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Long-term ADHD Med Use May Hike CVD Risk
Long-term exposure to medications for attention-deficit/hyperactivity disorder (ADHD) was associated with an increased risk of cardiovascular disease (CVD) in a case-control study published in JAMA Psychiatry.
“These findings highlight the importance of carefully weighing potential benefits and risks when making treatment decisions about long-term ADHD medication use,” authors noted. “Clinicians should regularly and consistently monitor cardiovascular signs and symptoms throughout the course of treatment.”
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Study participants were individuals in Sweden aged 6 to 64 years who had received an incident diagnosis of ADHD or ADHD medication dispensation between January 1, 2007, and December 31, 2020. Data on ADHD and CVD diagnoses was provided by the Swedish National Inpatient Register and the Swedish Prescribed Drug Register. Researchers used incidence density sampling to match participants with up to 5 controls without CVD who had the same follow-up duration.
Of the included 278,027 participants with ADHD, 10,388 were found to have CVD. Patients with CVD were then matched with 52,672 control patients without CVD. Both groups had a median age of 34.6 years, were 40.8% female, and had a median follow-up time of 4.1 years. Longer cumulative use of ADHD medications was associated with an increased risk of CVD compared with nonuse (0 to ≤1 year: AOR, 0.99 [95% CI, 0.93-1.06]; 1 to ≤2 years: AOR, 1.09 [95% CI, 1.01-1.18]; 2 to ≤3 years: AOR, 1.15 [95% CI, 1.05-1.25]; 3 to ≤5 years: AOR, 1.27 [95% CI, 1.17-1.39]; and >5 years: AOR, 1.23 [95% CI, 1.12-1.36]). Each 1-year increase of ADHD medication use was associated with a 4% increased risk of CVD, especially in the first 3 years of cumulative use, after which risk stabilized over the remaining 11 years of follow-up. Similar patterns were observed in both youth (younger than 25 year) and adults (25 years and over).
Authors noted that there could be under-ascertainment of CVDs in the registers used for this study and that exposure misclassification may have occurred if participants with ADHD did not take their medications as prescribed.
“Monitoring becomes even more crucial considering the increasing number of individuals engaging in long-term use of ADHD medication,” authors concluded.
