The long-term use of attention-deficit/hyperactivity disorder (ADHD) medications may increase a person’s risk of significant cardiovascular issues, according to a new analysis published in JAMA Psychiatry.[1]
“The use of ADHD medication has increased greatly in both children and adults during the past decades,” wrote first author Le Zhang, PhD, with the department of medical epidemiology and biostatistics at the Karolinska Institute in Sweden, and colleagues. “Although the effectiveness of ADHD medications has been demonstrated in randomized clinical trials and other studies, concerns remain regarding their potential cardiovascular safety.”
Zhang et al. explored data from more than 275,000 patients in Sweden with confirmed ADHD between the ages of 6 and 64 years old. All patients were diagnosed with ADHD or prescribed ADHD medications from 2007 to 2020. The most commonly prescribed ADHD medications were methylphenidate, atomoxetine and lisdexamfetamine.
Overall, the cardiovascular disease (CVD) incidence rate was 7.34 cases per 1,000 person-years. After certain exclusions were made, 10,388 CVD patients with a history of taking ADHD medications were compared with 51,672 matched controls without CVD. The median follow-up time was just slightly more than four years for both patients with and without CVD.
The group determined that patients taking ADHD medications for longer periods of time faced a higher risk of CVD than patients who did not take these medications. Over the course of the study, each additional year a patient took ADHD medications appeared to increase their CVD risk by 4%. This was seen in both children and adults, and in both men and women.
When individually looking at specific types of CVD, ADHD medications were linked to a heightened risk of hypertension and arterial disease. They were not linked to higher risk of arrhythmias, heart failure, ischemic heart disease, thromboembolic disease or cerebrovascular disease, but the authors did say this “does not rule out an increased risk for mild arrhythmias or subclinical symptoms.”
“We found individuals with long-term ADHD medication use had an increased risk of incident CVD in a dose-response manner in the first three years of cumulative ADHD medication use,” the authors wrote. “To our knowledge, few previous studies have investigated the association between long-term ADHD medication use and the risk of CVD with follow-up of more than two years.”
Even though this trend was comparable among men and women, the group did emphasize this is an area where more information is needed.
“Research has indicated that females diagnosed with ADHD may demonstrate different comorbidity patterns and potentially have different responses to stimulant medications compared with males,” the group wrote. “Therefore, additional studies are needed to explore and better understand the potential sex-specific differences in cardiovascular responses to ADHD medications.”
Similar findings were reported in JAMA Network Open back in November 2022. Click here to read more.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.