ADHD medication enhances the risk of heart problems in children

A new Danish study indicates that children recieving ADHD medication have a higher risk of getting heart problems.

The risk of developing heart problems is twice as big for children taking medicine for Attention Deficit-Hyperactivity Disorder (ADHD) when compared to children not receiving the medicine.

The study builds on data from 714,000 children born in 1990-1999. It is the most comprehensive, data-based study within the field explains the head of the project Søren Dalsgaard, a psychiatrist at the National Centre for Register-based Research at Aarhus University.

"I was surprised that the increased risk of heart problems was so high and that the risk did not only apply to children, who were already susceptible to heart ailments," says the psychiatrist.

"The result is worrying. It shows that clinicians must continue to be aware of the risk of heart ailments, when we prescribe medicine to ADHD patients," he says.
The study was published in the scientific publication Journal of Adolescent and Psychopharmacology.

The connection between medication and the risk of heart ailmentsIn the study, psychiatrist Dalsgaard first found a risk estimate for the difference between children without ADHD and children with this diagnosis.

The study showed that when children were given ADHD medicine their risk of getting heart problems rose from approximately 0.5 percent to about 1 percent. The precise increase of risk was calculated to be 83 per cent. Søren Dalsgaard stresses that this risk is still relatively low, also for the group receiving ADHD medicine. 


In-depth study of medication


In the study the scientists used a so-called ‘hazard ratio’. The technical term is a measurement of the relative likelihood of an event in two groups over time. A hazard ratio of 1 indicates that the probability of a particular outcome over time is the same in the two groups.

A hazard ratio of 1.83 corresponds to an increased risk of 83 percent. While a hazard ratio of 2.20 corresponds to an increased risk of 120 percent.

(Source: ’Håndbog i sund formidling’ by Siff Malue Nielsen and Ole Nørgaard, 2014).

The study covered nearly all types of ADHD medicine. Methylphenidate-based medications account for 98 per cent of treatments. This group of medication is sold under the brands Concerta, Methylin, Ritalin, Equasym XL, Motiron and Medikinet.

Other medicines such as Strattera account for the remaining 2 per cent of treatments, but their use is so low that Søren Dalsgaard did not have enough data to assess the precise effects of non-methylphenidate medications. Nonetheless, they were included in the study.

To make sure that the measured difference was not due to the disorder itself, the scientists compared children with ADHD diagnosis, who were receiving medicine, with other ADHD diagnosed children, who were not receiving medicine.The scientists found, that the hazard ratio for children receiving ADHD medicine was 120 per cent higher, than children not getting medicine.

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