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

Abstract

Autistic people have higher rates of cardiovascular disease and its risk factors than their nonautistic peers. Transition from pediatric to adult health care is associated with health challenges for autistic people and may exacerbate cardiovascular. However, this has not been studied extensively. This study evaluated the relationship between transition to adult health care and blood pressure in a cohort of autistic adolescents and young adults. This study used linked electronic medical record data from pediatric and adult care from January 2011 to May 2020 for a cohort receiving care in a medical home for autistic youth to evaluate trends in blood pressure before and after the first visit in adult health care using a linear mixed model. Time-to-event analysis was conducted to determine the proportion of study subjects with two blood pressures meeting criteria for hypertension. Linear mixed model results showed no immediate significant differences in systolic (-1.1 mmHg, 95% CI= -3.5, 1.2) or diastolic (0.47 mmHg, 95% CI= -1.2, 2.2) blood pressure related to transition to adult health care. Time-to-event analysis showed that more than half the cohort had at least 2 elevated blood pressure measurements over the study period, with the mean time to event of 2.5 years. The transition to adult health care was not associated with an increase in blood pressure in this cohort. Nonetheless, many participants in this cohort may meet the clinical definition of hypertension and warrant closer monitoring and potential treatment.