Genetic risk for ADHD and autism may influence heart disease risk
A landmark genetic analysis suggests that people with a higher genetic predisposition to attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) may face an increased risk of certain heart diseases. By aggregating data from 14 studies and applying Mendelian randomization, researchers aim to move beyond correlation and explore potential causal links between neurodevelopmental conditions and cardiovascular health.
What the study did
The research team, led by scientists from the Medical University of Białystok in Poland, performed a systematic review and meta-analysis of existing Mendelian randomization studies. This method uses genetic variants associated with a given condition to test whether that condition directly influences an outcome, reducing confounding factors related to lifestyle or environment. By focusing on genetic instruments tied to ADHD and ASD, the researchers sought to determine whether these neurodevelopmental conditions themselves could contribute to heart disease risk.
After searching three large databases, they identified 14 studies that met their criteria. The analysis examined two directions: first, whether a genetic predisposition to ADHD or ASD affects cardiovascular outcomes (the risk of heart diseases such as coronary artery disease, heart failure, and stroke), and second, whether a genetic risk for heart disease influences the likelihood of developing ADHD or ASD.
Key findings for ADHD
The combined analysis found notable associations between a genetic predisposition for ADHD and several cardiovascular outcomes. In particular, ADHD-linked genetic variants were associated with an increased risk of coronary heart disease, heart failure, and various types of stroke, including ischemic stroke and large-artery atherothrombotic stroke. These findings imply that the biological pathways driving ADHD could directly contribute to cardiovascular problems later in life, beyond the influence of lifestyle or medication side effects.
Key findings for autism spectrum disorder
In contrast, a genetic predisposition to autism spectrum disorder showed a different pattern. The study found an elevated risk of atrial fibrillation, a common irregular heart rhythm, and heart failure among those with ASD-associated genetic variants. The analysis did not reveal a direct link between ASD genetics and stroke or coronary artery disease, suggesting distinct cardiovascular pathways associated with ASD compared with ADHD.
Bidirectional insights
Examining the relationship in the reverse direction revealed that a genetic tendency toward atrial fibrillation was associated with a higher risk of ADHD. This bidirectional signal hints at complex interactions between cardiac rhythm disorders and neurodevelopmental risk, though the authors caution that more work is needed to confirm such pathways and to untangle causality from shared biology or confounding factors.
Limitations and considerations
The authors acknowledge several limitations. The number of studies available for some comparisons was small, warranting cautious interpretation of certain results. Most genetic data came from populations of European ancestry, limiting the generalizability to other ethnic groups. Additionally, many included studies did not report statistical power calculations, underscoring the need for larger, well-designed investigations to validate these associations.
Clinical implications
While the findings are not yet ready to alter clinical practice, they underscore the potential value of incorporating cardiovascular risk assessment into the routine care of people with ADHD and ASD. Early attention to lifestyle factors—such as physical activity, diet, and smoking cessation—may play a key role in reducing long-term cardiovascular risk for individuals with neurodevelopmental conditions. Clinicians should stay alert for cardiovascular symptoms in these patients and consider proactive risk monitoring as part of comprehensive care.
Future directions
The study highlights the need for further research to map the exact biological mechanisms linking ADHD and ASD genetics with heart health. Future work should include diverse populations to improve generalizability, as well as longitudinal designs to better establish causality and directionality. A deeper understanding of these pathways could open doors to targeted prevention and treatment strategies that address both neurodevelopmental and cardiovascular health.
Bottom line
In sum, this meta-analysis adds to growing evidence that genetic predispositions for ADHD and autism may influence cardiovascular health, pointing to potential causal pathways rather than mere association. While more research is needed, the findings encourage a broader view of health management that integrates neurological and cardiac considerations across the lifespan.
