Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases
A case-control study (n=278,027 individuals with diagnosis of ADHD of whom 10,338 had CVD followed for up to 14 years) showed the first 3 years of cumulative use were associated with an 8% increase in CVD risk (AOR 1.08, 1.04 to 1.11) with stable risk over remaining follow up.
Source:
JAMA Psychiatry
SPS commentary:
An accompanying editorial sets these results into clinical context and compares these findings with the results described by other researchers.
The authors endorse existing guidance from the European ADHD Guidelines Group which suggests that, “in the presence of BP values greater than the 95th percentile on average on 3 consecutive measurements, prescribers should either discontinue ongoing stimulant treatment (or not initiate a new treatment), making a referral to a specialist in hypertension, or, consider a dose reduction. If BP values do not normalize, a referral to a specialist, followed by treatment of hypertension if indicated, is recommended. Once BP has stabilized, ADHD pharmacotherapy can be resumed. Continuous and regular monitoring over time, along with implementation of lifestyle modifications, including diet and exercise, are crucial during the ongoing treatment.”