A large follow-up study led by researchers at the Karolinska Institutet and the University of Örebro in Sweden found that adults with ADHD have a higher risk of various cardiovascular diseases than those without the condition. The researchers reported the findings published in the journal World PsychiatryThey underscored the importance of monitoring cardiovascular health in ADHD patients.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, affecting approximately 2.5 percent of adults worldwide. It is often found in parallel with other mental and physical conditions, some of which are at high risk of cardiovascular diseases. However, whether ADHD is associated with general and specific cardiovascular disease has not received as much attention.

In the current study, the researchers sought to uncover the relationship between ADHD and 20 different types of cardiovascular disease, while distinguishing it from other known risk factors such as type 2 diabetes, obesity, smoking, sleep problems and mental disorders.

“We found that adults with ADHD were twice as likely to have at least one cardiovascular event compared to those without ADHD,” said first author Lin Li, a postdoctoral researcher in the Karolinska Institute’s Department of Medical Epidemiology and Biostatistics. “When we accounted for other well-established risk factors for CVD, the association weakened but remained significant, suggesting that ADHD is an independent risk factor for various cardiovascular events.”

The findings are based on data from a national registry of more than five million Swedish adults, including some 37,000 with ADHD. After an average of 11.8 years of follow-up, 38 percent of individuals with ADHD had at least one cardiovascular disease diagnosis, compared with 24 percent of those without ADHD.

The risk is higher for all types of cardiovascular disease and especially for heart attack, stroke, and coronary artery disease. The association was somewhat stronger in men than in women. Certain mental illnesses, especially eating and substance abuse disorders, have significantly increased the risk of cardiovascular disease in people with ADHD. Stimulant and other psychiatric medications, such as antidepressants and anxiolytics, did not materially affect the association between ADHD and cardiovascular disease.

The researchers note that due to the observational nature of the study, the findings cannot establish a causal relationship.

“Clinicians should carefully consider psychiatric disorders and lifestyle factors to reduce the risk of CVD in people with ADHD, but we need more research to investigate plausible biological mechanisms, such as the common genetic components of ADHD and cardiovascular disease,” says the final of the study. Author Henrik Larsson, Professor at the School of Medical Sciences, Örebro University, and Associate Researcher at Karolinska Institutet.

The researchers note that the study has some limitations, including a lack of data on certain lifestyle factors such as diet and exercise.

This project received funding from the EU’s Horizon 2020 research and innovation programme, the Swedish Research Council, the Swedish Brain Foundation, the Swedish Ministry of Health, Working Life and Safety and the Swedish Medical Research Association.

Publication: “Attention-deficit/hyperactivity disorder as a risk factor for cardiovascular disease: a nationwide population-based cohort studyHe said. Lin Li, Zheng Chang, Jiangwei Sun, Miguel Garcia-Arguibay, Iba Du Ritz, Maja Dobrosavljevic, Isabel Brel, Thomas Jernberg, Marco Solmi, Samuel Cortese, Henrik Larsen, World PsychiatryAccessed online September 8, 2022, doi: 10.1002/wps.21020

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