Can We Predict Heart Disease Risk in Adults Starting ADHD Medication?

What you need to know

• Adults with ADHD may be at higher risk for heart disease, especially when starting ADHD medication
• Researchers developed a new model to predict heart disease risk in adults starting ADHD medication
• The model includes both traditional risk factors like high blood pressure and new factors like substance use disorders
• More research is needed before the model can be used in clinical practice

Background

Heart disease is the leading cause of death worldwide. Adults with attention-deficit/hyperactivity disorder (ADHD) may be at higher risk for heart disease due to factors like high blood pressure, obesity, smoking, and diabetes. Additionally, ADHD medications can increase heart rate and blood pressure.

Doctors use risk prediction tools to identify people at high risk for heart disease. However, existing tools may not accurately predict risk in adults with ADHD. This study aimed to develop a new risk prediction model specifically for adults starting ADHD medication.

The Study

Researchers in Sweden used national health records to study 24,186 adults who started ADHD medication between 2008-2011. They followed these individuals for 2 years to see who developed heart disease.

The researchers created a model to predict heart disease risk using both traditional risk factors (like age, sex, high blood pressure) and new factors that may be relevant for people with ADHD (like substance use disorders and other psychiatric medications).

Key Findings

• 413 people (1.7%) developed heart disease within 2 years of starting ADHD medication
• The new model included 8 traditional risk factors and 4 new risk factors
• Adding the new risk factors improved the model’s ability to predict who would develop heart disease
• The model showed acceptable overall performance in distinguishing between those who did and did not develop heart disease

Traditional Risk Factors

The model included these traditional heart disease risk factors:

• Older age
• Male sex
• High blood pressure
• Diabetes
• Obesity
• High cholesterol
• Tobacco use disorder
• Family history of heart disease

New Risk Factors

The model also included these new risk factors:

• Substance use disorders (other than tobacco and alcohol)
• Use of mood stabilizer medications
• Use of antipsychotic medications
• Use of medications for substance use disorders

What This Means

This study suggests that considering additional risk factors beyond just the traditional ones may help better predict heart disease risk in adults starting ADHD medication. However, more research is needed before this model can be used in clinical practice.

Implications for Patients

If you are an adult with ADHD starting medication treatment, your doctor may want to assess your heart disease risk. This could involve checking for both traditional risk factors like high blood pressure as well as other factors like substance use or other psychiatric medications you take.

Patients at higher risk may need closer monitoring when starting ADHD medication. Your doctor may recommend lifestyle changes, additional tests, or adjustments to your treatment plan to help reduce your risk.

Limitations

Some key limitations of this study include:

• It only followed patients for 2 years, which may not be long enough to capture all cases of heart disease
• It relied on diagnostic codes in health records, which may not capture all risk factors
• The study was done in Sweden, so results may not apply to other countries
• More research is needed to validate the model in other groups of patients

Conclusions

• A new model may help better predict heart disease risk in adults starting ADHD medication
• The model considers both traditional risk factors and factors specific to people with ADHD
• More research is needed before the model can be used clinically
• Adults with ADHD starting medication may benefit from comprehensive heart disease risk assessment
• Patients at higher risk may need closer monitoring and individualized treatment plans

While this model shows promise, it is not yet ready for clinical use. Talk to your doctor about assessing your personal heart disease risk factors if you are starting ADHD medication as an adult. A comprehensive evaluation can help ensure you receive safe and effective treatment.