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首页> 外文期刊>International Journal of Environmental Research and Public Health >The Effect of Methylphenidate and Atomoxetine on Heart Rate and Systolic Blood Pressure in Young People and Adults with Attention-Deficit Hyperactivity Disorder (ADHD): Systematic Review, Meta-Analysis, and Meta-Regression
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The Effect of Methylphenidate and Atomoxetine on Heart Rate and Systolic Blood Pressure in Young People and Adults with Attention-Deficit Hyperactivity Disorder (ADHD): Systematic Review, Meta-Analysis, and Meta-Regression

机译：哌醋甲酯和阿托莫西汀对注意缺陷多动障碍（ADHD）的年轻人和成年人的心率和收缩压的影响：系统评价，荟萃分析和荟萃回归

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Objectives : This meta-analysis aims to study the effects of atomoxetine and methylphenidate on heart rate (HR), systolic blood pressure (SBP), and a number of adverse cardiac events on patients receiving treatment for attention-deficit hyperactive disorder (ADHD) in comparison to placebo and between atomoxetine and methylphenidate. Methods : We searched the following databases: PubMed, EMBASE, and ScienceDirect. Meta-analysis was performed on studies that examined the relationships between methylphenidate or atomoxetine and HR, SBP, as well as a number of adverse cardiac events. These studies were either placebo-controlled or comparison studies between methylphenidate and atomoxetine. Meta-regression identified patient- and treatment-related factors that may contribute to heterogeneity. Results : Twenty-two studies were included and the total number of participants was 46,107. Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR ( p 0.001) and SBP ( p 0.001) than those treated by placebo. Children and adolescents treated with atomoxetine had more significant increases post- vs. pre-treatment HR ( p = 0.025) and SBP ( p 0.001) than those treated with methylphenidate. Meta-regression revealed mean age of participants, mean dose, and duration of atomoxetine and methylphenidate as significant moderators that explained heterogeneity. There were no differences in the number of adverse cardiac events between participants with methylphenidate treatment and placebo or atomoxetine. Conclusions : Children/adolescents and adults treated with methylphenidate resulted in significant increases in post- vs. pre-treatment HR and SBP as compared to placebo. Similarly, children and adolescents treated with atomoxetine had significant increases in post- vs. pre-treatment HR and SBP than those treated with methylphenidate. These findings have potential implications for continuous monitoring of HR and SBP throughout the course of treatment although the risk for adverse cardiac events were insignificant.
机译：目的：这项Meta分析旨在研究阿莫西汀和哌醋甲酯对心力衰竭（ADHD）患者的心率（HR），收缩压（SBP）和一系列不良心脏事件的影响。与安慰剂比较以及托莫西汀和哌醋甲酯之间的比较。方法：我们搜索了以下数据库：PubMed，EMBASE和ScienceDirect。荟萃分析是在研究哌醋甲酯或托莫西汀与HR，SBP以及许多不良心脏事件之间关系的研究上进行的。这些研究要么是安慰剂对照研究，要么是哌醋甲酯和托莫西汀之间的比较研究。元回归确定了可能与异质性有关的与患者和治疗相关的因素。结果：纳入二十二项研究，参与者总数为46,107。与安慰剂相比，哌醋甲酯治疗的儿童/青少年和成人的治疗后HR（p <0.001）和SBP（p <0.001）显着增加。与用哌醋甲酯治疗的儿童和青少年相比，使用阿托西汀治疗的儿童和青少年的HR（p = 0.025）和SBP（p <0.001）较治疗前显着增加。荟萃回归显示参与者的平均年龄，平均剂量以及托莫西汀和哌醋甲酯的持续时间是解释异质性的重要调节剂。哌醋甲酯治疗的参与者与安慰剂或阿莫西汀之间的不良心脏事件数量没有差异。结论：与安慰剂相比，哌醋甲酯治疗的儿童/青少年和成人导致治疗后HR和SBP显着增加。同样，接受阿托莫西汀治疗的儿童和青少年的HR和SBP较治疗前和未接受哌醋甲酯的儿童和青少年显着增加。这些发现对整个治疗过程中持续监测HR和SBP具有潜在的意义，尽管不良心脏事件的风险微不足道。

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