Does autonomic nervous system dysfunction influence cardiovascular disease risk in young adults with intellectual disability?

Am J Physiol Heart Circ Physiol. 2021 Feb 1;320(2):H891-H900. doi: 10.1152/ajpheart.00807.2020. Epub 2020 Dec 31.


People with intellectual disability (ID) experience cardiometabolic-related morbidity and mortality. However, it has been suggested that this population presents and lives with underestimated cardiovascular risk factors at a younger age, hence affecting their overall health and quality of life and contributing to early mortality. We assessed autonomic nervous system function in subjects with ID (n = 39), aged 18-45 yr, through measures of sudomotor function, heart rate and systolic blood pressure variability, and cardiac baroreflex function. Traditional clinical cardiovascular measurements and a biochemical analysis were also undertaken. We found that young adults with ID presented with sudomotor dysfunction, impaired cardiac baroreflex sensitivity, and systolic blood pressure variability, when compared with age-matched control subjects (n = 38). Reduced hand and feet electrochemical skin conductance and asymmetry were significantly associated with having a moderate-profound ID. Autonomic dysfunction in individuals with ID persisted after controlling for age, sex, and other metabolic parameters. Subjects in the ID group also showed significantly increased blood pressure, body mass index, and waist/hip circumference ratio, as well as increased plasma hemoglobin A1c and high-sensitivity C-reactive protein levels. We conclude that autonomic dysfunction is present in young adults with ID and is more marked in those with more severe disability. These finding have important implications in developing preventative strategies to reduce the risk of cardiovascular disease in people with ID.NEW & NOTEWORTHY Adults with intellectual disability experience higher risk of premature death than the general population. Our investigation highlights increased cardiovascular risk markers and autonomic dysfunction in young adults with intellectual disability compared with control adults. Autonomic dysfunction was more marked in those with a more severe disability but independent of cardiovascular parameters. Assessment of autonomic nervous system (ANS) function may provide insight into the mechanisms of cardiometabolic disease development and progression in young adults with intellectual disability.

Keywords: baroreflex function; blood pressure; cardiovascular risk; heart rate variability; sudomotor function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Autonomic Nervous System / physiopathology*
  • Autonomic Nervous System Diseases / diagnosis
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / physiopathology
  • Baroreflex
  • Blood Pressure
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular System / innervation*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Heart Disease Risk Factors
  • Heart Rate
  • Humans
  • Intellectual Disability / complications*
  • Intellectual Disability / diagnosis
  • Male
  • Middle Aged
  • Persons with Mental Disabilities*
  • Risk Assessment
  • Severity of Illness Index
  • Sweat Glands / innervation*
  • Sweating
  • Young Adult