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4.4 million children and adolescents in the United States have been diagnosed with attention deficit hyperactivity disorder (ADHD) and more than half are treated with medication. Most ADHD medications are stimulants, which activate the sympathetic nervous system (SNS). SNS activation is closely associated with vascular functional and mechanical abnormalities. Therefore, ADHD medications, via instigating SNS activation and altering the hemodynamic profile, may have untoward effects on the vasculature and increase risk of developing cardiovascular disease in children and adolescents who use them. Our overall objective in this study is to determine whether ADHD medication use is associated SNS activation, endothelial dysfunction, and arterial stiffness in children and adolescents. We will address this objective by conducting a prospective, repeated measures, observational study and obtaining non-invasive measures of SNS activation, endothelial function, and arterial stiffness at baseline (prior to initiation of ADHD stimulant drug therapy) and at 6- and 12-months after initiation of therapy in 62 children and adolescents (8-17 years old) recruited from the University of Minnesota Pediatric Neurodevelopment Clinic.
SPECIFIC AIMS AND HYPOTHESES
Our overall objective in this study is to determine whether ADHD medication use is associated SNS activation, endothelial dysfunction, and arterial stiffness in children and adolescents.
Our hypotheses are:
1. Children and adolescents who initiate ADHD stimulant drug therapy will have increased SNS activation, as measured by heart rate variability, 6-months after initiating therapy. SNS activation will increase further at the 12-month time point.
2. Children and adolescents who initiate ADHD stimulant drug therapy will have decreased digital reactive hyperemia and increased pulse wave velocity and aortic augmentation index 6-months after initiating therapy. These changes in levels will be even more pronounced at the 12-month time point.
3. At the 6- and 12-month time points, the degree of SNS activation will be negatively correlated with digital reactive hyperemia and positively correlated with pulse wave velocity and aortic augmentation index in children and adolescents taking ADHD medication.
Study Design In this prospective, repeated measures, observational study we will obtain non-invasive measures of SNS activation (heart rate variability), endothelial function (digital reactive hyperemia), and arterial stiffness (carotid-radial pulse wave velocity; aortic augmentation index), at baseline (prior to initiation of ADHD stimulant drug therapy) and at 6- (± 7 days) and 12-months (± 7 days) after initiation of therapy.
Study visits will be conducted at the Clinical and Translational Science Institute (CTSI) at the University of Minnesota. All vascular testing will occur in the Vascular Biology Laboratory within the CTSI.
Observational Model: Case-Only, Time Perspective: Prospective
University of Minnesota
University of Minnesota - Clinical and Translational Science Institute
Published on BioPortfolio: 2014-08-27T03:14:27-0400
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