title: Risk of methylphenidate-induced prehypertension in normotensive adult smokers with attention deficit hyperactivity disorder.
abstract: The authors studied predictors of methylphenidate-induced increases in blood pressure (BP). In this secondary analysis of a randomized, double-blind, placebo-controlled smoking cessation trial, nonhypertensive adult smokers with attention deficit hyperactivity disorder randomized to osmotic-release oral system methylphenidate (OROS-MPH) (n=115) were matched one-to-one on baseline systolic BP (SBP) (±5 mm Hg) with participants randomized to placebo (n=115) and followed for 10 weeks. In adjusted mixed linear models of SBP and diastolic BP (DBP), baseline normal SBP (P<.0001) and DBP (P<.0001) were associated with significant OROS-MPH-induced increases compared with placebo, whereas significant increases were not observed in participants with baseline prehypertensive SBP (P=.27) and DBP (P=.79). Participants randomized to OROS-MPH with baseline normal BP had increased odds of developing either systolic (odds ratio [OR], 3.32; 95% confidence interval [CI], 1.41-8.37; P=.006) or diastolic prehypertension (OR, 4.32; 95% CI, 1.56-14.0; P=.004) compared with placebo using simple logistic regression. The authors demonstrated an augmented OROS-MPH-induced BP elevation and risk of prehypertension in adults with baseline normal BP. Significantly increased BP was not observed in adults with baseline prehypertension.
authors: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-8828, USA. arthur.westover@utsouthwestern.edu
authors: Arthur N
authors: AN
authors: Westover
authors: Paul A
authors: PA
authors: Nakonezny
authors: Theresa
authors: T
authors: Winhusen
authors: Bryon
authors: B
authors: Adinoff
authors: Wanpen
authors: W
authors: Vongpatanasin
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D015897:Comorbidity; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D058246:Prehypertension / Q000139:chemically induced* / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000503:physiopathology; D016540:Smoking Cessation / Q000379:methods
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate