TY - JOUR
T1 - Cardiac autonomic dysfunction and arterial stiffness among children and adolescents with attention deficit hyperactivity disorder treated with stimulants
AU - Kelly, Aaron S
AU - Rudser, Kyle
AU - Dengel, Donald R
AU - Kaufman, Christopher L.
AU - Reiff, Michael I
AU - Norris, Anne L.
AU - Metzig, Andrea M.
AU - Steinberger, Julia
N1 - Publisher Copyright:
© 2014 Elsevier Inc.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Objective To compare markers of cardiovascular health in youth diagnosed with attention deficit hyperactivity disorder (ADHD) by the use of stimulant medication with healthy controls.Study design Children and adolescents (n = 85; mean age 11.2 ± 2.8 years; 66 boys) diagnosed with ADHD using a stimulant and 53 siblings without ADHD (mean age 11.1 ± 3.8 years; 28 boys) were included in this cross-sectional study. Measured variables included blood pressure, heart rate (HR), HR variability: SD of the RR interval and low frequency to high frequency ratio, carotid-radial pulse wave velocity, carotid artery augmentation index (AIx), radial artery AIx, brachial artery flow-mediated dilation, and digital reactive hyperemic index.Results Compared with control patients, participants with ADHD had greater resting systolic blood pressure (3.9 mm Hg, 95% CI [1.2-6.7], P =.005), diastolic blood pressure (5.5 mm Hg, 95% CI [3.2-7.8], P <.001), HR (9.2 beats/min, 95% CI [6.0-12.3], P <.001), low frequency to high frequency ratio (0.55, 95% CI [0.22-0.89], P =.001), carotid AIx (7.2%, 95% CI [1.9-12.5], P =.008), and pulse wave velocity (0.36 m/s, 95% CI [-0.05, 0.78], P =.089), and lower SD of the RR interval (-33.7 milliseconds, 95% CI [-46.1, -21.3], P <.001). Neither flow-mediated dilation nor reactive hyperemic index was significantly different.Conclusions Children and adolescents being treated with a stimulant medication for ADHD exhibited signs of altered cardiac autonomic function, characterized by increased sympathetic tone, and showed evidence of arterial stiffening.
AB - Objective To compare markers of cardiovascular health in youth diagnosed with attention deficit hyperactivity disorder (ADHD) by the use of stimulant medication with healthy controls.Study design Children and adolescents (n = 85; mean age 11.2 ± 2.8 years; 66 boys) diagnosed with ADHD using a stimulant and 53 siblings without ADHD (mean age 11.1 ± 3.8 years; 28 boys) were included in this cross-sectional study. Measured variables included blood pressure, heart rate (HR), HR variability: SD of the RR interval and low frequency to high frequency ratio, carotid-radial pulse wave velocity, carotid artery augmentation index (AIx), radial artery AIx, brachial artery flow-mediated dilation, and digital reactive hyperemic index.Results Compared with control patients, participants with ADHD had greater resting systolic blood pressure (3.9 mm Hg, 95% CI [1.2-6.7], P =.005), diastolic blood pressure (5.5 mm Hg, 95% CI [3.2-7.8], P <.001), HR (9.2 beats/min, 95% CI [6.0-12.3], P <.001), low frequency to high frequency ratio (0.55, 95% CI [0.22-0.89], P =.001), carotid AIx (7.2%, 95% CI [1.9-12.5], P =.008), and pulse wave velocity (0.36 m/s, 95% CI [-0.05, 0.78], P =.089), and lower SD of the RR interval (-33.7 milliseconds, 95% CI [-46.1, -21.3], P <.001). Neither flow-mediated dilation nor reactive hyperemic index was significantly different.Conclusions Children and adolescents being treated with a stimulant medication for ADHD exhibited signs of altered cardiac autonomic function, characterized by increased sympathetic tone, and showed evidence of arterial stiffening.
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U2 - 10.1016/j.jpeds.2014.05.043
DO - 10.1016/j.jpeds.2014.05.043
M3 - Article
C2 - 25015574
AN - SCOPUS:84908235580
SN - 0022-3476
VL - 165
SP - 755
EP - 759
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 4
ER -