ACC

ACC 2024: ADHD stimulants may increase risk of heart damage in young adults

April 2, 2024

New research to be presented at ACC's Annual Scientific Session in Atlanta, April 6 - 8, analyzes the effect of prescribed stimulants on cardiomyopathy over a longer time period than previously studied. Most earlier studies assessing the safety of stimulant medications focused on the first year or two of use and found no evidence of harm to the heart.

In this study, researchers found that people prescribed stimulants such as Adderall and Ritalin were 17% more likely to have cardiomyopathy after the first year, and 57% more likely to have cardiomyopathy at eight years compared with those not taking these medications.

However, study authors say these findings don't mean clinicians need to change their approach to screening patients or prescribing stimulants: The overall risk of cardiomyopathy remained relatively low even when stimulants were used long-term.

“The longer you leave patients on these medications, the more likely they are to develop cardiomyopathy, but the risk of that is very low,” said Pauline Gerard, a second-year medical student at the University of Colorado School of Medicine in Aurora, Colorado, and the study’s lead author. “I don’t think this is a reason to stop prescribing these medications. There’s very little increased risk of these medications over the long term; it’s a real risk, but it’s small.”

Key study takeaways:

• Researchers used the TriNetX research database that covers approximately 80 hospitals across the U.S. to analyze data from people diagnosed with ADHD between 20-40 years of age.
• They included individuals with the presence or absence of a prescription for stimulant medications along with rates of cardiomyopathy that could potentially be linked to stimulant use. Individuals with heart damage caused by other known factors, such as cancer treatments, were excluded.
• For the analysis, researchers paired each person who had been prescribed stimulants with an individual who hadn't been prescribed stimulants but matched as much as possible for age, sex and other health conditions. Overall, 12,759 pairs were created and followed for at least 10 years.
• Of these pairs, people prescribed stimulants were found to be significantly more likely to develop cardiomyopathy throughout the 10-year follow-up period, with the gap growing larger each year except the last two, when it narrowed slightly.
• Nonetheless, the overall prevalence of cardiomyopathy was still quite low in both groups. After being prescribed stimulants for 10 years, 0.72% of patients developed cardiomyopathy, compared with 0.53% those who were not prescribed stimulants.
• Study authors suggest that further studies could help to identify subgroups of patients at greater risk who may benefit from future screening approaches.

Source:

Napoli, Nichole. American College of Cardiology. (2024, March 28). ADHD Stimulants May Increase Risk of Heart Damage in Young Adults. [Press release]. https://www.acc.org/About-ACC/Press-Releases/2024/03/26/18/35/adhd-stimulants-may-increase-risk-of-heart-damage-in-young-adults