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Stimulants Used in Attention Deficit/Hyperactivity Disorder Increase Blood Pressure: Presented at PAS

By Bonnie Darves

SAN FRANCISCO, CA -- May 7, 2004 -- The short-term effects of medications used to treat attention deficit hyperactivity disorder (ADHD) on blood pressure (BP) warrant frequent patient monitoring and should prompt researchers to look at long-term effects on children's health, according to a new study presented here May 3^rd at the Pediatric Academic Societies Annual Meeting.

Whether stimulants used increase paediatric patients' blood pressure (BP) over the long term, and whether that is cause for concern remains under debated, according to researchers from the University of Texas Medical School at Houston.

Chief investigator Joshua Samuels, MD, Assistant Professor of Nephrology at U of T said that since children with ADHD typically remain on stimulant treatment for several years, there may be reason to suspect that those on long-term therapy could be at higher risk for cardiovascular complications later in life, based on their study's findings that stimulants elevate both diastolic BP and heart rate, even over a 24-hour period.

"Is this increase clinically significant over the long term? We don't know, but it is clear that longer-term studies and follow-up are needed to determine the extent of these effects," Dr. Samuels said. Although earlier studies have confirmed the increase in BP associated with ADHD treatments, no study has looked at the changes over a 24-hour period, he added.

In the blinded, placebo-controlled trial, 13 children with a mean age of 12.7 years received stimulants for 3 days followed by placebo for 4 days in cross-over fashion. The patients were assessed for diastolic BP and systolic BP as well as heart rate changes every 20 minutes during the 24-hour period after each treatment phase.

The researchers found that both diastolic BP and heart rate were significantly elevated during treatment at 69.9 mm Hg versus 66.5 mm Hg, and 84.0 versus 79.8 during the placebo phase, respectively. Systolic BP was also elevated, but the difference between the two phases of study was not significant, Dr. Samuels said.

Although the elevations were less pronounced during sleep, the fact that BP and heart rate remained elevated may increase long-term cardiovascular risks for children. Dr. Samuels acknowledged that while the small sample size was small, the consistent findings suggest that the same trends would likely occur in larger patient populations.


[Presentation title: "24-hour blood pressure is increased by stimulant medications in children with attention deficit hyperactivity disorder: a randomized, blinded, placebo controlled crossover trial. Abstract #3242]

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