Find a therapist to help with ADHD

ADHD is associated with higher risk of serious conditions such as heart disease and diabetes.

Primary care, if adequately funded, is well-positioned to play a greater role in ADHD care.

Treating ADHD early while addressing its physical health risks is crucial.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterised by impairments in attention as well as hyperactivity and impulsiveness that onsets early in development. Generally, ADHD is viewed as a condition that needs to be managed by specialist mental health services. Typically, the focus of most research and clinical interventions is on ADHD and any comorbid mental health or neurodevelopmental conditions.

Physical health risks associated with ADHD

What is often not fully appreciated is that ADHD is also associated with many physical health conditions and risks1. These include cardiovascular disease, diabetes (and other metabolic diseases), cancers (notably lung cancer), and neurological and allergic conditions, among others. ADHD is associated, for example, with many well-known cardiovascular risks that are modifiable.2,3 These include obesity, cigarette smoking, and high blood pressure. If these risks are not addressed or treated, they can lead to ischemic heart disease (heart attacks), stroke, and premature death.

Many of the health risks that accompany ADHD are modifiable. Yet for most health care systems, physical and mental health services are entirely separated. How often does an individual with ADHD have their physical health carefully monitored and managed? Are modifiable physical health risks dealt with early on? Are those with ADHD or a mental health condition who also have severe obesity considered as priority candidates for new anti-obesity medication? An important barrier to integrating physical health care with ADHD management is that clinicians who assess and treat ADHD may not be equipped to assess and treat physical ill-health and risks.

Premature mortality is now a recognised risk associated with ADHD. These findings are deeply concerning. Although some of these early deaths are due to suicide and accidents, among older individuals, premature death is explained by physical ill-health. Several large studies from across the world have highlighted an association between ADHD and premature mortality.4,5 For example, a recent UK study based on primary care records observed that people with ADHD have a shortened life expectancy of seven to nine years.6

Improving ADHD care through integrated services

I believe we can address these inequities. First, primary care is the one service that not only provides long-term healthcare, but also has skills in physical and mental health. So, if primary care staff are adequately supported, trained, and funded, they are well-positioned to take on a broader long-term role in ADHD care that encompasses physical health. For more complex ADHD, the primary care role will need to be integrated with specialist care. This approach could lead to more person-centric, joined-up service provision that tackles physical health as well as ADHD and mental health. An increased role for primary care was highlighted as a recommendation in the recent NHS England independent ADHD Taskforce, and many countries (e.g., Australia) are training up primary care physicians to take on many aspects of ADHD health care.

Second, the management of physical health and reduction of known and modifiable physical health risk factors (e.g., high blood pressure) needs to be a recognised priority for those with ADHD.

Third, there is evidence from several quasi-experimental and one trial emulation study7 that ADHD medication treatment reduces some health risks (e.g., substance misuse) and mortality. Thus, a central priority is that ADHD is adequately treated. Just as diabetes is carefully managed to avoid adverse outcomes, similar standards need to apply to ADHD.

For service and historical reasons, physical health across mental health and neurodevelopmental conditions, including ADHD, has been neglected. Many of the current inequities in terms of ADHD, physical ill-health, and premature mortality are amenable to change.

Find a therapist to help with ADHD

1. Kang J, Lee H, Kim S, et al. Comorbid health conditions in people with attention-deficit/hyperactivity disorders: An umbrella review of systematic reviews and meta-analyses. Asian J Psychiatr. 2024;99. doi:10.1016/j.ajp.2024.1041352. Thapar AK, Riglin L, Blakey R, et al. Childhood attention-deficit hyperactivity disorder problems and mid-life cardiovascular risk: prospective population cohort study. Br J Psychiatry. 2023;223(4):472-477. doi:10.1192/bjp.2023.903. Stott J, O’nions E, Corrigan L, et al. Attention-Deficit/Hyperactivity Disorder Traits in Childhood and Physical Health in Midlife. JAMA Netw Open. 2026;9(1):e2554802-e2554802. doi:10.1001/jamanetworkopen.2025.548024. Dalsgaard S, Ostergaard SD, Leckman JF, Mortensen PB, Pedersen MG. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: A nationwide cohort study. The Lancet. 2015;385(9983):2190-2196. doi:10.1016/S0140-6736(14)61684-65. Chen VCH, Chan HL, Wu SI, et al. Attention-Deficit/Hyperactivity Disorder and Mortality Risk in Taiwan. JAMA Netw Open. 2019;2(8). doi:10.1001/jamanetworkopen.2019.87146. O’Nions E, El Baou C, John A, et al. Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: Matched cohort study. British Journal of Psychiatry. 2025;226(5):261-268. doi:10.1192/bjp.2024.1997. Li L, Zhu N, Zhang L, et al. ADHD Pharmacotherapy and Mortality in Individuals With ADHD. JAMA. 2024;331(10):850-860. doi:10.1001/jama.2024.0851

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