Global burden of ADHD medication-associated cardiovascular disease, 1967-2023: A comparative analysis using the WHO pharmacovigilance database.

Autor: Cho H; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea., Lee K; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea., Jeong YD; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea., Udeh R; School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, Australia., Acharya KP; Department of Livestock Services, Hariharbhawan, Lalitpur, Nepal., Kang J; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA., Boyer L; Health Service Research and Quality of Life Center (CEReSS), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France., Fond G; Health Service Research and Quality of Life Center (CEReSS), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France., Lee H; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea., Park J; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea., Kim HJ; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea., Hwang J; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea. Electronic address: cindy.jyhwang@gmail.com., Hwang HJ; Department of Cardiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea. Electronic address: neonic7749@khu.ac.kr., Yon DK; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea. Electronic address: yonkkang@gmail.com.
Jazyk: angličtina
Zdroj: Asian journal of psychiatry [Asian J Psychiatr] 2024 Nov; Vol. 101, pp. 104209. Date of Electronic Publication: 2024 Aug 30.
DOI: 10.1016/j.ajp.2024.104209
Abstrakt: Background: Despite the widespread use of attention-deficit hyperactivity disorder (ADHD) medications and their known sympathomimetic effects on the cardiovascular system, cardiovascular risk assessment of these medications using comprehensive global data is limited. This study investigated the association between individual ADHD medications and cardiovascular disease (CVD) using global pharmacovigilance data.
Methods: Reports from the World Health Organization international pharmacovigilance database were utilized (1967-2023; total reports, n=131,255,418). Reporting odds ratios (ROR), and information components (IC) were calculated to evaluate the association between each medication and specific CVDs.
Results: We identified 13,344 CVD cases related to ADHD medications out of 146,489 cases of all reports on ADHD medications. Cumulative reports on ADHD medications have shown a steady increase, notably in adults since 2010. ADHD medications were associated with a higher risk of CVD overall (ROR [95 % CI], 1.60 [1.58-1.63]; IC [IC 0.25 ], 0.63 [0.60]), with a higher association observed in females than in males. Among specific CVDs, all drugs were associated with an increased risk of torsade de pointes/QT prolongation, cardiomyopathy, and myocardial infarction. Conversely, heart failure, stroke, and cardiac death/shock were exclusively associated with amphetamines. Lisdexamfetamine showed a weaker association with all CVDs compared to amphetamines, and methylphenidate exhibited the lowest overall association with CVD. Atomoxetine had the second-highest association with torsade de pointes/QT prolongation.
Conclusions: The associations between CVDs and ADHD medications vary, with amphetamines posing a higher risk, while lisdexamfetamine and methylphenidate exhibit better safety profiles.
Competing Interests: Declaration of Competing Interest All the authors declared no competing interests.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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