ADHD drugs not significantly associated with CV events in youth

January 01, 0001

ADHD drugs not significantly associated with CV events in youth

Adverse-event reports from North America have raised concern that the use of drugs for attention deficit-hyperactivity disorder (ADHD) increases the risk of serious cardiovascular events. These US authors conducted a retrospective cohort study with automated data from four health plans, with 1,200,438 children and young adults between the ages of 2 and 24 years and 2,579,104 person-years of follow-up, including 373,667 person-years of current use of ADHD drugs. They identified serious cardiovascular events (sudden cardiac death, acute myocardial infarction, and stroke) from health- plan data and vital records, with end points validated by medical-record review.

They found: "Cohort members had 81 serious cardiovascular events (3.1 per 100,000 person-years). Current users of ADHD drugs were not at increased risk for serious cardiovascular events (adjusted hazard ratio, 0.75; NS). Risk was not increased for any of the individual end points, or for current users as compared with former users (adjusted hazard ratio, 0.70; NS). Alternative analyses addressing several study assumptions also showed no significant association between the use of an ADHD drug and the risk of a study end point."

The authors concluded: "This large study showed no evidence that current use of an ADHD drug was associated with an increased risk of serious cardiovascular events, although the upper limit of the 95% confidence interval indicated that a doubling of the risk could not be ruled out. However, the absolute magnitude of such an increased risk would be low."

Perhaps this study will lay the issue to rest.

For the full abstract, click here.

N Engl J Med published online 1 Novewmber 2011 © 2011 to the Massachusetts Medical Society
ADHD Drugs and Serious Cardiovascular Events in Children and Young Adults. William O. Cooper, Laurel A. Habel, Colin M. Sox, et al. Correspondence to Dr. Cooper: william.cooper@vanderbilt.edu

Category: P. Psychological, K. Circulartory. Keywords: attention deficit-hyperactivity disorder, ADHD, children, young adults, adverse drug events, cardiovascular events, retrospective cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 15 November 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.