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ADHD medication link with cardiovascular events disputed

ADHD medications do not increase the risk of cardiovascular events as has previously been suggested, a large analysis shows.

The study of 150,000 young or middle-aged adults using ADHD drugs and almost 300,000 matched case controls found no increased risk of heart attack, stroke or sudden cardiac death with ADHD drugs.

In the UK NHS figures show a continuing upward trend in use of ADHD drugs over the past decade, but evidence that the drugs can increase heart rate and blood pressure had led to concerns about their associated cardiovascular risk.

The study carried out by researchers at Kaiser Permanente Northern California, Oakland, USA, in adults aged 25 to 64 years assessed the effects of methylphenidate, amphetamine, or atomoxetine.

During follow-up, there were 1,357 cases of heart attacks, 296 cases of sudden cardiac death, and 575 cases of stroke, yet no association with use of ADHD medications compared with no or rare use.

There was also ‘little support' for an increased risk for any specific medication or with longer duration of current use, the researchers reported in JAMA.

Rate ratios were similar across age groups and did not appear to be influenced by prior cardiovascular disease or by prior non-ADHD psychiatric conditions.

But co-author Dr Alan Go, acting director the research division at Kaiser Permanente said it was important to note this was an observational study.

He said: ‘Consequently, we can't rule out the possibility of a slight or modest increase in risk, and patients should discuss use of the drugs with their physician and be closely monitored.'

JAMA 2011, published online 12 December

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