ADHD Drugs and Long Term Cardiac Risks

Summary

In this episode of 'Boomers Wearing Flannel,' Russ Barkley discusses a Danish study examining the long-term cardiovascular risks associated with stimulant medications for ADHD. He highlights a 30% increased risk of heart attack and stroke among high-dose users, cautioning that this relative increase must be understood in the context of the low baseline risk in young adults. Barkley emphasizes the importance of considering confounding factors, such as the severity of ADHD, and references a prior meta-analysis that found no significant cardiovascular risks linked to these medications. He concludes that broader evidence does not support alarm over stimulant use.

Takeaways

• 😀 Weekly research updates feature notable peer-reviewed articles.
• 😀 Stimulant treatment for ADHD raises ongoing concerns about cardiovascular risks.
• 😀 A recent study from Denmark highlights a 30% increased risk of heart attack and stroke in high-dose stimulant users.
• 😀 The absolute risk of heart attack and stroke remains low among young adults aged 23-41.
• 😀 Increased risk percentages can be misleading if baseline rates are low.
• 😀 The study may not control for ADHD severity, which could confound results.
• 😀 Previous meta-analyses found no significant cardiovascular risk associated with ADHD medications.
• 😀 ADHD itself is linked to higher cardiovascular risk factors, independent of medication.
• 😀 Lifestyle choices of individuals with ADHD, such as diet and exercise, contribute to increased heart disease risk.
• 😀 Caution is advised when interpreting single studies, especially when larger analyses provide different conclusions.

Q & A

What is the main topic of the research update presented by Russ Barkley?

The main topic is the long-term cardiovascular risks associated with stimulant treatment for attention deficit disorder (ADHD).

What recent study did Barkley discuss, and where was it published?

Barkley discussed a study published in the European Heart Journal that examined cardiovascular risks linked to stimulant medications for ADHD.

How many individuals were included in the Danish study referenced by Barkley?

The study included 27,724 individuals who were started on stimulant medication.

What significant finding did the Danish study report regarding high doses of stimulant medication?

The study found a 30% increased risk of heart attack and stroke in individuals on high doses of medication compared to those who discontinued treatment or were on low doses.

Why does Barkley caution against overinterpreting the findings of the Danish study?

Barkley cautions against overinterpretation because the baseline risk for heart attacks and strokes in the studied population is very low, and even slight increases can appear significant.

What confounding factor does Barkley highlight that may affect the study's results?

Barkley highlights the severity of ADHD as a confounding factor, noting that individuals with more severe ADHD may be more likely to be on higher doses of medication.

What did the previous meta-analysis referenced by Barkley find regarding cardiovascular risks from stimulant medications?

The meta-analysis found no significant evidence linking stimulant medication to increased cardiovascular risks, which raises questions about the validity of the recent Danish study.

How does Barkley explain the difference in findings between the Danish study and the meta-analysis?

Barkley suggests that the Danish study may have peculiarities or confounding factors that were not adequately controlled for, which could explain the discrepancy.

What age range did the population in the Danish study fall into?

The population in the study ranged from 23 to 41 years of age.

What should be kept in mind when interpreting risk ratios according to Barkley?

When interpreting risk ratios, it's important to consider the absolute numbers; a small increase over a low baseline risk may not be clinically significant.