Adult patients receiving treatment for attention-deficit/hyperactivity disorder (ADHD) for the first time have an increased 10-year risk for stroke, heart failure, and a composite cardiovascular outcome, with a higher risk occurring with a higher dosage, according to a study in the Journal of the American College of Cardiology .
Researchers evaluated the long-term risk for acute coronary syndrome, stroke, and heart failure associated with treatment for ADHD. They used data from Danish nationwide health registers.
Participants were aged 18 years and older and claimed a first-time prescription for treatment of ADHD ( methylphenidate , atomoxetine , lisdexamfetamine , dexamfetamine, or modafinil ) from 1998 to 2020. For comparison, a matched population without ADHD and no claimed prescription for treatment of ADHD was included.
Exposure was defined as a claimed prescription 180 days before the beginning of follow-up, 1 year after an initial claim of an ADHD medication prescription. The 3 exposure groups were the following: Prior users (who discontinued treatment before start of follow-up)
Less than 1 defined daily dose (DDD) per day
1 or more DDD per day
The 4 cardiovascular outcomes were acute coronary syndrome, stroke, heart failure, and a composite outcome that comprised each individual outcome.
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Greater attention to cardiovascular risk factors at initiation of treatment and to cardiovascular symptoms during treatment may be warranted in patients with ADHD, with particular focus on those taking a higher dosage for extended periods.The cohort included 73,264 adult first-time users of ADHD medications from 1998 to 2020. At baseline, 26,357 (36%) were prior users (42% women; median age, 30 years), 31,211 (43%) were on less than 1 DDD per day (47% women; median age, 31 years), and 15,696 (21%) were on 1 or more DDD per day (47% women; median age, 33 years). The control group included 145,456 individuals (45% women, median age, 31 years). The patients receiving treatment for ADHD were followed for a median of 6.5 years (Q1-Q3, 2.7-10 years).In the comparison of individuals with 1 or more DDD per day with prior users, an association was observed for an increased 10-year risk for stroke (risk ratio [RR], 1.2; 95% […]
ADHD Treatment Linked to Higher Long-Term Risk for Stroke and Heart Failure
