Questions about ADHD medication and heart disease are common, particularly for adults concerned about the long-term treatment. Research suggests that while ADHD medication may cause small increases in blood pressure and heart rate, untreated ADHD may also be associated with increased cardiovascular levels.
Attention Deficit Hyperactivity Disorder (ADHD) is increasingly recognised as a condition that can affect both mental and physical health across a person’s lifespan. While stimulant and non-stimulant medications remain effective treatments for many individuals with ADHD, questions are often raised about their potential cardiovascular effects, particularly regarding long-term risks.
Current evidence suggests that ADHD medications are associated with small increases in blood pressure and heart rate. However, merging research also indicates that ADHD itself may carry an increased cardiovascular risk independent of treatment. This highlights the importance of considering both the risks of medication and the potential health consequences of untreated ADHD when making treatment decisions.
Can ADHD Medication Have an Effect on the Heart?
The short answer is yes, but the effects are generally modest.
Stimulant and non-stimulant medication used to treat ADHD cause modest increases in blood pressure and pulse rate. Meta-analytic data suggests an average increase in systolic blood pressure of approximately 1-2mm Hg, diastolic blood pressure of 2 to 3 mm Hg, and heart rate increases of around 3 to 6 beats per minute (Farhart et al.,2025). These changes are generally considered small and are often not clinically significant in otherwise healthy adults.
Further long-term research suggests that long-term ADHD medication use may be associated with an increase in hypertension over time. A Swedish population study showed that individuals using ADHD medication for more than five years had a higher likelihood of developing hypertension, and to a lesser extent, arterial disease (Zhang et al.,2024). The greatest rise in risk occurred during the first three years of treatment before stabilising. Notably, the study did not find an increased risk for arrhythmia, heart failure, ischaemic heart disease or cerebrovascular disease.
Similar findings have also been reported in adults commencing ADHD medication treatment. A Danish cohort study involving 73,000 people who started ADHD medication found a link between treatment and a higher long-term risk of stroke, heart failure and overall cardiovascular issues, with the risk increasing alongside medication dose. Although the actual risks for individuals was still low, these results are important when weighing up extended treatment options.
Does Untreated ADHD Increase Cardiovascular Risk?
ADHD itself appears to be associated with increased cardiovascular risk independent of medication treatment. A Swedish population-based study demonstrated that people with ADHD had a significantly higher incidence of cardiovascular disease (38.05%) compared to the controls without ADHD (23.57%) (Li et al., 2022). Increased risks were observed across all types of cardiovascular disease, although the links were strongest for cardiac arrest, haemorrhagic stroke and peripheral vascular disease.
Longitudinal research has also shown that childhood ADHD symptoms may predict poorer cardiovascular health in adulthood. This includes higher body mass index, elevated blood pressure, and increased smoking rates, largely because ADHD may contribute to behaviours that raise these risks.
Genetic research further supports a potential causal relationship between ADHD and cardiovascular disease, with part of this association likely mediated through modifiable risk factors such as obesity and smoking (Leppert et al., 2021)
What Does This Mean For Adults Taking ADHD Medication?
Current evidence suggests that ADHD medication may contribute to small increases in blood pressure and may be associated with longer-term risk of hypertension in some individuals (Farhat et al., 2025); Zhang et al., 2024). However, untreated ADHD also appears to carry a broader cardiovascular risk burden that may persist across a lifespan ( Li et al., 2022; Leppert et al.,2021)
These findings reinforce why a balanced and individualised approach to treatment is necessary. Before commencement of medication, clinicians typically undertake a baseline cardiovascular assessment that looks at blood pressure, resting heart rate, weight/BMI and cardiac history, along with other assessments. Ongoing monitoring may be particularly important for individuals with pre-existing cardiovascular risk factors or family histories of heart disease.
For many patients, the potential benefits of ADHD treatments, including improvement in functioning, impulsivity, emotional regulation, occupational performance and quality of life, may outweigh the cardiovascular risks associated with treatment. Decisions regarding ADHD medication should therefore be made collaboratively between the patients and their clinician, taking into account individual risk factors, symptom severity and overall health.
At Eastern Suburbs Psychiatry, our team offers ADHD assessment and treatment for adults by psychiatrists, as well as child ADHD evaluations and care by our neuropsychologist in Sydney. The key is careful assessment, monitoring and personalised care rather than a one-size-fits-all approach.