Stimulant Medication Treatment in Children with Congenital Heart Disease and Attention-Deficit/Hyperactivity Disorder: Cardiovascular Outcomes.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8006933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-7312 (Electronic) Linking ISSN: 0196206X NLM ISO Abbreviation: J Dev Behav Pediatr Subsets: MEDLINE

Publication: <2000->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: [Baltimore, Md.] : Williams & Wilkins, [1980-

Attention Deficit Disorder with Hyperactivity*/drug therapy ; Central Nervous System Stimulants*/therapeutic use ; Heart Defects, Congenital*/chemically induced ; Heart Defects, Congenital*/complications ; Heart Defects, Congenital*/drug therapy; Humans ; Child ; Child, Preschool ; Retrospective Studies ; Blood Pressure

Objective: Children with congenital heart disease (CHD) are at increased risk for attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to determine whether children with CHD and ADHD clinically treated with stimulant medication were at increased risk for changes in cardiovascular parameters or death compared with CHD-matched controls.
Methods: In this retrospective cohort study, patients with CHD + ADHD treated with stimulant medication (exposed group [EG]) were matched by CHD diagnosis and visit age to patients not on stimulants (nonexposed group [NEG]). Cardiovascular parameters (heart rate [HR] and systolic and diastolic blood pressure [SBP and DBP]) and electrocardiograms (ECGs) from medical records over 12 months were compared using mixed effects models.
Results: Cardiovascular parameters for 151 children with CHD (mean age 8 ± 4 years) were evaluated (N = 46 EG and N = 105 NEG). Stimulant medication use was not associated with sudden cardiac death. HR and SBP did not significantly change over time in the EG and remained similar between groups. EG children had higher DBP compared with NEG children over time ( p = 0.001). Group × time interactions for HR, SBP, and DBP were not different between the EG and NEG. QTc was not significantly different between the EG and NEG (447 ms vs 439 ms, p = 0.23). EG children demonstrated improvement in ADHD symptoms.
Conclusion: Stimulant medication use in children with CHD was not associated with clinically significant changes in cardiovascular parameters compared with controls. Stimulants should be considered for ADHD treatment in children with CHD when prescribed with appropriate monitoring and coordination with the cardiologist.
Competing Interests: The authors declare no conflict of interest.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

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0 (Central Nervous System Stimulants)

Date Created: 20230421 Date Completed: 20230503 Latest Revision: 20230908

20230908

10.1097/DBP.0000000000001187

37081695