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Are adults with attention deficit hyperactivity disorder at greater risk of cardiovascular diseases?

Scientists are investigating to what extent adult attention deficit hyperactivity disorder (ADHD) is associated with a higher risk of conditions affecting the heart and blood vessels.

Health

There is more and more evidence pointing to a higher risk for cardiovascular diseases (CVDs) in people with mental disorders. However, we know very little about the risk for CVDs in people with ADHD. With support from the EU-funded CoCA, TIMESPAN and NEWBREED projects, a team of researchers aimed to fill this knowledge gap by exploring the potential links between ADHD and a broad range of CVDs in adults. The findings were published in the journal ‘World Psychiatry’.

Mechanisms underlying association between ADHD and CVDs

Co-led by CoCA and TIMESPAN project partner Karolinska Institutet in Sweden, researchers conducted a large observational study to find out the association between ADHD and about 20 different CVDs when separated from other risk factors, such as type 2 diabetes, obesity, smoking, sleep problems and mental disorders. “We found that adults with ADHD were more than twice as likely to develop at least one cardiovascular disease, compared with those without ADHD,” states study first author Lin Li, postdoctoral researcher at Karolinska Institutet’s Department of Medical Epidemiology and Biostatistics in a news release posted on the medical university’s website. “When we accounted for other well-established risk factors for CVDs, the association weakened but still remained significant, which indicates that ADHD is an independent risk factor for a wide range of cardiovascular diseases.” The study used the national registry data of over 5 million Swedish adults, including about 37 000 people with ADHD. After nearly 12 years of follow-up on average, 38 % of those with ADHD had at least one CVD diagnosis, compared to 24 % without. Risks were higher for all types of CVDs, and particularly for cardiac arrest, haemorrhagic stroke and peripheral vascular diseases. The connection was to some extent stronger in men than in women. The presence of two or more psychiatric conditions at the same time, especially eating and substance use disorders, greatly increased CVD risk in people with ADHD. Treatment using stimulants and other psychiatric drugs such as antidepressants and anxiety-reducing medication did not substantially impact the link between ADHD and CVD.

Additional studies needed

“Clinicians needs [sic] to carefully consider psychiatric comorbidity and lifestyle factors to help reduce the CVD risk in individuals with ADHD, but we also need more research to explore plausible biological mechanisms, such as shared genetic components for ADHD and cardiovascular disease,” explains study co-author Henrik Larsson, affiliated researcher at Karolinska Institutet and professor at NEWBREED project coordinator Örebro University’s School of Medical Sciences, also in Sweden. The results of the study supported by CoCA (Comorbid Conditions of Attention deficit / hyperactivity disorder), TIMESPAN (Management of chronic cardiometabolic disease and treatment discontinuity in adult ADHD patients), and NEWBREED (Training a new breed of interdisciplinary researchers to respond to the opportunities and challenges of ageing) emphasise the need to monitor cardiovascular health in people with ADHD and to develop age-appropriate and tailored strategies to reduce cardiovascular risk. For more information, please see: CoCA project website TIMESPAN project NEWBREED project web page

Keywords

CoCA, TIMESPAN, NEWBREED, attention deficit hyperactivity disorder, ADHD, cardiovascular disease, CVD, cardiovascular

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