Scientists have linked ADHD to an increased risk of heart problems with hypertension

People with attention deficit hyperactivity disorder (ADHD) were more likely to experience serious cardiovascular events at the beginning of hypertension treatment and had a higher risk of death from any cause than patients without this disorder. Researchers suggest that one of the possible causes is related to the characteristics of ADHD itself, which may interfere with regular medication and blood pressure control. About how scientists assessed the risks, why ADHD can complicate the treatment of hypertension, and what is known about this disorder, see the Izvestia article.

ADHD is associated with heart attacks and strokes

Scientists from Australia, Denmark, the Netherlands, Norway and Sweden conducted a retrospective multinational cohort study. Led by Zhou Yiling from the University of Groningen, they studied adults who were first prescribed first-line antihypertensive therapy. The researchers were interested in whether the incidence of serious cardiovascular events and death differs in patients with and without ADHD. The results are published in The Lancet Primary Care journal.

After taking into account gender, age, and the calendar year of the start of the study, people with ADHD had a higher risk of serious adverse cardiovascular events, including heart attack, stroke, and death from cardiovascular causes. After additional adjustments for mental disorders, psychotropic and cardiometabolic drugs, the relationship became weaker, but taking into account antihypertensive drugs practically did not change the result.

A similar pattern was observed for all-cause mortality. The adjusted figures were 8.6 cases per 1,000 person-years among people with ADHD and 8.5 among participants without the syndrome. Adjusted for age and gender, it increased.

A separate analysis showed that taking medications to treat ADHD itself was generally not associated with an increased risk of serious cardiovascular events or death from any cause. However, after separating the participants by the age at which they started ADHD treatment, a link was found between taking these drugs and higher all-cause mortality. The authors believe that this result requires further study.

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What is ADHD and how it manifests itself in adults?

Attention deficit hyperactivity disorder is a neurodevelopmental disorder that begins in childhood, but its manifestations can persist into adulthood. It is primarily associated with persistent problems with attention, hyperactivity, and impulsivity, which can interfere with a person's studies, work, and daily life.

The symptoms are conventionally divided into two main groups. The first category includes inattentiveness: it can be difficult for a person to focus on a task for a long time, organize work, follow instructions, and notice details. Forgetfulness, loss of possessions, and difficulty completing tasks that require prolonged concentration are also common.

The second group is associated with hyperactivity and impulsivity. It can be expressed in a constant feeling of anxiety, difficulties staying in one position for a long time, excessive talkativeness, interrupting interlocutors, and problems with waiting. At the same time, in adults, hyperactivity does not necessarily look like constant physical activity — sometimes it manifests itself mainly as an inner feeling of anxiety.

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Why ADHD can Complicate Hypertension Treatment

Hypertension is a chronic disease in which blood pressure significantly exceeds the norm and requires more than just medication. The patient should regularly measure blood pressure, follow the treatment regimen, monitor side effects, adjust therapy if necessary, and monitor other risk factors. For people with ADHD, following this sequence of actions can be an additional challenge.

It is adherence to treatment that researchers consider as one of the possible explanations for the discovered connection. Symptoms of ADHD can prevent a person from following a regular medication regimen and monitoring their condition. However, the authors do not claim that it is the disorder that directly causes heart attacks or strokes.

Another problem is that adults with ADHD are more likely to develop hypertension, according to previous studies. At the same time, there are no separate recommendations for the management of patients with hypertension and ADHD yet. Therefore, according to scientists, additional research is needed to help understand exactly how the disorder affects the course of hypertension and the effectiveness of its treatment.

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What the results of the study mean for patients

The authors suggest that adults with ADHD should be considered as a clinically vulnerable group when starting antihypertensive therapy. In their opinion, such patients may need additional support to help them follow the prescribed treatment regimen, monitor their medication intake, and regularly monitor their health.

However, the results of the study do not mean that people with ADHD should stop treating hypertension or change their prescribed medications on their own. The work was observational and revealed a statistical link between ADHD and adverse outcomes, but it does not prove that the disorder directly caused them.

Scientists also note the need to further study the safety of cardiovascular drugs specifically in patients with ADHD. In the future, this may help to develop more accurate recommendations for monitoring such people and make hypertension treatment more effective.