ADHD medications increase risk of heart disease

Swedish scientists, together with American colleagues, analyzed data from a sample of more than 300 thousand people and found that long-term use of medications for attention deficit hyperactivity disorder (ADHD) is associated with an increased risk of developing cardiovascular diseases. How reported V JAMA Psychiatrytaking these drugs for five years increases the risk of hypertension by 80 percent.

Due to the difficulties of diagnosing and formalizing the diagnosis, the prevalence of ADHD in the population ranges from 0.5 to 26 percent. Pharmacological therapy is recommended as first-line treatment for ADHD. Over the past decades, the use of ADHD medications has increased significantly increased both in children and adults. Although their effectiveness has been confirmed in randomized clinical trials, are saved concerns regarding their potential cardiovascular safety. Because studies typically evaluate the short-term effects of drugs, it remains unclear how safe they are when taken long-term.

A team of Swedish and American scientists led by Le Zhang from the Karolinska Institute examined the association between cumulative ADHD medication use and the risk of cardiovascular disease in a sample of 278,027 ADHD patients aged 6 to 64 years. Their incidence of cardiovascular disease was compared with 51,672 patients without ADHD. The median follow-up in both groups was 4.1 years. Overall, patients with ADHD had higher rates of medical and psychiatric comorbidities and lower levels of education compared with controls.

The most commonly prescribed drug was methylphenidate, followed by atomoxetine and lisdexamfetamine. Longer cumulative duration of ADHD medication use was associated with increased risk of cardiovascular disease. After three years of taking the drugs, the risk of cardiovascular disease increased by 27 percent, and after five years it increased by 23 percent. Over the entire follow-up period, each one-year increase in medication use was associated with a four percent increase in the risk of heart and vascular disease; in the first three years the annual increase in risk was eight percent.

The most common types of cardiovascular disease were hypertension and arrhythmias. Long-term (more than five years) use of ADHD medications was associated with an increased (80 percent) risk of developing hypertension. However, scientists did not find any statistically significant increase in the risk of developing arrhythmias, heart failure, coronary heart disease, thromboembolic diseases or cerebrovascular diseases.

The discovered patterns must be taken into account when prescribing medications for ADHD. In addition, drug manufacturers will need to update drug labels to detail the safety profile.

We previously reported that scientists have discovered a causal relationship between ADHD and anorexia nervosa, major depressive disorder and post-traumatic stress disorder, as well as suicide attempts.