Cardiovascular risk factors in attention-deficit/hyperactivity disorder: a family design study of Swedish conscripts
Open accessAbstract
Objective: (1) investigate the associations of attention‐deficit/hyperactivity disorder (ADHD) with systolic and diastolic blood pressure, resting heart rate, pulse pressure (PP), physical fitness, and BMI; (2) explore whether cardiovascular risk factors and ADHD share genetic and environmental influences; (3) assess if pharmacological treatment for ADHD influences these associations. Methods: We identified 395,978 individuals born between 1973 and 1991 who had military conscription examinations at a mean age of 18.3 years (SD = 0.57) and their full‐siblings within the same cohort (N = 208,060) by linking population‐based registers in Sweden. Results: Significantly increased risk of ADHD was observed in individuals with low systolic blood pressure (SBP) and PP, low physical fitness, and in those who had overweight or obesity after adjustments (adjusted Odds Ratio [OR] ranging from 1.10 to 1.45). Full siblings of individuals with low SBP, low physical fitness, and obesity were more likely to receive an ADHD diagnosis compared to full siblings without those risk factors (OR ranging from 1.17 to 1.31). Additionally, analyses showed robust associations between ADHD and low SBP, low physical fitness, and obesity, even in ADHD medication‐naïve individuals. Conclusions: Individuals with several cardiovascular risk factors are more often diagnosed with ADHD, regardless of psychiatric comorbidity. These association are not explained by ADHD pharmacotherapy, rather, they are in part due to shared familial risk factors.
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These conditions frequently co-occur with ADHD.
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Cites
Meta-analysis of the heritability of human traits based on fifty years of twin studies
Polderman, T. J. C., Benyamin, B., de Leeuw, C. A., Sullivan, P. F., van Bochoven, A., Visscher, P. M., & Posthuma, D. (2015) · Nature Genetics · doi:10.1038/ng.3285 · Cited by 2,467 · cited 1× · see citing works
“Given that ADHD and indicators of cardiovascular risk are highly heritable (Faraone & Larsson, 2019; Polderman et al., 2015), familial risk factors may predispose individuals to both conditions, but this remains to be investigated.”
BackgroundCorrell, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., Thapa‐Chhetri, N., Fornaro, M., Gallicchio, D., Collantoni, E., et al. (2017) · World Psychiatry · doi:10.1002/wps.20420 · Cited by 1,729 · see citing works
Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., et al. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.01.022 · Cited by 1,545 · cited 4× · see citing works
“Attention ‐ deficit/hyperactivity disorder (ADHD) is a neuro-developmental condition that has been estimated to affect approximately 3%–7% of the school ‐ age population (Faraone et al., 2021).”
InfluentialSelf-citationKollins, S. H., & Adcock, R. A. (2014) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2014.02.002 · Cited by 95 · see citing works
Katzman, M., & Sternat, T. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s111818 · Cited by 83 · see citing works
Latvala, A., Kuja-Halkola, R., Rück, C., D’Onofrio, B. M., Jernberg, T., Almqvist, C., Mataix-Cols, D., Larsson, H., & Lichtenstein, P. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.2717 · Cited by 82 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 20
- Buijs, R. M. (2013). The autonomic nervous system. In Handbook of clinical neurology (pp. 1– 11). Elsevier. 24095111
- Cortese, S. (2012). The neurobiology and genetics of attention‐deficit/hyperactivity disorder (ADHD): What every clinician should know. European Journal of Paediatric Neurology, 16, 422– 433. 10.1016/j.ejpn.2012.01.009 22306277 · DOI · Paper page
- Cortese, S., Moreira‐Maia, C. R., St Fleur, D., Morcillo‐Peñalver, C., Rohde, L. A., & Faraone, S. V. (2016). Association between ADHD and obesity: A systematic review and meta‐analysis. American Journal of Psychiatry, 173, 34– 43. 10.1176/appi.ajp.2015.15020266 26315982 · DOI · Paper page
- Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24, 562– 575. 10.1038/s41380-018-0070-0 29892054 PMC6477889 · DOI · Paper page
- Farb, D. H., & Ratner, M. H. (2014). Targeting the modulation of neural circuitry for the treatment of anxiety disorders. Pharmacological Reviews, 66, 1002– 1032. 10.1124/pr.114.009126 25237115 · DOI · Paper page
- Garcia‐Argibay, M., du Rietz, E., Lu, Y., Martin, J., Haan, E., Lehto, K., Bergen, S. E., Lichtenstein, P., Larsson, H., & Brikell, I. (2022). The role of ADHD genetic risk in mid‐to‐late life somatic health conditions. Translational Psychiatry, 12, 152. 10.1038/s41398-022-01919-9 35399118 PMC8995388 · DOI
- Garcia‐Argibay, M., Pandya, E., Ahnemark, E., Werner‐Kiechle, T., Andersson, L. M., & Larsson, H. (2021). Healthcare utilization and costs of psychiatric and somatic comorbidities associated with newly diagnosed adult ADHD. Acta Psychiatrica Scandinavica, 13297. 33749845
- Harvey, W. J., & Reid, G. (2003). Attention‐deficit/hyperactivity disorder: A Review of research on movement skill performance and physical fitness. Adapted Physical Activity Quarterly, 20, 1– 25. 10.1123/apaq.20.1.1 · DOI
- Hildrum, B., Mykletun, A., Holmen, J., & Dahl, A. A. (2008). Effect of anxiety and depression on blood pressure: 11‐year longitudinal population study. British Journal of Psychiatry, 193, 108– 113. 10.1192/bjp.bp.107.045013 18669991 · DOI
- Kemp, A. H., Quintana, D. S., Gray, M. A., Felmingham, K. L., Brown, K., & Gatt, J. M. (2010). Impact of depression and antidepressant treatment on heart rate variability: A Review and meta‐analysis. Biological Psychiatry, 67, 1067– 1074. 10.1016/j.biopsych.2009.12.012 20138254 · DOI · Paper page
- Meyer, T., Becker, A., Sundermann, J., Rothenberger, A., & Herrmann‐Lingen, C. (2017). Attention deficit‐hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: Results from the nationwide German health interview and examination survey for children and adolescents (KiGGS). European Child & Adolescent Psychiatry, 26, 165– 175. 10.1007/s00787-016-0852-3 27197525 · DOI
- Mick, E., McManus, D. D., & Goldberg, R. J. (2013). Meta‐analysis of increased heart rate and blood pressure associated with CNS stimulant treatment of ADHD in adults. European Neuropsychopharmacology, 23, 534– 541. 10.1016/j.euroneuro.2012.06.011 22796229 PMC3488604 · DOI
- Myers, J., Prakash, M., Froelicher, V., Do, D., Partington, S., & Atwood, J. E. (2002). Exercise capacity and mortality among men referred for exercise testing. New England Journal of Medicine, 346, 793– 801. 10.1056/nejmoa011858 11893790 · DOI · Paper page
- Quesada, D., Ahmed, N. U., Fennie, K. P., Gollub, E. L., & Ibrahimou, B. (2018). A Review: Associations between attention‐deficit/hyperactivity disorder, physical activity, medication use, eating behaviors and obesity in children and adolescents. Archives of Psychiatric Nursing, 32, 495– 504. 10.1016/j.apnu.2018.01.006 29784236 · DOI
- Spencer, T. J., Faraone, S. V., Tarko, L., McDermott, K., & Biederman, J. (2014). Attention‐deficit/hyperactivity disorder and adverse health outcomes in adults. The Journal of Nervous and Mental Disease, 202, 725– 731. 10.1097/nmd.0000000000000191 25211634 · DOI
- Sundstrom, J., Neovius, M., Tynelius, P., & Rasmussen, F. (2011). Association of blood pressure in late adolescence with subsequent mortality: Cohort study of Swedish male conscripts. BMJ, 342, d643. 10.1136/bmj.d643 21343202 PMC3042737 · DOI
- Tverdal, A., Hjellvik, V., & Selmer, R. (2008). Heart rate and mortality from cardiovascular causes: A 12 year follow‐up study of 379 843 men and women aged 40‐45 years. European Heart Journal, 29, 2772– 2781. 10.1093/eurheartj/ehn435 18820324 · DOI
- World Health Organization. (2000). Obesity: Preventing and managing the global epidemic: Report of a WHO consultation. World Health Organization. 11234459
- Yi, S.‐W., Mok, Y., Ohrr, H., Yi, J.‐J., Yun, Y. D., Park, J., & Jee, S. H. (2016). Low systolic blood pressure and vascular mortality among more than 1 million Korean adults. Circulation, 133, 2381– 2390. 10.1161/circulationaha.115.020752 27143683 · DOI
- Yildiran, T., Koc, M., Bozkurt, A., Sahin, D. Y., Unal, I., & Acarturk, E. (2010). Low pulse pressure as a predictor of death in patients with mild to advanced heart failure. Texas Heart Institute Journal, 37, 284– 290. 20548803 PMC2879196
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Garcia-Argibay, M., Chang, Z., Brikell, I., Kuja-Halkola, R., D'Onofrio, B. M., Lichtenstein, P., Newcorn, J. H., Faraone, S. V., Larsson, H., & Cortese, S. (2025) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00396-1 · Cited by 31 · see citing works
Self-citation
- Authors
- Garcia‐Argibay, M., Du Rietz, E., Hartman, C. A., Lichtenstein, P., Chang, Z., Fava, C., Cortese, S., & Larsson, H.
- Affiliations
- Örebro University (SE)
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- University Medical Center Groningen (NL)
- Karolinska Institutet (SE)
- University of Verona (IT)
- University of Nottingham (GB)
- Corresponding author
- Garcia‐Argibay, Miguel
- ORCID
- Venue
- International Journal of Methods in Psychiatric Research
- Publisher
- Wiley
- Published
- 2022-06-29
- Volume
- 31
- Issue
- 4
- Pages
- e1930-e1930
- ISSN
- 1049-8931 (ISSN-L)
- 1557-0657
- PMC
- PMC9720218
- OpenAlex
- W4283702095
- Cited by
- 16
- References
- 6
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 8 · 2022: 2
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Methods in Psychiatric Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- ePrints Soton (University of Southampton) (acceptedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lund University Publications (Lund University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Fredrik och Ingrid Thurings Stiftelse (2019‐00482)
- Vetenskapsrådet (2018‐02599)
- Hjärnfonden (FO2021‐0115)
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd (2019‐01172, 2019‐00176)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- attention deficit hyperactivity disorder, cardiovascular risk factors, systolic blood pressure, pulse pressure, resting heart rate, physical fitness, body mass index, obesity, family risk factors, ADHD medication, conscripts
- MeSH terms
- Heart Disease Risk Factors, Adolescent, Attention Deficit Disorder with Hyperactivity, Cardiovascular Diseases, Humans, Obesity, Risk Factors, Sweden
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