Cardiovascular Effects of ADHD Therapies

Torres-Acosta, Noel; O’Keefe, James H.; O’Keefe, Caroline L.; Lavie, Carl J.

doi:10.1016/j.jacc.2020.05.081

Cited by 45 publications

(35 citation statements)

References 49 publications

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“… 23 , 24 , 25 , 26 This gap in evidence is highlighted as an important area of concern, especially given the increasing use of these agents in this population. 27 We explored the association between prescription stimulants and the risk of CV events among older adults.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Stimulant Use and Cardiovascular Event Risks Among Older Adults

et al. 2021

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IMPORTANCE Use of stimulants continues to increase among older adults for a variety of indications. An association between stimulant use and increased risk of cardiovascular (CV) events has been established among children and young adults, but few studies have explored the risk of CV events among older patients, a group with increased baseline risk.OBJECTIVE To evaluate the association between stimulant use and risk of CV events among older adults.

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Section: Introductionmentioning

confidence: 99%

Assessment of Stimulant Use and Cardiovascular Event Risks Among Older Adults

et al. 2021

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“…Long term use of amphetamines is shown to slightly elevate the patients’ HR and BP [40] . A recent review showed ADHD medications cause modest elevations in resting heart rate and blood pressure, in addition, other adverse effects due to ADHD stimulants included arrhythmia, nonischemic cardiomyopathy, Takotsubo cardiomyopathy, and sudden death [41] . Our results indicate that treatment with stimulating agents for 3 months increases the blood pressure and heart rate but these alterations remain within the normal range.…”

Section: Discussionmentioning

confidence: 99%

Effects of methylphenidate on blood pressure, QT-interval, and cardiac output in ADHD diagnosed children: A three months’ follow-up study

Omidi

Ghorashi

Tajrishi

et al. 2021

IJC Heart & Vasculature

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Background Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood. It’s been suggested that both the condition and the medications used to treat it can affect the cardiovascular system. This study aims to determine whether methylphenidate has the significant effects in cardiac indices. Methods In this prospective study, 100 newly ADHD-diagnosed children aged 6 to 11 whom all on methylphenidate were included. The demographic, clinical data including the blood pressure and heart rate (HR), echocardiographic, and QT-interval were recorded at baseline and after three months of follow-up. Results After the follow-up period, we observed no abnormal systolic, diastolic, or mean arterial pressure in any of the participants based on their age, height, and gender (p < 0.001). However, the mean of all these variables was significantly increased (p 〈0 0 1). Mean pulse pressure was also higher than baseline but it wasn’t statistically significant (p = 0.059). No significant change was observed in echocardiographic parameters and QT. Conclusion Short-term treatment of ADHD in children with methylphenidate does not have a meaningful relationship with hypertension and increased corrected QT interval. However, an increase in blood pressure and corrected QT interval within a non-pathological range suggests that longer follow-ups may reveal an association.

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“…However, creatine use also has been linked to weight gain [23], which could represent a detriment to long-term cardiovascular health, as higher weight and BMI are primary risk factors for CVD [24]. Additionally, recent reviews have found that stimulants are associated with significant elevations in systolic and diastolic blood pressure [25,26]. Caffeine, a stimulant that can be used for performance enhancement and is commonly included in mixtures of legal PES, activates the sympathetic nervous system and catecholamines, leading to elevations in blood pressure [27,28].…”

Section: Introductionmentioning

confidence: 99%

Associations between legal performance-enhancing substance use and future cardiovascular disease risk factors in young adults: A prospective cohort study

et al. 2020

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Background Legal performance-enhancing substances (PES), such as creatine, are commonly used by adolescents and young adults. As PES are mostly unregulated by the US Food and Drug Administration, there has been limited empirical attention devoted to examining their long-term safety and health outcomes. Preliminary studies have demonstrated associations between PES use and severe medical events, including hospitalizations and death. PES could be linked to cardiovascular disease (CVD), the most common cause of mortality in the US, by altering the myocardium, vasculature, or metabolism. The objective of this study was to examine prospective associations between the use of legal PES in young adulthood and CVD risk factors at seven-year follow-up. Materials and methods Nationally representative longitudinal cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves III (2001–2002) and IV (2008), were analyzed. Regression models determined the prospective association between the use of legal PES (e.g. creatine monohydrate) and CVD risk factors (e.g. body mass index, diabetes, hypertension, hyperlipidemia), adjusting for relevant covariates. Results Among the diverse sample of 11,996 male and female participants, no significant differences by PES use in body mass index, diabetes, hypertension, or hyperlipidemia were noted at Wave III. In unadjusted comparisons, legal PES users (versus non-users) were more likely to be White, be male, be college educated, drink alcohol, and engage in weightlifting, exercise, individual sports, team sports, and other strength training. There were no significant prospective associations between legal PES use at Wave III and body mass index, hemoglobin A1c, systolic and diastolic blood pressure, and cholesterol (total, HDL, LDL, triglycerides) deciles at seven-year follow-up (Wave IV), adjusting for demographics, health behaviors, and Wave III CVD risk factors. Similarly, there were no significant prospective associations between legal PES use and diabetes, hypertension, or hyperlipidemia based on objective measures or self-reported medications and diagnoses, adjusting for demographics, health behaviors, and Wave III CVD risk. Conclusions We do not find evidence for a prospective association between legal PES use and CVD risk factors in young adults over seven years of follow-up, including BMI, diabetes, hypertension, or hyperlipidemia. It should be noted that legal PES use was operationalized dichotomously and as one broad category, which did not account for frequency, amount, or duration of use. Given the lack of regulation and clinical trials data, observational studies can provide much needed data to inform the safety and long-term health associations of legal PES use and, in turn, inform clinical guidance and policy.

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Cardiovascular Effects of ADHD Therapies

Cited by 45 publications

References 49 publications

Assessment of Stimulant Use and Cardiovascular Event Risks Among Older Adults

Assessment of Stimulant Use and Cardiovascular Event Risks Among Older Adults

Effects of methylphenidate on blood pressure, QT-interval, and cardiac output in ADHD diagnosed children: A three months’ follow-up study

Associations between legal performance-enhancing substance use and future cardiovascular disease risk factors in young adults: A prospective cohort study

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