The heart health and ADHD connection
People with ADHD are more likely to experience heart disease, high blood pressure, and stroke. Learn why, and get strategies for taking care of your heart.
Attention-deficit hyperactivity disorder, or ADHD, is a common neurodevelopmental disorder that affects the way your brain processes and stores information. But ADHD doesn’t just affect your brain. It can affect other aspects of your physical health, too — especially your heart health.
More research is needed to fully understand the connection between ADHD and heart health. But early research suggests that people with ADHD may have a higher risk of having or developing heart problems.1 While learning this information can feel alarming, it can also help you manage your health and, in some cases, prevent future challenges.
How ADHD can affect your heart
Heart disease is just one part of a group of conditions called cardiovascular disease (CVD). CVD includes conditions that directly affect your heart, such as heart disease, heart attack, and stroke. It can also include conditions such as high blood pressure and high cholesterol.
ADHD is neurodevelopmental in nature, which means it affects your brain. However, a key study on ADHD and heart health had some pretty startling findings. The study, published in 2022, aimed to understand how ADHD can affect your risk of developing CVD. Researchers looked at data from over 5 million adults, some with ADHD and some without. The people in the study had no cardiovascular diseases when the study began. The researchers followed each person’s health data for up to 13 years to see if they developed CVD.1
Researchers found that more than a third (38 percent) of the people they studied who had ADHD developed at least one heart issue. But that was true of less than a quarter (24 percent) of the group without ADHD. This led researchers to conclude that people with ADHD are significantly more likely to develop heart problems.1
If you’re asking yourself why, you’re not alone. What’s behind the connection between ADHD and heart health? Researchers are still trying to figure it out. But there are a few possible reasons.
Biological differences
One reason ADHD might affect your heart is because of brain chemicals called neurotransmitters. These tiny chemicals send messages between cells in the brain. People with ADHD often have lower levels of these chemicals, such as dopamine.2 Dopamine, in addition to other chemicals, helps your brain control things like your mood, movement, and even physical functions such as your heart.3
ADHD may also affect your autonomic nervous system. This system controls automatic processes in your body, such as your heartbeat. If this system isn’t balanced, it can lead to issues such as high or low blood pressure and irregular heartbeat. This can put stress on your heart over time.
Lifestyle and behavior
The way ADHD affects your behavior can also play a role in your heart health. Common ADHD symptoms like impulsivity or trouble managing your time make it harder to stick to heart-healthy habits, like eating well and exercising regularly.
For example, if you tend to act impulsively, you may choose fast food over buying ingredients and making a meal at home. Over time, eating more fast food can harm your heart health.4
Similarly, if you tend to lose track of time or have a hard time managing your calendar, it can be tricky to plan workouts. While missing a workout class now and then isn’t harmful, skipping exercise regularly can cause your heart to weaken over time. This can increase your risk of various forms of CVD.5
You may also struggle to make or keep preventive health appointments like your yearly physical. It’s important to check in with your health care provider from time to time — even if you’re feeling good. This can help your provider identify issues before they become conditions that need long-term management.
Congenital heart disease and ADHD
Congenital heart disease (CHD) is a heart condition that you’re born with. CHD affects the structure of the heart or blood vessels. There are many types of CHD. Each has a different effect on how the heart functions.
A 2023 review of studies looked at more than 120,000 people with CHD. Researchers found that children with CHD were much more likely to develop ADHD. Most of the children studied who had severe CHD also had neurodevelopmental disabilities, such as delays in learning, speech, or social skills.6
A few factors contributed to this increased risk. One is low birth weight, which is more common in infants with CHD. Kids with CHD often undergo more surgeries and other medical treatments. This can lead to disruptions in the way their brains develop.6 The stress of dealing with a chronic health condition may also increase ADHD symptoms.
This shows that CHD doesn’t just impact the heart, but also the brain — and how important it is for kids with a history of CHD to be screened for ADHD. Early detection can help them get the resources they need to learn and thrive. This can include behavioral therapy, medication, and extra support at school.
ADHD medications and heart health
Health care providers often prescribe medications to help manage ADHD symptoms. There are two groups of ADHD medications: stimulants and non-stimulants. While these medications can help reduce your ADHD symptoms, some of them have side effects that can also affect your heart.
Stimulant medications
Stimulant medications are the most common group of medications used for ADHD treatment. They include:
Methylphenidate (Ritalin, Concerta)
Amphetamine (Adderall, Vyvanse)
Dexmethylphenidate (Focalin)
Stimulants work by increasing the levels of certain chemicals in your brain. This helps to improve your focus and attention. However, these medications can also increase your heart rate and blood pressure.
Stimulant medications are safe for most people. But people with heart problems who are on stimulant medication need to be more closely monitored. If you’re taking stimulants, keep an eye on your heart health. Make sure to discuss any concerns or preexisting heart conditions with your prescribing health care provider.7
Non-stimulant medications
Non-stimulant medications are generally thought of as second-line medications. This means they’re prescribed when stimulant medications aren’t an option. They’re usually prescribed if you don’t respond to stimulants or if you can’t use stimulants because of another condition.
Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor (SNRI) that’s FDA-approved to treat ADHD. Like stimulant medications, Strattera can also increase your heart rate and blood pressure. However, the heart-related effects of Strattera are less severe than with stimulants.
There are also other medications, such as guanfacine and clonidine, that are used to treat ADHD. Guanfacine has been associated with lowering blood pressure. It can be a better option for people who have ADHD and high blood pressure.7
Other risk factors for cardiovascular diseases
There are other factors that can increase your chance of developing heart problems. Some of these risk factors are more common in people with ADHD.
Sleep problems
Most children and adults living with ADHD also have a sleep disorder. ADHD can throw off your body’s natural sleep rhythms, which can make it harder to fall asleep and wake up at the same time each day.8
Not getting enough sleep is connected with various health problems, including high blood pressure, heart disease, heart attack, and stroke. That means that long-term sleep problems caused by ADHD can be a risk factor for heart problems.9
Smoking and substance use
People with ADHD are more likely to use tobacco, alcohol, and other substances.10 Substance use can be hard on your cardiovascular system. For example, alcohol raises your blood pressure and can disrupt your heart rhythm. Using tobacco can cause inflammation in your blood vessels. Over time, this leads to a buildup of fatty deposits, called plaques, in the arteries of your heart. This can make it harder for your heart to pump blood.
More research is needed to understand why people with ADHD are more likely to misuse substances. Some research suggests that ADHD-related symptoms, like impulsivity, play a role. Impulsivity can make someone more likely to engage in risky behavior, like smoking. This can lead you to try — and eventually become dependent on — substances like tobacco.11 People with ADHD are also more likely to have difficulty quitting smoking.10
Excess weight
People with ADHD are more likely to be overweight or have obesity, especially if their ADHD isn’t being treated. Early research has found a few possible reasons, including:
Common co-occurring conditions, like depression, anxiety, and sleep problems, are associated with weight changes.
Symptoms like inattentiveness or forgetfulness can make it harder to stick to an exercise routine.
Inattentiveness can lead you to skip meals and then binge eat later.12
ADHD and binge eating disease — characterized by eating a lot of food in a short period of time — often occur together.13
Obesity is known to cause heart problems, like high blood pressure and heart disease.12 Treating your ADHD can make it easier to manage your weight.
Managing your heart health
It’s important to protect your heart health — whether you have ADHD or not. Thankfully, there are lots of things that can help with this. These include:
Getting regular checkups. Regular visits to your health care provider allow them to monitor any changes that could indicate cardiovascular issues, especially if you’re on ADHD medications that may affect your heart.
Eating well. Eating a nutrient-dense, balanced diet can help you keep your heart healthy. Focus on eating vegetables, fruits, lean protein, and whole grains.
Exercise regularly. Exercise has so many physical and mental health benefits. While getting any exercise is good, aim for 150 minutes (2.5 hours) of moderate-intensity exercise per week, such as brisk walking.14
Manage stress. ADHD can make stress management challenging. Practices like mindfulness and deep breathing can help protect your heart.15
Many of these habits can be especially challenging for people with ADHD. That’s OK! Taking small, consistent actions can make a big difference. Try these strategies to make it easier to stick with it:
Set an alarm to remind yourself to take a daily walk or prepare meals.
Find an exercise buddy to help you stay accountable.
Break goals into manageable steps that feel doable.
Ask your health care provider’s office if they can send email reminders to help you remember to make (and keep) appointments.
Questions to ask your health care provider
If you’re concerned about your heart health, it’s never too early or too late to talk to your health care provider. They can listen to your heart and run tests if you need them. Here are some questions to bring to your next appointment:
Should I worry about my ADHD medication affecting my heart?
Do I need to see a specialist or get additional tests because of my ADHD?
How does stress from ADHD symptoms affect my heart, and what can I do to manage it?
Remember, it may be hard for you to build new heart-healthy habits. Be patient with yourself. The key is to start small and figure out what works for you. Ask your health care provider to help you make these changes and recommend strategies.
Summary
If you have ADHD, you may be more likely to develop heart problems like high blood pressure or heart disease. This could be due to biological differences, lifestyle choices, your medication, or a combination of things.
ADHD medications — especially stimulants — can raise your blood pressure and heart rate. Other factors that can increase your risk of cardiovascular disease, like sleep problems, substance use, and excess weight, are also more common in people with ADHD.
It’s important to take care of your heart health. You can do this by eating well, exercising regularly, and managing stress. If you have concerns about your heart, discuss them with your health care provider. They can help monitor your heart and your medications if needed.
