Blood Pressure Trends among Autistic Youth Transitioning to Adult Care: A Retrospective Cohort Study.

Abstract

Introduction: Autistic people have higher rates of cardiovascular disease and its risk factors than non-autistic peers. Transition from pediatric to adult health care is associated with health challenges for autistic people and may exacerbate cardiovascular risk for this population. However, this has not been studied extensively. This study sought to evaluate the relationship between transition to adult health care and blood pressure in a cohort of autistic adolescents and young adults.

Methods: This study used linked electronic medical record (EMR) data from pediatric and adult care from January 2011 to May 2020 for a cohort seen in a medical home for autistic youth to evaluate trends in blood pressures before and after the first visit in adult health care using a linear mixed model. Time-to-event analysis was used to determine the proportion of study subjects with two blood pressures meeting criteria for hypertension.

Results: Linear mixed model results showed no immediate significant differences in systolic (-1.1 mmHg, 95% CI -3.5 to 1.2) or diastolic (0.47, 95% CI -1.2 to 2.2) blood pressure related to transition to adult health care. Time-to-event analysis showed that over half the cohort had at least two elevated blood pressures over the study period, with the mean time to event being 2.5 years.

Conclusions: The transition to adult health care was not associated with an increase in blood pressure in this cohort. Nonetheless, many of the youth in this cohort may meet the clinical definition of hypertension and merit closer monitoring and possible treatment of hypertension.