People who use ADHD medicine for a long time and in higher-than-average doses seem to have a higher risk of some cardiovascular diseases, according to a study published in JAMA Psychiatry.

In the study, conducted with over 275,000 Swedish ADHD patients, researchers examined ADHD medication use for up to 14 years. They were then able to show that ADHD medication when taken for a longer time and in higher doses than average is associated with a higher risk of some cardiovascular diseases, primarily hypertension and arterial disease.

In general, the risk of cardiovascular disease increased by approximately 4% annually. The risk increase was greatest in the first few years of treatment and then leveled off, and it was only statistically significant at doses higher than 1.5 times the average daily dose (so-called defined daily dose). This means that those treated with lower doses are not likely to develop cardiovascular disease, according to the researchers.

“There is a long list of drugs that have been linked to a comparable increased risk of hypertension when used long-term, such as the one found here, so patients should not be alarmed by these findings,” says Le Zhang, postdoc researcher at Karolinska Institute in Sweden and first author of the study, in a release. “However, in clinical practice, the raised risk should be carefully weighed against the recognized benefits of treatment on a case-by-case basis. Doctors should also regularly follow up the ADHD patients to find signs and symptoms of cardiovascular disease while they’re on medication over the long-term.”

Since this is an observational study, it is not possible to conclude that it is the ADHD medication that leads to an increased risk of cardiovascular disease. As the researchers point out, it could depend on other medications, symptom severity, or lifestyle factors.

The study was financed by the EU’s Horizon 2020 Research and Innovation Programme and Forte (the Swedish Research Council for Health, Working Life and Welfare). 

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