Stimulant tie to heart disease not so scary

[ADHD_DAD]

I saw news of a publication in JAMA Psychiatry in November 2023 allegedly showing a 4% increase in cardiovascular disease with long term use of stimulants for the treatment of ADHD. I reviewed the article (and link is attached). It involved a a study of individuals in Sweden who used stimulants for the the treatment of ADHD for the 14 year period between January 1, 2007 and December 31, 2020. While a link was found, the "cardiovascular disease" found to be related (4% increase in occurrence) was only hypertension (high blood pressure). This was not a surprising finding since I believe the link between stimulants (like caffeine) and high blood pressure has been long known (and the article suggests the study subjects were on the stimulants when the blood pressure was tested).

Importantly, it found NO relationship between long term stimulant use for ADHD and increased risk or occurrence of arrhythmias, heart failure, ischemic heart disease, thromboembolic heart disease or stroke. As noted, only link (4% increase) was to high blood pressure.

My recommendation is that if you have concerns about side effects of any kind, you discuss them with the prescriber. My own discussions have revealed that the thinking seems to be that the benefits of the medications far outweigh this risk. I continue to advocate for the "3 legged stool" approach to management: 1. medication, 2. lifestyle modification at home, 3. support and reasonable accommodations at school (the most challenging "leg" for us). It has been hugely successful for us. My son went from an inability to focus and learn, being labelled as learning disabled, and being held in nearly daily from recess to getting accepted to his first choice college (with an academic scholarship to boot). While I will not ignore the results of this study, it is not a scary as the TV made it seem. Link attached. jamanetwork.com/journals/ja...

[MyWanderfulBoy]

Thank you for sharing this. Definitely a case of the benefits outweighing the risk. The 3 legged stool approach is what’s helping my 7 year old son immensely.

[Onthemove1971]

Thank you for providing this for us. I also agree that the need for stimulants far out weigh the side effects.

[insideoutbutterfly]

Thank you for posting this article. I’m going to give to my daughters primary physician as a reminded to check cardio health during annual check ups. This article has me curious about adhd meds and cholesterol health our daughter just had her annual check up and her cholesterol levels had elevated. I will check into this and share what I learn. Thank you again

[ADHD_DAD in reply to insideoutbutterfly]

It is always good to ask questions. Life and parenthood frequently involve weighing risks against benefits. We are all just doing the best we can with the information we have and trying to be good parents. There is no one size fits all approach to parenting or ADHD management. I admire your efforts to constantly seek new information and stay up to date on current developments. I attached (and posted about) the article since I favor (when possible) reviewing the source material rather than accepting another's interpretation. Here, the news reported that JAMA published a study suggesting a tie between long term stimulant use and cardiovascular disease. This was alarming. Had the news report been that the study found NO relationship between long term stimulant use for ADHD and increased risk or occurrence of arrhythmias, heart failure, ischemic heart disease, thromboembolic heart disease or stroke (which is what the study actually found), it would not have alarmed me. My goal was to reassure other parents who perhaps saw (or read) only the news article but not the actual study. As noted in the title, the reality is "not so scary."

[4travelers in reply to insideoutbutterfly]

I treat adult cardiac patients- yes, ADHD meds can effect Blood pressure- this is nothing new. Stimulants don’t effect cholesterol. Yes, you should know your child’s cholesterol for managing their diet, but ADHD meds don’t effect it.

[Klmamma]

I bet the study didn't cover the genetic makeup of the users family either. People with ADHD are more likely to have a wide variety of diseases than those who don't. It's a quality of life issue for us too so we will continue to do it.