ArticleJournal of child and adolescent psychopharmacology2014
Cardiovascular safety of stimulants in children with attention-deficit/hyperactivity disorder: a nationwide prospective cohort study.
Article in Journal of child and adolescent psychopharmacology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Risk of Cardiovascular Diseases Associated With Medications Used in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Extended-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults.The Cochrane database of systematic reviews · 2022Pooled it
- Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of adverse events in non-randomised studies.The Cochrane database of systematic reviews · 2018Pooled it
- Pooled it
- Acute and Long-Term Cardiovascular Effects of Stimulant, Guanfacine, and Combination Therapy for Attention-Deficit/Hyperactivity Disorder.Journal of child and adolescent psychopharmacology · 2016Trial
- Methylphenidate and Long-Term Risk of Cardiovascular Diseases: A Nationwide Cohort Study.Pharmacoepidemiology and drug safety · 2026Article
- Is methylphenidate truly cardiac-safe? Insight from biventricular speckle tracking echocardiography in pediatric patients with attention deficit hyperactivity disorder.European journal of pediatrics · 2026Article
- Safety and Efficacy of Natural and Conventional Psychiatric Treatments: A Comparative Review of Mushroom-Derived Compounds and Medicinal Plants in the Management of Mental Disorders.Molecules (Basel, Switzerland) · 2026Review
- Investigation of the Effects of Methylphenidate on Hemodynamic Parameters in Children With ADHD.Pharmacology research & perspectives · 2026Observational
- Exploring the Association Between Attention-Deficit/Hyperactivity Disorder and Essential Hypertension in a Pediatric Population.Children (Basel, Switzerland) · 2026Article
- Young patients with congenital heart disease on psychotropic medications have higher recurrence of cardiac events than those without CHD.Frontiers in cardiovascular medicine · 2026Article
- Article
- Narcolepsy Is Associated With Subclinical Cardiovascular Disease as Early as Childhood: A Big Data Analysis.Journal of the American Heart Association · 2025Article
- Incidence and trend of cardiac events among children and young adults exposed to psychopharmacological treatment (2006-2018): A nationwide register-based study.British journal of clinical pharmacology · 2025Article
- Five Steps to Improve Cardiac Safety of Attention Deficit Hyperactivity Disorder Treatment.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- From Consensus Statement to Pills to Pixels: New Innovations in Attention-Deficit/Hyperactivity Disorder Care.Journal of child and adolescent psychopharmacology · 2024Review
- The Impact of Stimulant Medications on Blood Pressure and Body Mass Index in Children with Attention Deficit Hyperactivity Disorder.Academic pediatrics · 2024Observational
- Switch to Lisdexamfetamine in the Treatment of Attention-Deficit Disorder at a Psychiatric Outpatient Clinic for School-Aged Children: A Danish Cohort Study.Journal of child and adolescent psychopharmacology · 2024Observational
- Methylphenidate and Short-Term Cardiovascular Risk.JAMA network open · 2024Article
- Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases.JAMA psychiatry · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe purpose of this study was to determine whether stimulant users are at higher risk of a later cardiovascular event than are non-users, examining this association in both a national cohort and a population-based sample of children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD). We also aim to examine a possible dose-response relationship in such an association.
methodsWe conducted a longitudinal, prospective cohort study of all children born in Denmark between 1990 and 1999. Within this cohort, children with ADHD were identified. Data from national health registers on psychiatric and somatic diagnoses, stimulant prescriptions, cardiovascular risk factors, pre- and perinatal and sociodemographic covariates in all children and their parents were merged, using the unique personal identification number. Hazard ratios (HR) for cardiovascular events were estimated using Cox regression, adjusted for other known risk factors.
resultsIn the total population (n=714,258 contributing a total of 6,767,982 person-years) use of stimulants increased the risk of a cardiovascular event; adjusted HR=1.83 (1.10-3.04). In children with ADHD (n=8300) stimulant treatment also increased the risk of a cardiovascular event (adjusted HR=2.20 [2.15-2.24]), with a complex time-dependent dose-response relationship.
conclusionsThis is the first nationwide cohort study of the cardiovascular safety of stimulants in children and adolescents, and it represents, to our knowledge, the longest prospective follow-up study. Cardiovascular events were rare but twice as likely in stimulant users as in non-users, both in the total national population and in children with ADHD. We found a complex, time- and dose-dependent interrelationship between cardiovascular adverse events and stimulant treatment in children and adolescents. Our results suggest a safety signal with an increased risk of cardiovascular disease associated with stimulant treatment in children and adolescents, even after adjusting for a number of potential confounders.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.