ADHD as a predictor for Coronary Microvascular Dysfunction in women with angina
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Background There is increasing knowledge regarding differences in cardiovascular health between men and women. In Europe and the Unites States in women with angina, two thirds do not have obstructive coronary artery disease. Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in women and tends to persist during adulthood. This study hypothesized that through the activated state of the nervous system in ADHD patients, this could lead to endothelial dysfunction causing women with ADHD to be prone to develop coronary microvascular dysfunction (CMD). Methods In total 635 female patients aged 18 years and older met inclusion criteria. A total of 625 female patients filled out the ultra-short questionnaire for ADHD completely. Patients with stable angina were categorized into functional (CMD), obstructive coronary arteries or a combination of both. A logistical analysis was preformed to determine whether ADHD was a predictor for CMD in female patients with angina. Results CMD was diagnosed in 136 of the 625 included patients. ADHD was diagnosed in 40 (29.4%) patients with CMD and 181 (37%) in the control group. At baseline ADHD did not significantly differ between the two groups (p=0.101). In logistical analysis, ADHD was not a significant predictor for CMD both as an individual predictor (p=0.247) and after entering with cardiovascular risk factors (p=0.416). Conclusion ADHD was observed not to be a significant predictor of CMD despite the high prevalence of ADHD (29.4%) compared to the general population. This higher prevalence highlights the importance of screening for ADHD in female patients with angina to optimize care and treatment.