Register / Log In

ADHD stimulant treatment not linked
to long-term heart problems


Stimulants used to treat attention-deficit/hyperactivity disorder (ADHD) in children may affect heart rate in the short term but do not seem to increase high blood pressure risk in the long term.

That information comes from the Multimodal Treatment Study of Children With ADHD (MTA), funded by the National Institutes of Mental Health.

The MTA initially was a 14-month study in which 579 children were randomly assigned to 1 of 3 intensive treatment groups (medication management alone, behavioral treatment alone, and a combination of both) or to routine community care. Results published in 1999 indicated that medication management alone or in combination with behavioral therapy produced better symptomatic relief for children with ADHD than just behavioral therapy or usual community care.

Even though participants returned to community treatment after the study ended, MTA researchers continued to gather data at 2, 3, 6, 8, and 10 years after study entry. Researchers used that follow-up data to look for any association between chronic use of the stimulant medication and any effects on blood pressure or heart rate over the 10-year period.

After the initial study, children who had received stimulant treatment had higher heart rates, on average, than children in the other study groups. For children who continued to take stimulants during the follow-up period, heart rates were slightly elevated but not to the level of tachycardia.

Study investigators noted that the effects of stimulants on the heart still can be detected even after years of use, indicating that the body never completely adapts, but also pointed out that none of the children reported any adverse cardiovascular events over the 10-year period.

They cautioned, however, that lifetime risk of cardiovascular disease is increased even with modest elevations in heart rate, according to some epidemiological studies, and that pediatricians should remain alert to how long-term stimulant treatment is affecting their patients’ heart rates.

Go back to the current issue of the eConsult.

Spending too little time with patients can have a detrimental effect on preventive care and evaluation of developmental issues. Find out how much a few extra minutes can benefit children and how it improves the likelihood that parents will recommend you to their friends.

Will you be able to find a subspecialist for referral when you need one? The trend of pediatric subspecialists moving to private practice could be a double-edged sword. Although subspecialists in private practice may be more readily available for your referrals of sick children, activities associated with an academic setting?conducting research, teaching, or advancing specialty care?could suffer, according to a recent study. What will that mean for advances in pediatrics?

Telling obese teenagers to spend more time in bed may seem counterintuitive when increased activity combined with diet is the gold standard for staving off the health effects of excess weight, such as type 2 diabetes. Yet a new study finds that lack of sleep can disrupt insulin secretion and glucose levels in obese teenagers. How much time asleep and what type of sleep is most protective in vulnerable adolescents?

Strong corticosteroid use in patients with psoriasis younger than 8 years should be avoided, according to a recent study that found the greatest offenders were not pediatricians but dermatologists. In fact, treatment differed substantially on the basis of practice type. See how your typical response to psoriasis aligns with the treatment regimen recommended by researchers.


 
Stay Connected