Nav: Home

ADHD medication linked to slightly increased risk of heart rhythm problems

May 31, 2016

Use of methylphenidate in children and young people with ADHD is associated with a slightly increased risk of abnormal heart rhythm (arrhythmia) shortly after the start of treatment, suggests research published by The BMJ today.

Though the absolute risk is likely to be low, the researchers say the benefits of methylphenidate "should be carefully weighed against the potential cardiovascular risks of these drugs in children and adolescents."

Methylphenidate is a central nervous system stimulant used to treat attention deficit hyperactivity disorder (ADHD), and narcolepsy. It is sold under various trade names, Ritalin being one of the most commonly known.

The cardiac safety of stimulants, which are known to slightly raise blood pressure and accelerate the heart rate, has been hotly debated, but the evidence is conflicting.

So a team of researchers based in Australia, Canada and South Korea set out to measure the cardiac safety of methylphenidate in children and young people with ADHD.

Using the South Korea National Health Insurance Database, they extracted data on 1,224 cardiac events from a population of 114,647 children and young people aged 17 or younger and newly treated with methylphenidate at any time from 2008 to 2011.

Cardiac events included heart rhythm problems (arrhythmias), high blood pressure (hypertension), heart attacks (myocardial infarction), ischemic stroke, and heart failure.

Cases of arrhythmia were statistically significantly more likely to have occurred during the first two months of use compared with periods of non-use, and risk was highest in the first three days of use.

The risk was more pronounced in children with existing congenital heart disease.

No significant risk of myocardial infarction was observed, though risk increased after the first week of treatment and remained raised for the first two months of continuous treatment.

No increased risk was observed for hypertension, ischemic stroke, or heart failure.

The authors point out that this is an observational study so no firm conclusions can be drawn about cause and effect - and that their findings should be interpreted with caution. However, the results prompt them to suggest that methylphenidate use might "trigger" the occurrence of arrhythmia in individual patients.

"Methylphenidate exposure in children and young people with diagnosis of ADHD is associated with arrhythmia and potentially with myocardial infarction in specific time periods of use," they write. "With the increased use of drugs for ADHD globally, the benefits of methylphenidate should be carefully weighed against the potential cardiovascular risks of these drugs in children and adolescents."

In a linked editorial, John Jackson, a research fellow at Harvard School of Public Health in Boston, says it is difficult to describe the absolute risk in this type of study, but in the average child, the risk of serious cardiovascular events is extremely small (3 per 100,000 per year) and any absolute increase associated with methylphenidate is also likely to be small.

And he points out that regulatory labeling and treatment guidelines for stimulants recommend caution using these drugs in children with personal or familial history of cardiovascular disease and call for routine monitoring of blood pressure.

"This study underscores the need to consider the severity of ADHD symptoms and the option of non-stimulants for children with high cardiovascular risk and to closely monitor patients for whom stimulants are critical for their wellbeing and development," he concludes.
-end-


BMJ

Related Blood Pressure Articles:

Do you really have high blood pressure?
A study by researchers at the University of Montreal Hospital Research Centre (CRCHUM) shows that more than half of family doctors in Canada are still using manual devices to measure blood pressure, a dated technology that often leads to misdiagnosis.
Why do we develop high blood pressure?
Abnormally high blood pressure, or hypertension, may be related to changes in brain activity and blood flow early in life.
For some, high blood pressure associated with better survival
Patients with both type 2 diabetes and acute heart failure face a significantly lower risk of death but a higher risk of heart failure-related hospitalizations if they had high systolic blood pressure on discharge from the hospital compared to those with normal blood pressure, according to a study scheduled for presentation at the American College of Cardiology's 66th Annual Scientific Session.
$9.4 million grant helps scientists explore how cell death from high blood pressure fuels even higher pressure
It's been known for decades that a bacterial infection can raise your blood pressure short term, but now scientists are putting together the pieces of how our own dying cells can fuel chronically high, destructive pressure.
Blood pressure diet improves gout blood marker
A diet rich in fruits, vegetables, low-fat dairy and reduced in fats and saturated fats (the DASH diet), designed decades ago to reduce high blood pressure, also appears to significantly lower uric acid, the causative agent of gout.
New tool to improve blood pressure measurement
Oxford University researchers have developed a prediction model that uses three separate blood pressure readings taken in a single consultation and basic patient characteristics to give an adjusted blood pressure reading that is significantly more accurate than existing models for identifying hypertension.
Blood vessels sprout under pressure
It is blood pressure that drives the opening of small capillaries during angiogenesis.
Better blood pressure control -- by mobile phone
An interactive web system with the help of your mobile phone can be an effective tool for better blood pressure control.
Time to reassess blood-pressure goals
High blood pressure or hypertension is a major health problem that affects more than 70 million people in the US, and over one billion worldwide.
With help from pharmacists, better blood pressure costs $22
A pharmacist-physician collaboration in primary-care offices effectively and inexpensively improved patients' high blood pressure.

Related Blood Pressure Reading:

Blood Pressure Down: The 10-Step Plan to Lower Your Blood Pressure in 4 Weeks--Without Prescription Drugs
by Janet Bond Brill PhD RD (Author)

For the nearly 78 million Americans with hypertension, a safe, effective lifestyle plan—incorporating the DASH diet principles and much more—for lowering blood pressure naturally

If you have high blood pressure, you're not alone: nearly a third of adult Americans have been diagnosed with hypertension, and another quarter are well on their way. Yet a whopping 56 percent of diagnosed patients do not have it under control. The good news? Hypertension is easily treatable (and preventable), and you can take action today to bring your blood pressure down in just four... View Details


Blood Pressure: Blood Pressure Solution : The Ultimate Guide to Naturally Lowering High Blood Pressure and Reducing Hypertension (Blood Pressure Series) (Volume 1)
by Mark Evans (Author)

Blood Pressure Series Book #1

Includes a FREE bonus book “Super Foods for Super Health”

With close to a third of adult Americans have been diagnosed with high blood pressure and hypertension, yet over 50% of diagnosed patients don’t have it under control, high blood pressure and hypertension are a serious problem... The good news is, Blood Pressure and Hypertension is easily treatable! In this book, we will go over the proven process to successfully prevent, control and lower high blood pressure. By implementing the strategies listed within this... View Details


Thirty Days to Natural Blood Pressure Control: The "No Pressure" Solution
by MPH, David DeRose MD (Author), MPH, Greg Steinke MD (Author), Trudie Li FNP (Author), Clifford Goldstein (Editor)

High Blood Pressure. Even if you haven’t received the diagnosis yet, as many as three-quarters of the Western world will have to contend with high blood pressure sometime in their lives. However you no longer need to be a victim. Drs. DeRose and Steinke along with Nurse Practitioner Li draw from cutting-edge medical research and their decades of clinical experience to guide you on an amazing 30-day journey. Learn simple natural strategies that have helped many people decrease or eliminate their dependence on medications. Other titles may promise fast results with natural blood pressure... View Details


Blood Pressure Solution: The Path to Naturally Lower and Control your Blood Pressure, Without Medication
by Margaret Schmitt (Author)

Do you have high blood pressure?
Do you want to find a solution to it?
Do you want to do it without medication and by using all natural remedies?
More than a billion people worldwide have hypertension. It is a leading cause of hundreds of thousands of deaths every year and most drugs only target the symptoms and are not designed to provide a long-term solution.

Now, with Blood Pressure Solution: The Path to Naturally Lower and Control your Blood Pressure, Without Medication, you have the ideal book to help you develop a comprehensive... View Details


The Magnesium Solution for High Blood Pressure (The Square One Health Guides)
by Jay S. Cohen (Author)

Written by health professionals who are well recognized in their respective fields, these concise, easy-to-read books focus on a wide range of important health concerns. From migraine headaches to high cholesterol, each title looks at a specific problem; each provides a clear explanation of the disorder, its causes, and its symptoms; and each offers natural solutions that can either greatly reduce or completely eliminate the problem. Some titles also focus on natural alternatives to drugs with serious side effects―alternatives that in many cases can be used in conjunction with prescription... View Details


The New Bible Cure for High Blood Pressure: Ancient Truths, Natural Remedies, and the Latest Findings for Your Health Today
by Don Colbert M.D. (Author)

You can lower your blood pressure and feel better-naturally! How hard is your heart working? In this concise, easy-to-read booklet you'll discover a wealth of information to help you reduce and prevent high blood pressure. Learn biblical secrets on health and the latest medical research on how to bring your blood pressure under control and maintain it within healthy guidelines. Discover breakthroughs that your doctor may never have shared with you!
The difference between good and bad stress Important foods that naturally lower your high blood pressure Essential vitamins and minerals... View Details


60 Ways to Lower Your Blood Pressure: What You Need to Know to Save Your Life
by Robert D. Lesslie (Author)

You may have high blood pressure and not even know it. Yet high blood pressure greatly increases your risk for a devastating heart attack or stroke. What can you do to discover whether you're at risk, disarm this silent killer, and increase your chances of enjoying the years you've been given?

In 60 Ways to Lower Your Blood Pressure, physician and bestselling author Robert Lesslie provides easy-to-understand, expert advice, including

what your blood pressure numbers mean and what you can do to improve themthe truth about the benefits of exercise, sleep, and stress... View Details


Blood Pressure: 40 Super-food that will naturally lower your blood pressure
by Arnold Yates (Author)

Use these powerful recipes and strategies to naturally lower your blood pressure! Greetings, My name is Arnold Yates and I am a Doctor and a bodybuilder. I have a PHD in exercise physiology. The reason I created this book is because I don't want people to go through what I went through. Decades of learning, trial and error is compressed into this book. My goal is to spread valuable information to the mass media so that people can improve their health & wellness. Get this book to cut your learning curve and get the body you want in a shorter amount of time. It is important for people with... View Details


Lower Your Blood Pressure: A 21-Day DASH Diet Meal Plan to Decrease Blood Pressure Naturally
by Jennifer Koslo PhD RDN CSSD (Author)

Make your healthy heart a habit with the diet and meal plan in Lower Your Blood Pressure.

As 54% of the 75 million Americans who suffer from hypertension know, leading a heart-healthy lifestyle is easier said than done. Recognizing both the rewards and challenges of dieting to lower your blood pressure, Jennifer Koslo, PhD, RD, CSSD, lays out an effective and easy to follow 21-day DASH diet meal plan to help you start and stick to healthy habits. Featuring over 75 low-sodium, high-potassium, and magnesium-filled recipes, Lower Your Blood Pressure is... View Details


Lower Your Blood Pressure in Eight Weeks: A Revolutionary Program for a Longer, Healthier Life
by Stephen T. Sinatra (Author)

The numbers speak for themselves. More than 50 million Americans suffer from high blood pressure—and yet despite the billions we spend on medication, the death rate from high blood pressure has risen 36 percent in the past decade. Clearly, the time has come for a radical new treatment plan. And that’s exactly what Dr. Stephen T. Sinatra delivers in this invaluable new book.

All too often people with high blood pressure get the same frustrating advice from their doctors: lose some weight, lay off the salt, and fill a bunch of prescriptions. One of the nation’s leading authorities... View Details

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

The Big Five
What are the five biggest global challenges we face right now — and what can we do about them? This hour, TED speakers explore some radical solutions to these enduring problems. Guests include geoengineer Tim Kruger, president of the International Rescue Committee David Miliband, political scientist Ian Bremmer, global data analyst Sarah Menker, and historian Rutger Bregman.
Now Playing: Science for the People

#456 Inside a Conservation NGO
This week we take a close look at conservation NGOS: what they do, how they work, and - most importantly - why we need them. We'll be speaking with Shyla Raghav, the Climate Change Lead at Conservation International, about using strategy and policy to tackle climate change. Then we'll speak with Rebecca Shaw, Lead Scientist at the World Wildlife Fund, about how and why you should get involved with conservation initiatives.