Endorsed by the American Academy of Child and Adolescent Psychiatry, the American College of Cardiology, Children and Adults with Attention-Deficit/Hyperactivity Disorder and the National Initiative for Children's Healthcare Quality
DALLAS, May 16 /PRNewswire-USNewswire/ -- The American Heart
Association released on April 21, 2008 a statement about cardiovascular
evaluation and monitoring of children receiving drugs for the treatment of
Attention Deficit Hyperactivity Disorder (ADHD). As a result of language in
the news release and the statement as published, there have been
conflicting interpretations of the recommendations regarding the use of an
electrocardiogram (ECG) in assessing children with ADHD who may need
treatment with medications. The purpose of this joint advisory of the
American Academy of Pediatrics (AAP) and the American Heart Association
(AHA) is to clarify the recommendations.
-- The scientific statement included a review of data that show children
with heart conditions have a higher incidence of ADHD.
-- Because certain heart conditions in children may be difficult (even, in
some cases, impossible) to detect, the AAP and AHA feel that it is
prudent to carefully assess children for heart conditions who need to
receive treatment with drugs for ADHD.
-- Obtaining a patient and family health history and doing a physical exam
focused on cardiovascular disease risk factors (Class I recommendations
in the statement) are recommended by the AAP and AHA for assessing
patients before treatment with drugs for ADHD.
-- Acquiring an ECG is a Class IIa recommendation. This means that it is
reasonable for a physician to consider obtaining an ECG as part of the
evaluation of children being considered for stimulant drug therapy, but
this should be at the physician's judgment, and it is not mandatory
to obtain one.
-- Treatment of a patient with ADHD should not be withheld because an ECG
is not done. The child's physician is the best person to make the
assessment about whether there is a need for an ECG.
-- Medications that treat ADHD have not been shown to cause heart
conditions nor have they been demonstrated to cause sudden cardiac
death. However, some of these medications can increase or decrease
heart rate and blood pressure. While these side effects are not usually
considered dangerous, they should be monitored in children with heart
conditions as the physician feels necessary.
An erratum to the statement has been developed to clarify the language and to assure that the intent is clear to all readers. This is available at:
This clarification has been endorsed by the American Academy of Child and Adolescent Psychiatry, the American College of Cardiology, Children and Adults with Attention-Deficit/Hyperactivity Disorder and the National Initiative for Children's Healthcare Quality.
|SOURCE American Heart Association|
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