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Attention deficit-hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS).
Eur Child Adolesc Psychiatry 2017; 26(2):165-175EC

Abstract

Alterations in blood pressure in attention-deficit/hyperactivity disorder (ADHD), specifically during dopaminergic stimulant intake, are not fully understood. It has been reported that vitamin D deficiency might modify dopaminergic pathways and thus influence ADHD symptoms. Using data from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, we compared blood pressure and vitamin D levels in healthy controls to both diagnosed ADHD patients and suspected ADHD subjects, as defined by a value of ≥7 on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire. In a total cohort of n = 6922 study participants aged 11-17 years, mean arterial blood pressure was significantly higher in controls (86.7 ± 8.2 mmHg) than in the two groups of confirmed (85.5 ± 7.8 mmHg, p = 0.004, n = 430) and suspected ADHD patients (84.6 ± 8.2, p < 0.001, n = 399). In addition, we found an inverse association between vitamin D and blood pressure in both ADHD groups (p < 0.003). Regression analyses adjusted for age, sex, body-mass index, psychotropic medication use, and serum vitamin D levels confirmed that low blood pressure was a significant and independent predictor of ADHD. Furthermore, we observed that vitamin D mediated the effect of systolic blood pressure on ADHD diagnosis (b = 0.007, 95 % confidence interval [CI] 0.001-0.013, p = 0.021, R 2 = 0.050). In a large and representative national sample of German adolescents, we found a significant association between low blood pressure and ADHD symptoms. In addition, we observed that circulating vitamin D mediated the inverse relation between blood pressure and ADHD, although the effect size was very low. These findings highlight the role of dysregulated pathways of the autonomic nervous system in ADHD.

Authors+Show Affiliations

Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany. thomas.meyer@med.uni-goettingen.de. Department of Psychosomatic Medicine and Psychotherapy, and German Centre for Cardiovascular Research, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany. thomas.meyer@med.uni-goettingen.de.Department of Child and Adolescent Psychiatry and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.Department of Child and Adolescent Psychiatry and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany. Department of Psychosomatic Medicine and Psychotherapy, and German Centre for Cardiovascular Research, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27197525

Citation

Meyer, Thomas, et al. "Attention Deficit-hyperactivity Disorder Is Associated With Reduced Blood Pressure and Serum Vitamin D Levels: Results From the Nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS)." European Child & Adolescent Psychiatry, vol. 26, no. 2, 2017, pp. 165-175.
Meyer T, Becker A, Sundermann J, et al. Attention deficit-hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Eur Child Adolesc Psychiatry. 2017;26(2):165-175.
Meyer, T., Becker, A., Sundermann, J., Rothenberger, A., & Herrmann-Lingen, C. (2017). Attention deficit-hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). European Child & Adolescent Psychiatry, 26(2), pp. 165-175. doi:10.1007/s00787-016-0852-3.
Meyer T, et al. Attention Deficit-hyperactivity Disorder Is Associated With Reduced Blood Pressure and Serum Vitamin D Levels: Results From the Nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Eur Child Adolesc Psychiatry. 2017;26(2):165-175. PubMed PMID: 27197525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attention deficit-hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). AU - Meyer,Thomas, AU - Becker,Andreas, AU - Sundermann,Jessika, AU - Rothenberger,Aribert, AU - Herrmann-Lingen,Christoph, Y1 - 2016/05/19/ PY - 2015/10/21/received PY - 2016/04/15/accepted PY - 2016/5/21/pubmed PY - 2017/3/8/medline PY - 2016/5/21/entrez KW - Attention-deficit hyperactivity disorder KW - Blood pressure KW - Vitamin D SP - 165 EP - 175 JF - European child & adolescent psychiatry JO - Eur Child Adolesc Psychiatry VL - 26 IS - 2 N2 - Alterations in blood pressure in attention-deficit/hyperactivity disorder (ADHD), specifically during dopaminergic stimulant intake, are not fully understood. It has been reported that vitamin D deficiency might modify dopaminergic pathways and thus influence ADHD symptoms. Using data from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, we compared blood pressure and vitamin D levels in healthy controls to both diagnosed ADHD patients and suspected ADHD subjects, as defined by a value of ≥7 on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire. In a total cohort of n = 6922 study participants aged 11-17 years, mean arterial blood pressure was significantly higher in controls (86.7 ± 8.2 mmHg) than in the two groups of confirmed (85.5 ± 7.8 mmHg, p = 0.004, n = 430) and suspected ADHD patients (84.6 ± 8.2, p < 0.001, n = 399). In addition, we found an inverse association between vitamin D and blood pressure in both ADHD groups (p < 0.003). Regression analyses adjusted for age, sex, body-mass index, psychotropic medication use, and serum vitamin D levels confirmed that low blood pressure was a significant and independent predictor of ADHD. Furthermore, we observed that vitamin D mediated the effect of systolic blood pressure on ADHD diagnosis (b = 0.007, 95 % confidence interval [CI] 0.001-0.013, p = 0.021, R 2 = 0.050). In a large and representative national sample of German adolescents, we found a significant association between low blood pressure and ADHD symptoms. In addition, we observed that circulating vitamin D mediated the inverse relation between blood pressure and ADHD, although the effect size was very low. These findings highlight the role of dysregulated pathways of the autonomic nervous system in ADHD. SN - 1435-165X UR - https://www.unboundmedicine.com/medline/citation/27197525/Attention_deficit_hyperactivity_disorder_is_associated_with_reduced_blood_pressure_and_serum_vitamin_D_levels:_results_from_the_nationwide_German_Health_Interview_and_Examination_Survey_for_Children_and_Adolescents__KiGGS__ L2 - https://dx.doi.org/10.1007/s00787-016-0852-3 DB - PRIME DP - Unbound Medicine ER -