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Risk of Methylphenidate-Induced Prehypertension in Normotensive Adult Smokers With Attention Deficit Hyperactivity Disorder

  1. Arthur N. Westover MD, MSCS1,2,
  2. Paul A. Nakonezny PhD1,2,
  3. Theresa Winhusen PhD3,
  4. Bryon Adinoff MD1,4,
  5. Wanpen Vongpatanasin MD4

Article first published online: 14 DEC 2012

DOI: 10.1111/jch.12039

Issue

The Journal of Clinical Hypertension

The Journal of Clinical Hypertension

Volume 15, Issue 2, pages 124–132, February 2013

Additional Information

How to Cite

Westover, A. N., Nakonezny, P. A., Winhusen, T., Adinoff, B. and Vongpatanasin, W. (2013), Risk of Methylphenidate-Induced Prehypertension in Normotensive Adult Smokers With Attention Deficit Hyperactivity Disorder. The Journal of Clinical Hypertension, 15: 124–132. doi: 10.1111/jch.12039

Author Information

  1. 1

    From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX;

  2. 2

    Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX;

  3. 3

    Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH;

  4. 4

    VA North Texas Health Care System, Dallas VAMC, Dallas, TX;

*Arthur Westover, MD, MSCS, Departments of Psychiatry and Clinical Sciences, UT Southwestern Medical Center, 5323 Harry Hines Bouldevard, Dallas, TX 75390-8828 E-mail:arthur.westover@utsouthwestern.edu

Publication History

  1. Issue published online: 22 JAN 2013
  2. Article first published online: 14 DEC 2012
  3. Manuscript received: July 6, 2012; revised: September 14, 2012; accepted: September 20, 2012

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The authors studied predictors of methylphenidate-induced increases in blood pressure (BP). In this secondary analysis of a randomized, double-blind, placebo-controlled smoking cessation trial, nonhypertensive adult smokers with attention deficit hyperactivity disorder randomized to osmotic-release oral system methylphenidate (OROS-MPH) (n=115) were matched one-to-one on baseline systolic BP (SBP) (±5 mm Hg) with participants randomized to placebo (n=115) and followed for 10 weeks. In adjusted mixed linear models of SBP and diastolic BP (DBP), baseline normal SBP (P<.0001) and DBP (P<.0001) were associated with significant OROS-MPH–induced increases compared with placebo, whereas significant increases were not observed in participants with baseline prehypertensive SBP (P=.27) and DBP (P=.79). Participants randomized to OROS-MPH with baseline normal BP had increased odds of developing either systolic (odds ratio [OR], 3.32; 95% confidence interval [CI], 1.41–8.37; P=.006) or diastolic prehypertension (OR, 4.32; 95% CI, 1.56–14.0; P=.004) compared with placebo using simple logistic regression. The authors demonstrated an augmented OROS-MPH–induced BP elevation and risk of prehypertension in adults with baseline normal BP. Significantly increased BP was not observed in adults with baseline prehypertension. J Clin Hypertens (Greenwich). 2012; 00:00–00. ©2012 Wiley Periodicals, Inc.

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