Abstract 4144597: Cardiovascular Health Among Youth with Neurodevelopmental Disability: Analysis of National Survey of Children's Health (NSCH) – 2021

Introduction: The National Survey of Children's Health (NSCH) provides data for key measures of child health and well-being. The aim of this study is to characterize the cardiovascular health (CVH) status of youth with neurodevelopmental disabilities (NDD) compared to those without neurodevelopmental disabilities (non-NDD). Hypothesis: Youth with NDD are more likely to have poor CVH status compared to non-NDD youth. Methods: We compared the odds of poor CVH status in youth with NDD vs non-NDD, using 2021 NSCH data, according to a modified AHA Life’s Essential 8 (LE8) scoring system. Participants were identified as having NDD based on the Diagnostic and Statistical Manual of Mental Disorders and diagnosis of an intellectual, communication, autism spectrum, attention-deficit/hyperactivity, specific learning, or neurodevelopmental motor disorder, including Tic disorder. The CVH status of each youth was scored according to a modified LE8 score- range 0 to 100 points, with higher scores indicating good health. Individual scores were generated for sleep (sleep duration), smoking (smoking/exposure), diabetes mellitus (yes/no), obesity (BMI percentile), heart condition (yes/no), and dyslipidemia (yes/no). A composite CVH score was generated using scores for sleep, smoking, diabetes mellitus, and obesity. Logistic regression was used to analyze the relationship between NDD and CVH status. Propensity score techniques were applied to address the potential selection bias between NDD and non-NDD. Results: 12,134 youth, 3 to 17 years of age, were identified as having NDD and 44,960 without. Compared to those with NDD, non-NDD participants were less likely to have age-inappropriate sleep duration (63.4 vs. 55.3, p <0.0001 ), smoking/exposure (94.5 vs. 90.7, p<0.0001 ), diabetes mellitus (95.2 vs. 90.2, p <0.0001 ), obesity (80.0 vs. 73.2, p <0.0001 ), a heart condition (95.4 vs. 93.8, p=0.021 ), or dyslipidemia (98.1 vs. 95, p<0.0001 ). Overall CVH status was (93.9 vs. 91.0, p<0.0001 ) among non-NDD vs NDD participants. NDD participants had a greater odds of having a heart condition (OR=1.91, 95% CI: 1.51-2.42) and poor CVH status (OR=1.53, 95% CI: 1.45-1.62). Propensity score matching showed similar results. Conclusions: Neurodevelopmental disability is associated with poorer CVH status in youth. Efforts to improve CVH status in youth should include greater focus on youth with NDD.