title: Cardiovascular risk of stimulant treatment in pediatric attention-deficit/hyperactivity disorder: update and clinical recommendations.
abstract: OBJECTIVE
  This review provides an update on the cardiovascular impact of therapeutic stimulant-class medication for children and adolescents with attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  Relevant clinical literature was ascertained using PubMed searches limited to human studies and the English language as of May 2011. Current practice guidelines and consensus statements also were reviewed.
  
  
  RESULTS
  Stimulant-class medications for healthy children and adolescents with ADHD are associated with mean elevations in blood pressure (≤5 mmHg) and heart rate (≤10 beats/min) without changes in electrocardiographic parameters. A subset (5-15%) of children and adolescents treated may have a greater increase in heart rate or blood pressure at a given assessment or may report a cardiovascular-type complaint during stimulant treatment. It is extremely rare for a child or adolescent receiving stimulant medication to have a serious cardiovascular event during treatment, with the risk appearing similar to groups of children not receiving stimulant medication.
  
  
  CONCLUSIONS
  Clinicians should adhere to current recommendations regarding the prescription of stimulant medications for youth with ADHD. Scientific inquiry is indicated to identify patients at heightened risk and to continue surveillance for the longer-term cardiovascular impact of these agents.
authors.affiliation: Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, and Harvard Medical School, USA. phammerness@partners.org
authors.forename: Paul G
authors.initials: PG
authors.lastname: Hammerness
authors.forename: James M
authors.initials: JM
authors.lastname: Perrin
authors.forename: Rachel
authors.initials: R
authors.lastname: Shelley-Abrahamson
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards
chemical_list: D000697:Central Nervous System Stimulants