“ADHD stimulants are safe for your heart long term.”
ADHD stimulants are not clearly linked with serious heart events long term, though they raise blood pressure slightly and years of use are linked with more hypertension.
For most people, the heart risk of ADHD stimulants is small and is managed with routine blood pressure and pulse checks. It is not zero, so long-term use is worth reviewing with the prescriber from time to time.
Ask for a blood pressure and pulse check at your next medication visit, and ask how often it should be repeated.
Safety note: Stimulants raise blood pressure and pulse, so both should be checked before starting and regularly during treatment. People who already have heart disease or high blood pressure need a closer review before and during treatment.
Talk to a healthcare professional if: you have chest pain, fainting, or a racing or pounding heartbeat while taking an ADHD medicine, or you have heart disease or high blood pressure. Do not stop a prescribed medicine without a plan.
A review of 19 observational studies with more than 3.9 million people found no clear rise in serious heart events, and trials show only small rises in blood pressure and pulse; a long Swedish study found more high blood pressure with years of use. Confidence is limited because the long-term data are observational and do not fully agree, and the trials last only weeks.
ADHD stimulants are not clearly linked with serious heart events long term, though they raise blood pressure slightly and years of use are linked with more hypertension. In trials, adults' top blood pressure number rose by about 2 points and pulse by about 4 or more beats a minute. In a Swedish study of about 278,000 people with ADHD, more than 5 years of use was linked with 23% higher odds of heart and blood vessel disease, especially high blood pressure.
Long-term studies are observational, so they cannot fully separate the medicine from other differences between people who take it for years and those who do not. The review of 19 studies had a median follow-up of about 1.5 years and could not rule out a modest rise in risk, especially for heart rhythm problems; it found no clear link with heart attack or stroke. The blood pressure rise in trials was similar for stimulants and for the non-stimulant ADHD medicines atomoxetine and viloxazine.
- Zhang L, Yao H, Li L, Du Rietz E, Andell P, Garcia-Argibay M, D'Onofrio BM, Cortese S, Larsson H, Chang Z. Risk of Cardiovascular Diseases Associated With Medications Used in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis. JAMA Network Open. 2022;5(11):e2243597. DOI: 10.1001/jamanetworkopen.2022.43597. PMID: 36416824. PMCID: PMC9685490
- Zhang L, Li L, Andell P, Garcia-Argibay M, Quinn PD, D'Onofrio BM, Brikell I, Kuja-Halkola R, Lichtenstein P, Johnell K, Larsson H, Chang Z. Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases. JAMA Psychiatry. 2024;81(2):178-187. DOI: 10.1001/jamapsychiatry.2023.4294. PMID: 37991787. PMCID: PMC10851097
- Farhat LC, Lannes A, Del Giovane C, et al. Comparative cardiovascular safety of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2025;12(5):355-365. DOI: 10.1016/S2215-0366(25)00062-8. PMID: 40203844