Risk Factors for Coronary Artery Disease among Individuals with Rare Syndrome Intellectual Disabilities

Abstract

Coronary artery disease is a leading cause of death among the aging members of the general population. Treatment strategies addressing the well defined risk factors and genetic factors and which prevent and reduce arterial vascular disease have been established. As in the general population, the prevalence of coronary artery disease also increases with age among adults with intellectual disability (ID), presumably due to the same risk factors. Within the ID population, however, there is a subgroup of individuals with ID due to rare syndromes who are predisposed to premature arteriosclerosis. Hypertension, diabetes mellitus, obesity, hyperhomocysteinemia, and structural arterial abnormalities appear to be associated with these syndromes predisposing them to the early development of widespread vascular disease. Reviewed are the associations between the development of premature arteriosclerosis and rare syndromes of ID. Awareness of the associations may lead to the development of more focused preventive healthcare plans among these groups of individuals.

Prevalence of hypertension in adults with intellectual disability in the Netherlands

“…It is beyond the intention of this article to list all the syndromes possibly linked with hypertension. For a literature study we refer to the paper by Wallace (2004) on risk factors for coronary artery disease in rare syndromes with ID which includes a section on syndromes linked with hypertension and an explanation on the different aetiological pathways.…”

Primary care for people with an intellectual disability — what is prescribed? An analysis of medication recommendations from the BEACH dataset

“…The comparatively low rate of cardiovascular medication recommendations, particularly antihypertensives, at ID group encounters is surprising given elevated cardiovascular risk factors associated with a diagnosis of ID. 35 People with ID are prescribed antipsychotics (many of which have a high cardiometabolic liability) at greater rates, and beginning at an earlier age, than the general population. 36 They are also less likely to be physically active, 37 more likely to be overweight, 38 and more likely to experience genetic syndromes associated with elevated baseline risk.…”

“…36 They are also less likely to be physically active, 37 more likely to be overweight, 38 and more likely to experience genetic syndromes associated with elevated baseline risk. 35…”

Sexual Satisfaction in Obese People

“…Negative social experiences leading to sometimes serious psychological consequences arise primarily from stereotypes and false perceptions about the causes of obesity, the possibility of controlling it, and the personality traits of obese people (Carr et al 2013;Hall 2018). Obesity is caused by multiple uncontrollable and etiologic personal and environmental factors, such as endocrine disorders, medication, and genetic conditions (Wallace 2004). The psychosocial situation of obese people is also affected by socially shared beliefs regarding appearance and body structure-especially regarding women.…”