Aim of project

Autistic people appear to be at a higher risk of several independent risk factors of cardiovascular mortality. These include, hypertension, heart arrythmias, high cholesterol, dyslipidaemia and obesity. These are exacerbated by high levels of anxiety throughout their life, a sedentary lifestyle and the metabolic side effects of widely prescribed psychiatric medications. However, this might also reflect convergent genetics with related syndromes and/or increased exposure to steroids in utero.

The Clinical Practice Research Datalink (CPRD) provides access to anonymized GP records of patients across the UK, including reported signs and symptoms, primary care records, diagnoses, laboratory results, prescriptions and demographic information for more than 20 million individuals. Use of the CPRD is also an opportunity to include individuals with intellectual disability (ID) and non-verbal autistic individuals, whose medical history cannot be captured by self-report measures.

Researchers will use the CPRD to examine several risk factors for cardiovascular health, including:

  1. Signs & symptoms: High BP, high cholesterol, high BMI, angina, shortness of breath at rest
  2. Comorbid conditions: Obesity, type 2 diabetes, rheumatoid arthritis
  3. Heart conditions: Congenital malformations, valve insufficiencies & arrhythmias
  4. History of cardiovascular events (e.g. myocardial infarctions, pulmonary oedema, strokes)

Importance of research

The cost associated with autism are forecast to exceed those of type 2 diabetes and ADHD in the US. However, there is still limited understanding on the specific health hazards faced by autistic adults and a lack of dedicated screening programmes that would consider specific comorbidities, genetic susceptibilities and the personal circumstances of autistic people who face challenges in communication and interaction with healthcare professionals.

Researchers will access the considerable resources offered by the Clinical Practice Research Datalink, including the mother-to-baby link, to conduct the largest ever assessment of cardiovascular health in autism. If confirmed, they will make recommendations for tailored screening by GPs of cardiovascular conditions in autistic people, as life-style changes can reduce such risks.

With primary care records for more than 40,000 autistic individuals across the UK (diagnosed from 1990 to present), this will be one of the largest epidemiological studies of autistic adults and will be adequately powered to replicate previous findings and make new discoveries.

Researchers Involved

  • Alex Tsompanidis
  • Elizabeth Weir

Key Findings

This will be a 1 year study starting November 2019 with the first stage of analyses completed by September 2020 and the whole project completed by December 2020.