Identification of Mediating Pathways Between Attention Deficit/Hyperactivity Disorder and Coronary Artery Disease and
Jing Lin1,2, Yiling Zhou1, Tian Xie1,3
1Department of Epidemiology, University of Groningen, https://ror.org/03cv38k47University Medical Center Groningen, Groningen, The Netherlands.
Summary
Attention deficit/hyperactivity disorder (ADHD) causally increases the risk of coronary artery disease and heart failure. Modifiable factors like educational attainment and smoking mediate these cardiovascular disease risks, suggesting intervention targets.
Area of Science:
- Cardiovascular Epidemiology
- Psychiatric Genetics
- Mendelian Randomization
Background:
- Attention deficit/hyperactivity disorder (ADHD) is linked to increased cardiovascular disease (CVD) risk.
- The causal nature of this association and mediating pathways remain unclear.
Purpose of the Study:
- To investigate the causal association between ADHD and coronary artery disease (CAD) and heart failure (HF).
- To quantify the mediating roles of modifiable risk factors in the ADHD-CVD relationship.
Main Methods:
- A two-step, two-sample Mendelian randomization study design.
- Utilized summary statistics from genome-wide association studies for ADHD, mediators, CAD, and HF.
- Employed genetic variants (SNPs) as instrumental variables.
Main Results:
- Genetically predicted ADHD showed increased odds for CAD (OR 1.13) and HF (OR 1.11).
- Educational attainment significantly mediated the ADHD-CAD link (32.27%); BMI, T2D, EA, smoking initiation, and depression explained 83.59% of the association.
- Smoking initiation significantly mediated the ADHD-HF link (35.87%); BMI, T2D, and SI explained 82.39% of the association.
Conclusions:
- Evidence supports a causal relationship between ADHD and increased risks of CAD and HF.
- Modifiable factors substantially mediate these associations, highlighting potential intervention targets for reducing CVD risk in ADHD populations.
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