ADHD Stimulant Use Raises Risk of Cardiomyopathy in Young Adults: Daily Dose

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Last week, we reported on findings from a study presented at the American College of Cardiology’s 73rd Annual Scientific Session, held April 6-8, 2024, in Atlanta, Georgia.

The study

Researchers examined the association between cardiomyopathy and duration of stimulant medication use in adults under 40 years old. Using the TriNetX research database, which includes information from approximately 80 US hospitals, investigators assessed data from patients aged 20 to 40 years diagnosed with ADHD. Participants were grouped by presence or absence of stimulant medication prescription and further categorized by length of patient record (ie, 1-10 years).

The primary outcome was ICD-10 codes indicating cardiomyopathy potentially linked to stimulant medications, and the analysis window was limited to 30 years after diagnosis.

Investigators paired each participant who was prescribed stimulants with an individual who had not been prescribed stimulants but who were as similar as possible in other categories such as age, sex, and other health conditions.

The findings

Overall, investigators matched 12 759 pairs who were followed for at least 10 years.

After 1 year, the prevalence of cardiomyopathy was 0.36% in the stimulant arm and 0.31% in the non-stimulant arm (P = .003). After 10 years, the prevalence of cardiomyopathy steadily increased to 0.72% in the stimulant group and 0.53% in the non-stimulant group (P = .048).

Results also showed that among participants in the stimulant arm, the odds of cardiomyopathy were 1.17-fold higher after 1 year (OR 95% CI, 1.06-1.30), which rose to 1.57-fold at 8 years (OR 95% CI, 1.25-1.97) and slightly decreased to 1.37-fold at 10 years (OR 95% CI, 1.002-1.88).

Authors' comment

"Our findings reveal a progressively elevated risk of cardiomyopathy associated with the duration of stimulant medication use in young adults with ADHD. This underscores the need for a deeper understanding of the cardiovascular risks tied to ADHD stimulant medications, highlighting concerns about safety and the importance of considering alternative treatments.”

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