Adults with ADHD have a greater risk of developing a range of cardiovascular diseases than those without the condition, according to a large observational study. The study researchers say that these findings, published in the journal World Psychiatry, underscore the need to monitor cardiovascular health in people with ADHD.
Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, with a global prevalence of around 2.5% in adults. It often exists in parallel with other psychiatric and physical conditions, some of which have been linked to an increased risk of cardiovascular disease (CVD). But whether ADHD is independently associated with overall and specific cardiovascular diseases has not received as much attention.
In the current study, led by Karolinska Institutet and Örebro University, the researchers investigated associations between ADHD and some 20 different cardiovascular diseases when separated from other known risk factors such as smoking and diabetes.
A doubled risk
“We found that adults with ADHD were more than twice as likely to develop at least one cardiovascular disease, compared with those without ADHD,” says the study’s first author Lin Li, postdoctoral researcher at Karolinska Institutet. “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 accessed data of more than five million Swedish adults, of which some 37 000 had ADHD. After an average 11.8 years of follow-up, 38% of individuals with ADHD had at least one diagnosis of cardiovascular disease, compared with 24% of those without ADHD.
Risks were elevated for all types of cardiovascular diseases and especially high for cardiac arrest, haemorrhagic stroke and peripheral vascular diseases, with somewhat stronger associations in men than in women. Some psychiatric comorbidities, especially eating and substance use disorders, significantly increased the risk of cardiovascular disease in people with ADHD. Pharmacological treatments for ADHD, such as anti-anxiety drugs, did not significantly affect the association between ADHD and cardiovascular disease. A causal link could not be established due to the observational nature of the study, and limitations included a lack of information about confounding factors such as lifestyle.
Important information for clinicians
“Clinicians needs 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,” said Henrik Larsson, the study’s last author, a professor at the School of Medical Sciences, Örebro University, and affiliated researcher at Karolinska Institutet.
Source: Karolinska Institutet
