Cardiovascular Medicine Use Among Adults With ADHD: A Nationwide Study in Australia
Masako Araki1, Helga Zoega2, Malcolm Gillies1
1UNSW Sydney, Australia.
Insights
Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) use cardiovascular medications more often than those without, especially younger adults. Distinct sex-based patterns in medication use were also observed, highlighting the need for tailored cardiovascular care.
Area of Science:
- Pharmacology
- Cardiology
- Psychiatry
Background:
- Cardiovascular conditions are prevalent in adults with Attention-Deficit/Hyperactivity Disorder (ADHD).
- Limited data exists on cardiovascular medicine usage patterns in adult ADHD populations.
Purpose of the Study:
- To investigate the prevalence and patterns of cardiovascular medicine use in Australian adults with and without ADHD.
- To examine differences in cardiovascular medicine use by age, sex, and specific medication types.
Main Methods:
- A population-based study using dispensing claims from a 10% random sample of Australians.
- 14,753 adults with ADHD were matched with 59,012 adults without ADHD.
- Prevalence of cardiovascular medicine use in 2021 was estimated and associations were analyzed using Poisson regression.
Main Results:
- Cardiovascular medicine use was significantly higher in adults with ADHD (16.5%) compared to those without (10.0%).
- The highest prevalence difference was observed in younger adults aged 18-29 years.
- Specific medications like propranolol, diuretics, and antithrombotic agents showed increased use in the ADHD group, with notable sex-specific patterns for diuretics.
Conclusions:
- Adults with ADHD exhibit an elevated prevalence of cardiovascular medicine use, particularly younger individuals.
- Observed sex-specific patterns in medication use suggest potential differential effects.
- Regular cardiovascular health monitoring and management are crucial for individuals with ADHD throughout their lifespan.
Background:
Despite cardiovascular conditions being common in adults with ADHD, data on patterns of cardiovascular medicine use in this population are scarce.
Methods:
Using dispensing claims for a 10% random sample of Australians, this population-based study comprised 14,753 adults with ADHD (defined as having ≥2 ADHD medicine dispensings in 2012-2020) who were 1:4 sex- and age-matched with 59,012 adults without ADHD (no ADHD dispensings). We estimated the prevalence of cardiovascular medicine use in 2021 among adults with and without ADHD, overall and by medicine type, sex, and age. Using Poisson regression, we calculated age- and sex-adjusted prevalence ratios (PRs) with 95% confidence intervals (CIs) to assess associations.
Results:
Overall cardiovascular medicine use was more prevalent among adults with ADHD than those without (16.5% vs. 10.0%, aPR = 1.7, 95% CI [1.6, 1.7]), with the highest difference among those aged 18 to 29 years (aPR = 2.8, 95% CI [2.4, 3.1]). We observed increased differences in use of propranolol (3.2% vs. 0.7%), loop diuretics (0.8% vs. 0.4%), potassium-sparing diuretics (0.9% vs. 0.4%), cardiac therapy (0.8% vs. 0.5%), and antithrombotic agents (2.2% vs. 1.4%). Among females, we noted associations of ADHD with specific diuretic subgroups (loop, aPR = 2.8, 95% CI [2.1, 3.7]; potassium-sparing, aPR = 2.5, 95% CI [1.9, 3.3]).
Conclusion:
We identified an elevated prevalence of cardiovascular medicine use among adults with ADHD, particularly among younger people. We also observed distinct patterns in specific medicine use between sexes, suggesting potential sex-specific effect modification. Our findings underscore the importance of regular monitoring and management of cardiovascular health among people with ADHD across the lifespan.
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