Prolonged pharmacotherapy for ADHD increased cardiovascular risk

Long-term cumulative pharmacotherapy for attention deficit hyperactivity disorder (ADHD) was associated with a small but statistically significant increase in the risk of arterial hypertension and arterial disease. Each year of pharmacotherapy was found to be associated with an average increase in cardiovascular disease risk of 4%, with the risk increasing by 8% per year in the first three years.

Researchers from Karolinska Institute (Sweden) studied the association of cumulative pharmacotherapy for ADHD, individual medications, and their doses with various cardiovascular events in children and adults by gender and age. The results of the study were published by Medscape.

ADHD therapy lasting 3-5 years increased the risk of arterial hypertension by 72% and arterial disease by 65%. If treatment lasted more than five years, the risk increased by 80% and 49%, respectively.

Each additional year of ADHD medication increased the risk of cardiovascular disease by 4%. The risk increased by 8% per year in the first three years of treatment and then stabilized. No effect of sex and age on these rates was found.

They analyzed data from 278,027 people aged 6-64 years with a diagnosis of ADHD or who were receiving medications designed to treat the syndrome. Cardiovascular disease was identified in 10,388 participants. The duration of follow-up was 14 years.

Decisions to prescribe medications to treat ADHD should be based on a careful evaluation of the potential benefit-to-risk ratio, the authors said. Clinicians should be especially vigilant when prescribing medications to patients with established heart disease. And patients using high-dose ADHD medications should be closely monitored for early detection of cardiovascular disease.