While there is sufficient evidence that proves ADHD medications can help in reducing the neurodevelopmental condition’s core symptoms, researchers have repeatedly raised concerns about both stimulants and nonstimulant medications’ cardiovascular safety.
ADHD medications regulate the levels of neurotransmitters like dopamine and norepinephrine and could potentially increase heart rate and blood pressure, according to prior findings. Methylphenidate, a stimulant commonly used to treat ADHD, has been associated with increased pulse or heart rate.
But as these previous studies only evaluated short-term effects, there is still some uncertainty on whether these changes could lead to a significant risk of developing cardiovascular disease over a long period. Whereas longterm studies have reported mixed findings.
In a recent study that included 3.9 million participants , a group of Sweden-based researchers found there was no association between the use of medicines for treating ADHD and the outcome of any cardiovascular disease (CVD).
The team analyzed 19 studies that included adults, children, and adolescents from six countries. Almost 61% of them were male. The median follow-up period of the participants was up to 9.5 years. The researchers investigated a wide range of cardiovascular diseases like hypertension, heart failure, cardiac arrest, tachyarrhythmias (abnormal heart rhythms), myocardial infarction, and stroke.
“This meta-analysis suggests no statistically significant association between ADHD medications and the risk of CVD across age groups, although a modest risk increase could not be ruled out, especially for the risk of cardiac arrest or tachyarrhythmias,” the researchers concluded.
While the absolute risk is relatively low — especially among young and middle-aged adults — CVD risk might be offset by the benefits of medications that help in alleviating ADHD symptoms and reduce the frequency of impulsivity or risky behaviors. “However, the trade-off between benefits and risks could be different in high-risk patients,” the researchers warned in their paper.
“Further investigation is warranted for the cardiovascular risk in female patients and patients with preexisting CVD as well as long-term risks associated with ADHD medication use,” they added.
In response to this study, Roy Ziegelstein from Johns Hopkins University School of Medicine wrote in JAMA: “Clinicians should be similarly cautious in reaching conclusions about the safety of ADHD medications, especially in older adults with established CVD.”
“It must also be noted that polypharmacy is particularly common in older individuals, and the potential for drug-drug interactions is therefore greater,” he added.