title: Attention-deficit/hyperactivity disorder treatment: what are the long-term cardiovascular risks?
abstract: BACKGROUND
  This drug safety review provides an update on the long-term cardiovascular risks of therapeutic stimulant class medication for children and adults with attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  Relevant literature on the long-term (defined as ≥ 12 months) cardiovascular effects of stimulant class medications for ADHD was sought using PubMed searches for clinical literature, epidemiological reports, as well as reviews of post-marketing data and clinical guidelines/consensus statements. Comparison was made to the non-stimulant atomoxetine.
  
  
  CONCLUSIONS
  Long-term cardiovascular risks of stimulants for healthy children and adults with ADHD are limited to minor mean elevations in blood pressure (≤ 7 mmHg) and heart rate (≤ 10 bpm). In a sizeable minority of individuals these elevations are greater and/or reach a clinical threshold. Subjective complaints may also be anticipated during long-term treatment, yet without an increase in serious cardiac outcomes above background rates per age. Future research is needed on possible latent or cumulative cardiovascular risks in healthy individuals, as well as the longer-term cardiovascular safety in vulnerable populations.
authors: Harvard Medical School , Boston, MA , USA.
authors: Paul G
authors: PG
authors: Hammerness
authors: Chris
authors: C
authors: Karampahtsis
authors: Ronke
authors: R
authors: Babalola
authors: Mark E
authors: ME
authors: Alexander
mesh_terms: D000328:Adult; D000069445:Atomoxetine Hydrochloride / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D006801:Humans; D013997:Time Factors
chemical_list: D000697:Central Nervous System Stimulants; D000069445:Atomoxetine Hydrochloride
keywords: attention-deficit/hyperactivity disorder; cardiovascular; stimulant