If you’re an adult with ADHD, there’s a good chance you’re also keeping an eye on your cholesterol, blood pressure and overall heart health. You may wonder if your ADHD medications could raise your blood pressure, interfere with your cholesterol medication or be safe to take if you have heart disease.
Megan Chan, a pharmacist with Banner Health, explained more about how you can manage ADHD while protecting your heart health.
Do ADHD medications raise blood pressure or heart rate?
Some ADHD medications, especially stimulant medications such as amphetamine-based (Adderall, Vyvanse) or methylphenidate-based (Ritalin, Concerta) treatments, may cause small increases in heart rate and blood pressure.
For most healthy adults, these increases are mild. “They are usually about five beats per minute for heart rate and two to five mmHg in blood pressure,” Dr. Chan said. Some people have bigger changes, especially if they are on higher doses of ADHD medications.
It’s important to pay attention to these increases, especially if you already have:
- High blood pressure
- High cholesterol
- Heart disease
- A family history of heart rhythm problems
Providers typically check blood pressure and heart rate before starting medication and monitor them over time. A mild increase does not automatically mean you need to stop treatment. It simply means your provider may monitor you more closely or adjust your plan.
Are ADHD medications safe if you have heart disease?
Having heart disease does not automatically mean you cannot take ADHD medication. But it does mean your provider will evaluate your situation carefully.
Before prescribing ADHD medication, your provider may:
- Review your personal and family heart health, including heart attacks, valve disease and arrhythmias (irregular heartbeat)
- Ask about chest pain, fainting or palpitations
- Check your blood pressure
- Consider whether you should see a cardiologist
“Your provider will want to be cautious if you have uncontrolled high blood pressure or significant heart disease, because even a small increase in blood pressure or heart rate could make an impact,” Dr. Chan said.
In some cases, your provider may recommend more testing. In others, careful monitoring is enough. The goal is to balance treating your ADHD symptoms and protecting your heart health.
Where Strattera (atomoxetine) fits in
Strattera is a nonstimulant ADHD medication. It works differently from stimulant medications, and you and your provider may want to consider it, based on your heart risk factors.
“It’s typically a second option for ADHD treatment, after stimulant medications,” Dr. Chan said. People who can’t tolerate stimulant medications or who have heart health concerns may want to try it.
However, “nonstimulant” does not mean “no impact.” “Straterra is not without its cardiovascular risks. It has also shown increases in blood pressure and heart rate,” Dr. Chan said. If you take Strattera, it’s still important to monitor your heart health.
The right medication choice depends on:
- Your ADHD symptoms
- Your medical history
- How well your blood pressure is controlled
- Your overall cardiovascular risk
Can you take ADHD medication with cholesterol or blood pressure medication?
“ADHD medications are generally safe to take with cholesterol and blood pressure medications,” Dr. Chan said. People often take statins to treat high cholesterol along with ADHD medications. There is no automatic reason they cannot be used together.
Adults who take medication for ADHD also often take blood pressure medications. Your provider will monitor your blood pressure and heart rhythm and consider:
- Possible interactions
- Monitoring your liver health, in some cases
- How your medications are affecting your body overall
Don’t stop or adjust medications on your own. If you have side effects or concerns, talk with your provider before you make any changes.
How ADHD symptoms can affect heart health indirectly
There’s another layer to consider: ADHD itself can influence heart health behaviors. “The indirect implications of ADHD symptoms on cardiac health is an important, often overlooked topic,” Dr. Chan said.
Adults with ADHD may struggle with:
- Maintaining routines
- Remembering to take blood pressure or cholesterol medications
- Keeping doctors’ appointments
- Impulse eating
- Managing stress
- Following through on exercise plans
These factors can indirectly affect cholesterol, blood pressure and weight.
Treating ADHD can make it easier to manage long-term health conditions by making it easier for you to stick with healthy habits.
How providers monitor heart health while you’re on ADHD medication
Monitoring is part of safe treatment. “Before starting treatment, providers will measure your baseline blood pressure and heart rate, review your cardiac history and ask about any cardiac symptoms,” Dr. Chan said.
They may order electrocardiograms or consult cardiologists to make sure it’s safe for you to take ADHD medications.
Routine follow-up helps catch small changes early. Going forward, your provider may:
- Check your blood pressure and heart rate at visits
- Ask about any new symptoms
- Review your medications
- Order labs tests when needed
When to call your provider
Contact your provider if you have:
- Chest pain
- Shortness of breath
- Fainting
- A rapid or irregular heartbeat
- Increase in blood pressure
- New or worsening heart symptoms
Frequently asked questions
Do ADHD medications cause heart attacks?
For most adults who don’t have heart disease, the risk of serious cardiac events is low. If you have heart disease, you should be evaluated carefully before you start ADHD medication.
Is it safe to take Adderall with high cholesterol?
High cholesterol alone does not prevent you from taking stimulant medications like Adderall. Your provider will review your overall cardiovascular risk and monitor your health.
What is the safest ADHD medication for someone with heart concerns?
There is no single “safest” medication for everyone. Nonstimulant medications like Strattera (atomoxetine), and the blood pressure medications Catapres or Kapvay (clonidine), which also treat ADHD, may be options in certain cases.
Should adults get heart testing before starting ADHD medication?
Most adults will have their blood pressure and heart rate checked. Your provider may recommend other testing if you have a history of heart disease or concerning symptoms.
A whole-person approach to brain and heart health
With screening, monitoring and communication, many adults safely manage both ADHD and heart health. Talk with your provider about your medical history, medications and concerns.
Treating ADHD can improve your focus, organization and daily functioning. By protecting your heart health, you can benefit from safe ADHD treatment in the long term.
If you have questions about your ADHD medication and heart health, schedule a visit with a Banner Health primary care provider or specialist to help put together a personalized plan.
