ADHD drugs don’t increase heart risks in adults, study finds

The stimulant medications used to treat ADHD in adults do not increase patients’ risk of heart attack, stroke or sudden cardiac death, according to a study published online Monday by the Journal of the American Medical Assn.

Researchers identified more than 150,000 people from around the country between the ages of 25 and 64 who took the drugs for attention-deficit/hyperactivity disorder and compared each of them to two people of the same age and gender who did not take the drugs. They found that the risk of major heart problems was low in both groups and the difference was statistically meaningless.

The findings echo the results of a similar study by the same group of researchers who examined the risk of heart attack, stroke or sudden death in children and young adults between the ages of 2 and 24. That study was published this spring in the New England Journal of Medicine.

In both adults and children, the stimulant drugs had been shown to cause small increases in blood pressure and to elevate heart rate. So it was natural for researchers to question whether those side effects would translate into an increased risk of serious cardiovascular events. Concern was elevated by reports of such problems to the Food and Drug Administration’s Adverse Event Reporting System. In 2006, an FDA advisory committee went so far as to recommend that the psychostimulant drugs be forced to carry a “black box warning” of the risk of sudden death.

To get a clearer picture of the risk, researchers gathered data on 150,359 adult ADHD drug users. The most commonly used drugs were methylphenidate and amphetamine (accounting for 45% and 44% of prescriptions, respectively), followed by the non-stimulant atomoxetine (8%) and pemoline (3%).

The researchers looked at the numbers in several ways. Even under their worst-case scenario conditions, the risk was tiny. As an editorial accompanying the study put it, there was only one additional case of a heart attack, stroke or sudden cardiac death for every 5,900 person-years of treatment.

The bottom line for the estimated 1.5 million American adults who take these ADHD meds: There is “no evidence of an increased risk” of heart attack, stroke or sudden cardiac death in people taking the drugs, the authors wrote.

The study is online here, and the editorial is online here.

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