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Providing a medical home for children and youth |
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Mercer Island Pediatric Associates |
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Breaking News—April 24, 2008 |
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· April 24, 2008—Response to Journal Article "Children with ADHD Should Get Heart Tests Before Treatment with Stimulant Drugs." American Heart Association (2008). 21 Apr. 2008 <http://americanheart.mediaroom.com>.
On April 21, 2008, the American Heart Association, in its journal Circulation, released a statement recommending screening children for cardiac conditions, before and during treatment with stimulant medication for ADHD.
The statement recommends using heart rate and blood pressure checks, and screening for conditions with related cardiac symptoms, before prescribing stimulant drugs for ADHD. Additionally, it recommends that each child diagnosed with ADHD be given an electrocardiogram (ECG) before these drugs are prescribed. If stimulant medications are already being prescribed, a review of the history and physical examination, and an ECG are recommended.
These recommendations came as a result of concerns about sudden cardiac death (SCD) and other cardiovascular events in individuals taking stimulant medications. Between 1999 and 2003, 25 people (19 children) taking ADHD medication died suddenly, and 43 people (26 children) experienced cardiovascular events such as strokes, cardiac arrest, and heart palpitations. To put those numbers into some perspective, it is estimated that sudden cardiac death claims the lives of 1000 to 7000 children each year in the United States, the vast majority of whom are not taking these medications.
The AHA recognized the fact that there is limited information on the relationship between stimulant medications and these unfortunate events, stating in this paper “it is not known if the risk of SCD on stimulants is higher than in the general population or that the approach described will decrease the risk.”
The physicians at Mercer Island Pediatrics believe that the recommendations from the AHA are cautious but prudent, pending further evidence-based research. Your practitioner will discuss the issues raised in this report with patients currently on stimulant medications and their families at their next routine medication recheck. We are able to offer an ECG that can be scheduled in our office, if appropriate. |