Medications used to treat attention deficit hyperactivity disorder (ADHD) are associated with long-term risk of cardiovascular disease, according to a new study published in JAMA Psychiatry. Swedish researchers found that people taking ADHD medications had a higher risk of hypertension and arterial disease, and the risk increased over time.

According to CNN, the scientists followed thousands of individuals with ADHD for an average of four years and up to 14 years, between 2007 and 2020. The study participants, between the ages of 6 and 64, were closely monitored for a wide range of cardiovascular disease diagnoses.

The study found that each additional year of ADHD medication raised the risk of heart disease by 4%, stabilizing after more substantial increases were noted in the first three years of treatment. Overall, people who take these medications for more than five years were 23% more likely to develop heart disease compared with people who didn’t take the medications.

Heart disease is quite rare in children, so experts suggest that pediatricians can manage younger ADHD patients without involving a cardiologist. However, children with special concerns based on their medical conditions and adults with underlying risk factors for heart disease, might benefit from a more cautious and conservative approach to prescribing ADHD drugs.

About 1 in 10 children between the ages of 3 to 17 have been diagnosed with ADHD, and the diagnosis is becoming more common in adults, too.

Dr. David Goodman, a leading expert on ADHD and related disorders, says that the increased risk of cardiovascular disease is “relatively insignificant in ordinary healthy adults.”  Goodman, an assistant professor in the department of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine, adds: “You need to measure the benefit of the treatment against the relatively small risks, and patients will say the benefits are tremendous and I wouldn’t want to give them up.”

Goodman says it is important that ADHD patients be screened for heart health before starting treatment and to be monitored regularly. ADHD patients can help care for their own heart by following the tips outlined in the American Heart Association’s Life's Essential 8, lifestyle behaviors that can improve cardiovascular health.

The researchers acknowledged that the risk for cardiovascular disease in those taking ADHD medicine may be underestimated in their study because some patients did not require medical intervention for heart disease and others did not take medication as prescribed. And they noted that while the study didn’t show that the medication caused heart disease, the findings “highlight the importance of carefully weighing potential benefits and risks when making treatment decisions on long-term ADHD medication use.”

“Clinicians should be vigilant in monitoring patients, particularly among those receiving high doses, and consistently assess signs and symptoms of cardiovascular disease throughout the course of treatment,” the researchers wrote, according to CNN.