Cardiovascular disease and related risk factors in adults with cerebral palsy: A systematic review

Introduction/Background Cerebral palsy (CP) is the most common pediatric-onset physical disability. Individuals with mild to moderate CP can expect life expectancies similar to the general population; however recent evidence has shown that individuals with CP have progressive functional declines, as well as increased physical inactivity and sedentary behaviour - each of which increases with age. These factors likely place individuals with CP at a greater risk for secondary chronic conditions, such as cardiovascular disease (CVD). The aim of this study is to summarize the literature on the prevalence of CVD, risk factors of CVD, and CVD-related mortality in adults with CP. Material and method A systematic review was conducted across the PubMed, Ovid, Cochrane and CINAHL databases. Selection criteria included adults with CP ≥ 18 years. Outcomes were grouped into two classes of interest: (1) CVD and CVD risk factors; and (2) CVD-related mortality. Results Nineteen studies met the inclusion criteria. Only one study reported directly on the prevalence of CVD in adults with CP, where adults with CP reported greater CVD conditions than adults without CP (15.1 vs. 9.1%, P <0.001). Overweight and obesity were the most commonly reported risk factors of CVD. Five studies included data on CVD-related mortality in persons with CP, where CVD- and circulatory system-related deaths were elevated and more common at a younger age in adults with CP than in the general population. Heterogeneity in results prevented quantitative analysis. Conclusion Our understanding of the prevalence of CVD in this population is fragmented by studies that are small in size and geographically isolated thus preventing definitive conclusions. Of the CVD risk factors identified in this review, it appears that overweight/obesity may be elevated in adults with CP, identifying an important health characteristic that could be managed during clinical encounters early on in this population.