Growing evidence shows that people on the autism spectrum face a higher risk of cardiometabolic conditions such as heart disease, stroke, and type 2 diabetes. A large nationwide study from the Netherlands, involving more than 8 million people, adds important detail to this picture and highlights why proactive heart health is essential for autistic children, adolescents, and adults.
In this guide, you will learn how autism relates to cardiometabolic health, practical steps on how to prevent heart disease, early signs of a heart attack to watch for, and how lifestyle and medical care can work together to reduce long-term risks.
What the Dutch study found about autism and heart health
The nationwide cohort study analyzed medical records across the Netherlands and compared people with and without an autism diagnosis. Researchers found that individuals with autism were more likely to be diagnosed with cardiometabolic conditions, and that these diagnoses tended to appear earlier, often in adolescence or young adulthood.
Cardiometabolic conditions explained
Cardiometabolic conditions are disorders that affect both the cardiovascular system and metabolism. They often occur together and can raise the risk of serious events like heart attack or stroke. Common cardiometabolic conditions include:
- High blood pressure
- Abnormal cholesterol or triglycerides
- Type 2 diabetes and prediabetes
- Obesity and central (abdominal) obesity
- Coronary artery disease and other cardiovascular diseases
The new findings underline that cardiometabolic health is not just an issue for older adults. For many people on the autism spectrum, the window for prevention starts far earlier.
Why cardiometabolic risks may be higher in autism
Autism itself does not cause heart disease, but it is linked to a cluster of biological, behavioral, and social factors that can influence cardiometabolic risk. These factors interact in complex ways and vary widely from person to person.
Potential contributing factors
- Genetic and biological influences. Some of the same genetic or neurodevelopmental pathways associated with autism may also affect blood pressure, metabolism, or inflammation.
- Co-occurring conditions. Attention-deficit/hyperactivity disorder, anxiety, sleep disorders, and the use of certain medications can affect weight, appetite, blood sugar, and heart rate.
- Dietary patterns and sensory needs. Sensory sensitivities and strong food preferences can make varied eating difficult, which may affect cholesterol, blood sugar, and weight.
- Lower physical activity. Barriers to sports, crowded gyms, or group exercise can reduce daily movement, which is a key factor in how to prevent heart disease.
- Access to care. Communication differences, underdiagnosis in older adults, and overwhelmed healthcare systems can delay routine screenings and treatment.
These influences do not mean that cardiometabolic disease is inevitable. They simply highlight why earlier screening, tailored support, and clear information about heart health are especially important for autistic individuals and their families.
Early heart protection: why timing matters
The Dutch study suggests that cardiometabolic conditions are appearing in autistic adolescents and young adults more often than in their non-autistic peers. This earlier onset means prevention and monitoring should begin early, often in childhood and the teenage years.
Discuss with your healthcare provider when to start checking blood pressure, cholesterol, blood sugar, and weight trends, and how often to repeat these tests. Regular checkups can catch subtle changes long before symptoms appear.
Practical ways to support heart health in autism
Heart disease prevention is not about perfection. It is about building small, sustainable habits that respect individual differences and sensory needs. The strategies below can be adapted for autistic adults and for parents supporting autistic children or teens.
1. Make cardiovascular exercises at home more accessible
For many autistic people, busy gyms, bright lights, or team sports can be overwhelming. Cardiovascular exercises at home can be a more comfortable and realistic option and are an important part of how to prevent heart disease.
Ideas that can be tailored to different energy levels and sensory profiles include:
- Structured indoor cardio. Walking in place, step routines using a low step, low-impact dance videos, or stationary cycling.
- Short movement breaks. Several 5 to 10 minute bursts of activity throughout the day, such as marching, jumping jacks, or light jogging on the spot.
- Stimming-compatible movement. Repetitive movements that many autistic people find naturally regulating, such as pacing or rocking, can sometimes be shaped into light aerobic exercise by increasing duration or adding arm movements.
- Sensory-aware exercise. Dim lighting, noise-cancelling headphones, predictable routines, and preferred music can help movement feel safer and more enjoyable.
If possible, aim for at least 150 minutes of moderate-intensity aerobic activity per week, broken into manageable pieces. A healthcare professional or physiotherapist familiar with autism can help tailor goals and choose safe activities.
2. Focus on the best foods for heart health, with flexibility
Nutrition plays a crucial role in heart disease prevention and cardiometabolic disease treatments. For autistic individuals, any plan must consider taste, texture, and routine while still moving gently toward the best foods for heart health.
Heart-supportive strategies include:
- Prioritizing whole foods where possible. Vegetables, fruits, whole grains, beans, nuts, and seeds support healthy blood pressure, cholesterol, and blood sugar.
- Lean proteins. Fish, poultry, eggs, tofu, and legumes can replace some processed meats that are linked to higher cardiovascular risk.
- Healthy fats. Olive oil, avocado, and nuts provide unsaturated fats that are more favorable for cholesterol than trans fats and many saturated fats.
- Gentle swaps. Instead of overhauling the entire diet, consider small substitutions that suit sensory needs, such as switching to a slightly higher-fiber bread or adding finely chopped vegetables to familiar dishes.
- Predictable routines. Many autistic people prefer routine. A repeating meal schedule with a slow rotation of heart-healthy options can be more acceptable than constant novelty.
A registered dietitian who understands autism and sensory challenges can help design a realistic eating plan that supports cardiometabolic health without creating distress.
3. Support weight, blood pressure, and blood sugar without stigma
Weight, blood pressure, and blood sugar are sensitive topics. For autistic people, criticism, pressure to conform, or sudden demands for change can be especially overwhelming and counterproductive.
Instead of focusing solely on the scale, consider these heart-focused measures:
- Trends in blood pressure and fasting blood sugar
- Changes in cholesterol over time
- Energy levels, sleep quality, and day-to-day functioning
- Ability to participate in valued activities without shortness of breath or chest discomfort
Work with healthcare professionals who respect neurodiversity and prioritize collaborative decision-making.
Recognizing early signs of a heart attack
Knowing the early signs of a heart attack can save a life. This is important for everyone, but particularly for people with higher cardiometabolic risk, including some autistic individuals.
Common warning signs
Classic early signs of a heart attack may include:
- Chest pain, pressure, tightness, or a squeezing feeling that lasts more than a few minutes or goes away and comes back
- Pain or discomfort spreading to the arms, back, neck, jaw, or upper stomach
- Shortness of breath, with or without chest discomfort
- Sudden cold sweat, nausea, vomiting, or lightheadedness
- Unusual fatigue, especially in women and older adults
Not everyone experiences all these symptoms, and some people, including women and people with diabetes, may have less typical signs like sudden fatigue or shortness of breath without obvious chest pain.
Special considerations for autistic individuals
Some autistic people may describe pain or internal sensations differently, or may find it difficult to interpret them. Sensory sensitivities can also make it hard to distinguish between familiar discomfort and something new and serious.
Families, caregivers, and healthcare providers can help by:
- Creating simple, visual or written guides that describe heart attack symptoms in concrete language
- Practicing what to do in a medical emergency, including who to call and what to say
- Encouraging anyone with sudden chest discomfort or unexplained shortness of breath to seek urgent care, even if they are unsure
Any suspected heart attack is a medical emergency. Immediate medical evaluation is critical.
Medical options: cardiovascular disease treatments
When screenings detect high blood pressure, diabetes, high cholesterol, or early heart disease, there are effective cardiovascular disease treatments that can reduce risk and improve quality of life. Treatment plans are highly individual and should be tailored to the person’s health status and communication needs.
Typical treatment components
- Lifestyle therapies. Adjustments in nutrition, physical activity, sleep, and stress support almost all cardiometabolic disease treatments.
- Medications. Drugs to control blood pressure, lower cholesterol, or manage blood sugar are often used when lifestyle measures alone are not enough.
- Monitoring. Regular follow-up to check lab results, manage side effects, and track symptoms is essential.
- Specialist care. Cardiologists, endocrinologists, or lipid specialists may be involved, particularly for complex cases.
Making treatment autism-informed
For autistic individuals, cardiovascular disease treatments work best when clinicians and families consider sensory and communication needs, such as:
- Allowing extra time for appointments and explanations
- Using clear, concrete language and visual aids
- Keeping routines predictable when possible
- Discussing medication side effects in advance, especially those that may change appetite, weight, or energy
Involving the autistic person in all decisions to the greatest extent possible helps improve adherence and reduces anxiety around medical care.
Building a heart-healthy support network
Preventing heart disease in autism is not the responsibility of one person. It relies on a coordinated effort between individuals, families, schools, workplaces, and healthcare teams.
Supportive steps can include:
- Advocating for routine cardiometabolic screening during regular health visits
- Asking providers to explain cardiometabolic risks and prevention in autism-specific terms
- Encouraging schools and community programs to offer sensory-friendly movement opportunities
- Sharing information about early signs of a heart attack with family members and caregivers
By bringing cardiometabolic health into everyday conversations about autism, we can identify risks earlier, take meaningful preventive steps, and support longer, healthier lives.
Key takeaways
- Large-scale research suggests that people with autism face a higher and earlier risk of cardiometabolic conditions.
- Prevention efforts, including cardiovascular exercises at home and focusing on the best foods for heart health, should begin in childhood and adolescence where possible.
- Knowing the early signs of a heart attack and having a clear emergency plan can be lifesaving.
- Effective cardiovascular disease treatments exist, and care should be adapted to the unique needs and preferences of autistic individuals.
Heart health for autistic people is both a medical and a quality-of-life issue. With informed support, early monitoring, and practical lifestyle strategies, it is possible to reduce cardiometabolic risks and build a more secure foundation for long-term wellbeing.