• James R Latronica, Taylor J Clegg, Wen-Jan Tuan, and Curtis Bone.
• From the University of Pittsburgh School of Medicine, Department of Psychiatry; Department of Family Medicine, Pittsburgh, PA (JRL); Penn State Health Milton S. Hershey Medical Center, Hershey, PA, (TJC, WJT); Penn State Health Milton S. Hershey Medical Center, Department of Family and Community Medicine, Hershey, PA (CB). latronicajr3@upmc.edu.
• J Am Board Fam Med. 2021 Nov 1; 34 (6): 1074-1081.

BackgroundPrescription amphetamines are the most common pharmacological treatment for attention deficit hyperactivity disorder (ADHD) and use among older age groups is increasing. The purpose of this study is to assess the risk of adverse cardiovascular events among individuals older than 65 years.MethodsWe conducted a retrospective matched cohort study using TriNetX database with propensity score matching (PSM) to assess the odds of a cardiovascular event among individuals with ADHD exposed to amphetamine compared with individuals with ADHD who were not exposed to this medication. During the index period of January 1, 2018, through December 31, 2020, 13,233 individuals older than 65 years (mean age = 69 years) met the study criteria.ResultsThe cohort exposed to amphetamine had increased blood pressure and increased odds of cardiovascular events (odds ratio [OR], 6.16; absolute risk difference = 3.31%) compared with the control group.ConclusionsAmphetamines have clear safety data in younger age cohorts; however, this safety data may not generalize to older populations. Additional research is warranted to clarify further exposure and subpopulation-level risk factors associated with adverse cardiovascular events among older patients.© Copyright 2021 by the American Board of Family Medicine.

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