The various drugs used to combat attention deficit hyperactivity disorder, or ADHD, do not increase the risk of heart attacks, strokes or sudden death, according to a new study published in The New England Journal of Medicine that was funded by public health officials, who hope to resolve ongoing confusion over the cardiovascular risks of these drugs.
In reaching their conclusion, the researchers studied data from four health plans of more than 1.2 million children and young adults between two and 24 years old who were taking or had taken ADHD meds and found no increased risk of heart problems. In fact, just 81 cases of serious heart problems were found, suggesting the low number of events limited the statistical power of the study.
The study is one of three commissioned by the FDA after reports of heart attacks, strokes and sudden cardiac arrest in children taking ADHD meds were submitted five years ago to regulators, including Health Canada. The concerns prompted several FDA advisory committee hearings and Canadian regulators temporarily suspended marketing ADHD pills.
Meanwhile, the American Heart Association issue some controversial guidelines suggesting that children who were taking the meds for the first time should be tested for any possible heart problems. "After ADHD is diagnosed, but before therapy with a stimulant or other medication is begun, we suggest that an ECG (electrocardiogram) be added to the pre-treatment evaluation to increase the likelihood of identifying cardiac conditions that may place the child at risk for sudden death,” Victoria Vetter, head of the AHA statement writing committee, and professor of pediatrics at the University of Pennsylvania School of Medicine in Philadelphia, said at the time (see this).
But as the NEJM study notes, this led to "concern and confusion" among doctors and families about the risks of the drugs, although the AHA later revised its recommendations (here is the study abstract and here is the FDA statement).