Attention Deficit Hyperactivity Disorder, combined type (ADHD-CT): differences in blood pressure (BP) due to posture and the child report of anxiety

Abstract

Aim ADHD-CT and anxiety has been associated with increased diastolic BP in controlled trials of single dosage studies of methylphenidate, although parent and child reports of anxiety have not been considered separately. Therefore, we tested the hypothesis that primary school-age children with ADHD-CT and anxiety have increased diastolic BP from a sitting to a standing position compared to children with ADHD-CT without anxiety, whether defined from a parent or child perspective. Method Thirty-eight medication naive children with ADHD-CT were studied. Four groups were formed from parent and child reports of anxiety, using categorical and continuous measures of anxiety. The groups were compared using one-way ANOVA. Where omnibus F was significant, the post hoc SNK procedure (p < 0.05) was used to determine the source of this significance. Results Primary school-age children with ADHD-CT and anxiety, defined from the child's report alone, had significantly increased diastolic BP from a sitting to a standing position than children with ADHD-CT without anxiety. Conclusions The recognition of anxiety and its management in primary school-age children with ADHD-CT is generally poorly understood. In this particular group of children, only the child's report of anxiety was associated with significantly increased diastolic BP from a sitting to a standing position. Therefore, careful and thorough assessment of the child's perspective is required. The characteristics of this anxiety and its association with postural BP require further careful longitudinal study. Biological implications are noted.