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ADHD and adherence to antihypertensive medication treatment: a multinational cohort study

Honghui Yao1, Yiling Zhou2, Lin Li1

  • 1Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels Väg 12A, 171 65, Stockholm, Sweden.

BMC Medicine
|February 20, 2026
PubMed

Insights

Adults with attention-deficit/hyperactivity disorder (ADHD) are more likely to stop taking blood pressure medication. However, ADHD medication may improve adherence to these essential treatments.

Area of Science:

  • Cardiology
  • Neuroscience
  • Pharmacology

Background:

  • Antihypertensive medication adherence is crucial for managing hypertension and preventing cardiovascular disease.
  • Attention-deficit/hyperactivity disorder (ADHD) is linked to cardiovascular issues, including hypertension.
  • The impact of ADHD and its treatments on antihypertensive medication adherence remains unclear.

Purpose of the Study:

  • To investigate the association between ADHD and antihypertensive medication discontinuation and adherence.
  • To explore the role of ADHD medication in antihypertensive treatment adherence.

Main Methods:

  • A multinational cohort study involving over 12 million adults initiating antihypertensive medication.
  • ADHD identification through diagnosis or medication dispensation.
  • Analysis of antihypertensive medication discontinuation and adherence (Proportion of Days Covered < 80%) using Cox models and logistic regression, with meta-analysis for pooled results.

Main Results:

  • Adults with ADHD showed a higher rate of antihypertensive medication discontinuation (HR 1.14) over 5 years, particularly middle-aged and older adults.
  • Individuals with ADHD had significantly higher odds of poor adherence (OR 1.45-1.64) up to 5 years.
  • ADHD medication use was associated with reduced odds of poor adherence in individuals with ADHD (OR 0.66-0.58).

Conclusions:

  • Adults with ADHD face challenges in adhering to antihypertensive treatments, leading to higher discontinuation rates.
  • ADHD medication use may positively influence adherence to antihypertensive therapy in this population.
Abstract

Keywords:
ADHDAntihypertensive agentsMedication adherence

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