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The impact of methylphenidate treatment on the functional and structural properties of the left ventricle: A

Adrián García Ron1, María Rodriguez Mesa2, Eva Arias Vivas1

  • 1Unidad de Neuropediatría, Instituto del Niño y del Adolescente, Hospital Clínico San Carlos, Madrid, Spain.

Anales De Pediatria
|December 23, 2021
PubMed
Abstract

Insights

Methylphenidate (MPH) treatment for ADHD in children showed increased blood pressure and altered diastolic function, but no severe cardiovascular events or structural changes. Further research is needed on long-term cardiovascular risk factors.

Area of Science:

  • Pediatric Cardiology
  • Neurodevelopmental Disorders
  • Pharmacology

Background:

  • Methylphenidate (MPH) is commonly prescribed for Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents.
  • Concerns exist regarding the long-term cardiovascular safety of MPH treatment.

Purpose of the Study:

  • To evaluate the cardiovascular impact of MPH treatment in healthy children and adolescents with ADHD.
  • To monitor blood pressure and echocardiographic parameters over two years.

Main Methods:

  • Prospective, longitudinal, crossover study involving 73 ADHD patients (average age 9.2 years, 75.3% male).
  • Cardiovascular evaluation included blood pressure monitoring and echocardiographic assessment of cardiac structure, systolic, and diastolic functions at baseline, 1 year, and 2 years.
  • Analysis focused on changes in blood pressure, structural properties, and systolic/diastolic function parameters.

Main Results:

  • A statistically significant increase in both systolic (3.7 mmHg) and diastolic (2 mmHg) blood pressure was observed.
  • No severe cardiovascular events or echocardiographic alterations in structural properties or systolic function were detected.
  • A significant increase in isovolumic relaxation time (IVRT) and deceleration time was noted, indicating potential diastolic function changes, but without significant alterations in LV distensibility or early diastolic pressure.

Conclusions:

  • MPH treatment in children with ADHD is associated with modest increases in blood pressure and specific changes in diastolic function.
  • No significant adverse cardiovascular structural or functional changes were observed in this cohort over two years.
  • Long-term cardiovascular effects of psychostimulants warrant further investigation as a potential modifiable cardiovascular risk factor.
Keywords:
Attention-deficit hyperactivity disorderCardiovascular adverse effectsCardiovascular safetyDeficit de atención e hiperactividadDiastolic functionEfectos adversos cardiovascularesFunción diastólicaLisdexanfetaminaLisdexanfetamineMethylphenidateMetilfenidatoPsicoestimulantesSeguridad cardiovascularStimulant medications

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