Dissertation
Attention deficit/hyperactivity disorder, health behaviors, and cardiovascular risk
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Spring 2020
DOI: 10.17077/etd.005415
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in children. While ADHD is onset in childhood, it usually persists into adulthood. Emerging evidence, although still sparse and inconsistent, suggests an association of ADHD with unhealthy behaviors and health conditions such as hypertension, hyperlipidemia, and diabetes in adults. The objective of this research was to characterize cardiovascular disease (CVD) risk and CVD-related health behaviors among adults with a history of ADHD.
First, we examined the association of a history of ADHD diagnosis with CVD among US adults using data from the National Health Interview Survey. After adjustment for demographic, socioeconomic and lifestyle factors, we found a significant association of ADHD with CVD and two major subtypes of CVD (coronary heart disease and stroke) in almost all age groups. Second, we examined the association of ADHD with established risk factors of CVD among adults using data from the National Longitudinal Study of Adolescent to Adult Health. After adjustment for demographic, socioeconomic and lifestyle factors, individuals with a history of ADHD diagnosis were more likely to be current cigarette smokers and have hyperlipidemia, compared with individuals without ADHD diagnosis. Third, we examined the association of ADHD with use of tobacco products and other substances among young adults. We found that participants with ADHD, compared with those without ADHD, were more likely to use conventional cigarettes, e-cigarettes and other tobacco products, alcohol, and drugs such as marijuana and cocaine.
In summary, our study indicates that ADHD is a novel risk factor associated with CVD and CVD-related health behaviors. If ADHD is confirmed as a novel risk factor for later CVD and related pre-CVD biological conditions, individuals with ADHD should be considered as a target population for cardiovascular health promotion programs.
Details
- Title: Subtitle
- Attention deficit/hyperactivity disorder, health behaviors, and cardiovascular risk
- Creators
- Guifeng Xu
- Contributors
- James Torner (Advisor)Linda G Snetselaar (Committee Member)Lane Strathearn (Committee Member)Kelli Ryckman (Committee Member)Faryle Nothwehr (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Epidemiology
- Date degree season
- Spring 2020
- DOI
- 10.17077/etd.005415
- Publisher
- University of Iowa
- Number of pages
- xiii, 112 pages
- Copyright
- Copyright 2020 Guifeng Xu
- Language
- English
- Description illustrations
- illustrations (some color)
- Description bibliographic
- Includes bibliographical references (pages 101-112).
- Public Abstract (ETD)
ADHD is a common mental disorder that currently affects about 1 in 10 children in the United States. It is usually diagnosed in children and adolescents, and the symptoms of ADHD usually continue into adulthood. Therefore, it is important to know whether having a diagnosis of ADHD can affect these individuals’ long-term health conditions. Cardiovascular disease (CVD) is the leading cause of death and disability in the United States and worldwide. While accumulating evidence indicates that individuals with ADHD are more likely to have CVD-related risk factors, no study has directly investigated the risk of CVD in adults with ADHD.
In this study, we found that risk of CVD in adults with ADHD was doubled compared with individuals without ADHD, after considering many CVD-related factors. In addition, we found that the risk of coronary heart disease and stroke, two major subtypes of CVD, in adults with ADHD increased by 88% and 75%, respectively.
The American Heart Association (AHA) has proposed seven CVD-related established risk factors (usually referred to as “Life's Simple 7”) that people can improve through lifestyle changes: smoking status, physical activity, weight, diet, blood glucose, blood lipids, and blood pressure. In this study, we found individuals with ADHD are more likely to be smokers and have lipid disorder, but we did not observe a significant association between ADHD and the other 5 factors. In addition, we found that ADHD was associated with increased likelihood of using e-cigarettes, other tobacco products, alcohol, and drugs among young adults.
In summary, our study indicates that ADHD is a novel risk factor for CVD. Future studies may consider individuals with ADHD diagnosis as a target population in cardiovascular health promotion programs.
- Academic Unit
- Epidemiology
- Record Identifier
- 9983956193202771
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