high cholesterol, and 2 out of 5 had high blood pressure. Poor sleep and taking certain medications (antipsychotics) made these problems worse. The researchers suggest that helping autistic adults sleep better and carefully watching their health if they take these medications could help reduce heart disease risks.

This cross-sectional study examined cardiovascular disease (CVD) risk factors in 545 autistic adults without intellectual disability. The research found extremely high rates of CVD risk factors: 73.2% had overweight/obesity, 45.3% had high cholesterol, 39.4% had high blood pressure, and 10.3% had diabetes. Multiple regression analyses revealed that older age, male sex, and poor sleep quality were associated with higher numbers of CVD risk factors. Antipsychotic medication use specifically increased diabetes risk, while poor sleep quality increased overweight/obesity likelihood.

The study suggests that sleep quality improvement and careful CVD monitoring in autistic adults using antipsychotics could reduce cardiovascular risk in this vulnerable population.

Results indicate urgent need for cardiovascular health screening and interventions in autistic adults. Sleep quality improvement should be prioritized as a modifiable risk factor. Enhanced monitoring is essential for autistic adults using antipsychotic medications, with consideration of alternative treatments when appropriate.

Cross-sectional design prevents causal inferences. Self-reported CVD risk factors may introduce measurement error. Sample recruited through specific research platforms may not represent all autistic adults. Study excluded adults with intellectual disability, limiting generalizability.

Approximately 40% of American adults are affected by cardiovascular disease (CVD) risk factors (e.g., high blood pressure, high cholesterol, diabetes, and overweight or obesity), and risk among autistic adults may be even higher. Mechanisms underlying the high prevalence of CVD risk factors in autistic people may include known correlates of CVD risk factors in other groups, including high levels of perceived stress, poor sleep quality, and antipsychotic medication use. A sample of 545 autistic adults without intellectual disability aged 18+ were recruited through the Simons Foundation Powering Autism Research, Research Match. Multiple linear regression models examined the association between key independent variables (self-reported perceived stress, sleep quality, and antipsychotic medication use) and CVD risk factors, controlling for demographic variables (age, sex assigned at birth, race, low-income status, autistic traits).

Overall, 73.2% of autistic adults in our sample had an overweight/obesity classification, 45.3% had high cholesterol, 39.4% had high blood pressure, and 10.3% had diabetes. Older age, male sex assigned at birth, and poorer sleep quality were associated with a higher number of CVD risk factors. Using antipsychotic medications was associated with an increased likelihood of having diabetes. Poorer sleep quality was associated with an increased likelihood of having an overweight/obesity classification.

Self-reported CVD risk factors are highly prevalent among autistic adults. Both improving sleep quality and closely monitoring CVD risk factors among autistic adults who use antipsychotic medications have the potential to reduce risk for CVD.