A large observational study has found that adults with ADHD had an elevated risk of a range of cardiovascular diseases.
Researchers from the Karolinska Institute and Örebro University in Sweden found that adults with attention-deficit/hyperactivity disorder (ADHD) are more likely than those without the disorder to develop a variety of cardiovascular diseases. The results, which were recently published in the journal World Psychiatry, highlight the need of monitoring the cardiovascular health of ADHD patients.
ADHD is one of the most common neurodevelopmental disorders, with a worldwide prevalence of roughly 2.5 percent in adults. It often coexists with other physical and mental disorders, some of which have been linked to an elevated risk of cardiovascular disease (CVD). However, there hasn’t been as much focus on whether ADHD is independently linked to overall and specific cardiovascular diseases.
The present study aimed to uncover the link between ADHD and 20 different cardiovascular diseases when it was separated from other known risk factors such as type 2 diabetes, obesity, smoking, sleep problems, and mental disorders.
“We found that adults with ADHD were more than twice as likely to develop at least one cardiovascular disease, compared with those without ADHD,” says the study’s first author Lin Li, a postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institute. “When we accounted for other well-established risk factors for CVDs, the association weakened but still remained significant, which indicates that ADHD is an independent risk factor for a wide range of cardiovascular diseases.”
The results are based on data from a national registry of over five million Swedish adults, including 37,000 individuals with ADHD. 38 percent of people with ADHD had at least one diagnosis of cardiovascular disease after an average of 11.8 years of follow-up, compared to 24 percent of those without ADHD.
The risks for all kinds of cardiovascular diseases were increased, but especially high for cardiac arrest, hemorrhagic stroke, and peripheral vascular diseases. The link was somewhat stronger in males than in women. Some psychiatric comorbidities, particularly food and substance use problems, elevated the risk of cardiovascular disease in patients with ADHD dramatically. Stimulants and other psychiatric drugs, such as antidepressants and anxiety medications, had no effect on the relationship between ADHD and cardiovascular disease.
The researchers note that due to the observational nature of the study, the findings cannot establish a causal relationship.
“Clinicians need to carefully consider psychiatric comorbidity and lifestyle factors to help reduce the CVD risk in individuals with ADHD, but we also need more research to explore plausible biological mechanisms, such as shared genetic components for ADHD and cardiovascular disease,” says the study’s last author Henrik Larsson, professor at the School of Medical Sciences, Örebro University, and affiliated researcher at Karolinska Institute.
Reference: “Attention-deficit/hyperactivity disorder as a risk factor for cardiovascular diseases: a nationwide population-based cohort study” by Lin Li, Zheng Chang, Jiangwei Sun, Miguel Garcia-Argibay, Ebba Du Rietz, Maja Dobrosavljevic, Isabell Brikell, Tomas Jernberg, Marco Solmi, Samuele Cortese and Henrik Larsson, 8 September 2022, World Psychiatry.
The study was funded by the European Union’s Horizon 2020 research and innovation program, the Swedish Research Council, the Swedish Brain Foundation, the Swedish Council for Health, Working Life and Welfare, and the Swedish Society for Medical Research.
The researchers note the study has some limitations, including a lack of data on some lifestyle-related factors, such as diet and physical activity, that could impact the association.