A Narrative Review of Cardiovascular Health in Autistic Individuals: Epidemiologic Evidence, Mechanistic Pathways, and Future Directions

Autistic individuals—representing one in 31 individuals in the U.S.—experience disproportionate poor cardiovascular health. This review synthesizes the current evidence on cardiovascular health in autism, with attention to epidemiology, modifying factors, mechanistic pathways, and implications for future research and practice. Evidence from population-based cohorts and systematic reviews demonstrates elevated cardiovascular risk factors among autistic individuals, driven by interacting behavioral, biological, psychosocial, and environmental pathways and modified by individual and family characteristics. Studies are limited by methodological challenges and future research should: (1) focus on comprehensive assessments of cardiovascular health, (2) align with developmental science, (3) integrate multiple levels of analysis, (4) evaluate associations between mental and physical health, and (5) shift from autism biomarkers to health biomarkers. Cardiovascular health is an urgent priority for autistic individuals and there is a need for improved research to inform effective health interventions for this population.