Daily Dose: Extended Use of ADHD Drugs Linked to Higher CVD Risk

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in JAMA Psychiatry that examined the association between long-term use of ADHD medication and the risk of cardiovascular disease (CVD) up to 14 years.

The study

Researchers used Sweden’s nationwide health registers to assess data on 258 835 persons aged 6-64 years with an incident diagnosis of ADHD or ADHD medication dispensation from 2007 to 2020. The primary outcome was incident CVD, such as ischemic heart disease, cerebrovascular diseases, HTN, heart failure, arrhythmias, thromboembolic disease, and arterial disease.

Among the cohort, 10 388 individuals had a diagnosis of CVD and were included in the final assessment and matched with 51 672 control participants. Among both groups, the median age was 34.6 years, 59.2% were men, and were followed for a median of 4.1 years.

Findings

Across the 14-year follow-up period, each 1-year increase of ADHD medication use was associated with a 4% increased risk of CVD (AOR 1.04, 95% CI 1.03-1.05), with a larger increase in risk in the first 3 years of cumulative use (AOR 1.08, 95% CI 1.04-1.11) and stable risk over the remaining follow-up. Investigators noted similar results were observed in children and youth (aged <25 years) and adults (aged ≥25 years).

Authors' comment

"Clinicians should be vigilant in monitoring patients, particularly among those receiving higher doses, and consistently assess signs and symptoms of CVD throughout the course of treatment. Monitoring becomes even more crucial considering the increasing number of individuals engaging in long-term use of ADHD medication."

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