Risk Factors for Adverse Cardiac Events in Individuals Prescribed Stimulants Across the Lifespan
Destin Groff1, Wen-Jan Tuan2, Kraig Holt3
1Penn State College of Medicine, Hershey, PA, USA.
Journal of Attention Disorders
|February 10, 2025
Summary
Individuals with atherosclerotic heart disease face the highest risk of cardiovascular events when taking prescription stimulants. Other risk factors include hypertension, cocaine use, and anxiety, with age influencing outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Prescription stimulants, FDA-approved for ADHD, are increasingly prescribed to adults.
- Concerns exist regarding the safety of stimulant use in adults with comorbidities.
- Identifying risk factors for adverse cardiovascular events is crucial for safe stimulant prescribing.
Purpose of the Study:
- To identify risk factors for adverse cardiovascular events in individuals prescribed stimulants.
- To analyze stimulant safety across the lifespan, focusing on adult populations.
- To inform clinical decisions regarding stimulant prescriptions.
Main Methods:
- Case-control study using the TriNetX research network.
- Included individuals younger than 90 prescribed stimulants between 2010-2020.
- Multivariate logistic regression analyzed risk factors for cardiovascular events.
Main Results:
- Nearly 50,000 adverse cardiovascular events occurred among 987,762 stimulant users.
- Atherosclerotic heart disease showed the highest odds of adverse events (aOR=36.7).
- Hypertension, cocaine use, and anxiety were significant predictors, with age as a potential modifier.
Conclusions:
- Atherosclerotic heart disease is the primary risk factor for cardiovascular events in stimulant users.
- Mental health diagnoses are independent predictors of adverse outcomes.
- ADHD itself was not an independent risk factor in adults when controlling for other variables.
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