People with a learning disability may be at increased risk of early-onset cardiovascular disease – particularly stroke, heart failure, and deep vein thrombosis – according to new research.
The research, published in BMC Medicine, also found that the risk of heart disease increased with the severity of the learning disability.
The study’s authors say the findings suggest that healthcare professionals should be aware of the increased risk of cardiovascular disease in patients with a learning disability.
Cardiovascular disease (CVD) is a leading cause of ill health and death worldwide, accounting for one third of all deaths in 2019.
While previous studies have found that people with learning disabilities are more likely to experience adverse health outcomes, very few have analysed the association between learning disability and CVD.
This study therefore set out to discover whether having a learning disability is a risk factor for CVD. To do this, the researchers used data from national registers in Denmark.
In total, the researchers included data from 2,288,393 individuals. They followed them from birth until the date of the first diagnosis of any or a specific type of CVD event, emigration, death, or end of follow-up, depending on which came first.
Of the two million individuals included in the study, 11,954 were diagnosed with a learning disability. During the follow-up period, 5.5% (652) received a diagnosis of CVD (incidence rate, 2.4 per 1000 person-years).
Of those who did not have a learning disability, 3.4% (78,088) received a diagnosis of CVD (incidence rate, 1.9 per 1000 person-years).
This means that people with a learning disability had a 24% increased overall risk of early-onset CVD from childhood to early adulthood.
The risks were significantly elevated for the most common specific types of CVD, including cerebrovascular disease (150% increased risk), stroke (120% increased risk), heart failure (256% increased risk), and deep vein thrombosis (110% increased risk).
The severity of the learning disability also had an impact on CVD risk, and the strongest associations were observed in individuals with a severe or profound learning disability.
Using an analysis technique, the authors estimated the individuals’ ‘hazard ratio’ (likelihood of being diagnosed with CVD) based on the severity of their learning disability. Overall, people with a mild intellectual disability had a hazard ratio (HR) of 1.14, those with a moderate intellectual disability had a HR of 1.24, while those with a severe/profound intellectual disability had a HR of 1.91.
The authors of the study say the findings could be explained by the fact that people with learning disabilities are more likely to have the major risk factors associated with CVD.
Discussing the findings, they wrote: “People with intellectual disability experience higher rates of obesity, diabetes, hyperglycemia, and hyperlipidemia than people without intellectual disability… [This group] are more likely to lead a sedentary lifestyle with limited physical activity and lack awareness of the negative health impacts of certain risk factors, which could also contribute to the elevated risk of CVD.”
They add that certain factors such as social exclusion, lower income, and limited access to healthcare and leisure facilities also predispose people with learning disabilities to a higher risk of developing heart disease.
The study’s authors say the findings highlight the importance of routinely screening people with learning disabilities for CVD, as well as supporting people with learning disabilities to lead a healthy lifestyle.
They also suggest implementing CVD surveillance and early intervention strategies in order to facilitate efficient and effective care among individuals with learning disabilities in primary healthcare settings.
