When we think about ADHD, we tend to think of distraction, restlessness, short productivity and missed deadlines. It’s a condition of the brain, so we assume its impact lies squarely in cognition, behaviour and emotion.
To an extent that’s true, but emerging research suggests that ADHD may also help to shape something more physical: our cholesterol levels, blood pressure and long-term heart health.
Studies show that people with ADHD are more likely to have unfavourable cholesterol levels, alongside higher rates of obesity, diabetes and cardiovascular disease.
A landmark paper published in 2022 found ADHD is an independent risk factor for a wide range of cardiovascular diseases.
The research, based on population data from more than 5 million people in Sweden, found that people with ADHD are twice as likely as others to develop metabolic issues. Cardiac arrest, haemorrhagic stroke and arteriosclerosis are the most likely.
Researchers partly explained this by showing that other risk factors, like smoking, obesity, diabetes and lower educational attainment are all more common in people with ADHD. But even after controlling for these factors, cardiovascular disease was still more prevalent in the ADHD population.
The findings track with other data from University College London, published this year. There, researchers found people with high ADHD traits in childhood are more likely to have health impacts in middle-age and later life.
“What we've tended to find is that people with ADHD unfortunately die younger and have more physical health problems when they're older,” says Prof Joshua Stott, author of the UCL paper. “We found that having a diagnosis of ADHD was associated with about seven years’ reduced life expectancy.
“I think what's less clear is the reason for that. A working hypothesis is that people with ADHD are exposed to environments that are likely to increase cardiovascular risk.”
The growing body of evidence suggests there are certainly behavioural disadvantages associated with ADHD and long-term health.
But there could also be profound genetic links between the condition and cardiovascular risk. Scientists are now asking how biology and behaviour may influence both ADHD and the complicated ways our bodies regulate fat and energy.
The brain-heart connection
At first glance, the relationship between ADHD and heart health might seem like a simple story.
People with the condition can often be poor meal planners who eat impulsively. Many follow irregular routines and struggle with poor sleep. They’re more likely to smoke. They’re more likely to binge eat.
Those factors combined are a recipe for high cholesterol, weight gain and other metabolic issues.
According to Prof Stephen Faraone, an ADHD researcher from the Upstate Medical University in Syracuse, New York, people with ADHD struggle with ‘executive functions’ – the cognitive processes that help set and carry out goals.
“We need all those brain functions to plan and to organise our life,” he says.
“When parents are handling food for children with ADHD, that’s one thing,” he says.
“But when you’re an adult and you’re handling your own diet, it can be a big problem. If you don’t plan your meals, you’re going to eat out and often that’s not a good meal because you’re not planning it.”
The link between ADHD and metabolic markers like cholesterol is not straightforward, however. It’s not simply the case that the traits of ADHD lead to an unhealthy lifestyle. Genetics, neuroscience, medication and early development all play a role.
“There are a lot of pieces to this puzzle,” Faraone says.
The cholesterol question
A number of studies have shown that high cholesterol is more common amongst people with ADHD. In China, for example, researchers found that obese children with high LDL cholesterol (the bad kind) were more likely to have ADHD. In Turkey, researchers found similar findings in non-obese children too.
This would help to explain the long-term cardiovascular outcomes in people with ADHD because high levels of LDL cholesterol or an imbalance between LDL and HDL (the good kind) are both associated with heart risks. High levels of LDL help cause the build-up of plaques in our arteries while low HDL levels reduce the removal of those same plaques.
Other research pokes holes in this theory, however. Studies in both children and adolescents with ADHD have found that they actually have lower LDL cholesterol than control groups.
“What's additionally interesting is that some of the drugs, particularly the stimulant drugs, that treat ADHD, also can lower cholesterol levels,” Faraone says. Could it be possible that cholesterol is higher in untreated ADHD than treated ADHD?
Right now, we don’t have that data but there are other interesting clues.
Another theory on the link between cholesterol and ADHD comes from research suggesting a generational effect.
Studies have shown that a mother’s cholesterol levels during pregnancy might affect the neurodevelopment of her children. Specifically, researchers found that low levels of HDL correlate with an increased risk of ADHD in the offspring.
But this too is a complicated picture, says Faraone. “We have a big problem in the field with studies of these environmental exposures,” he says.
“For example, I thought for years that maternal smoking increased the risk for ADHD – that it might have a causal effect. The association is real. It’s been documented in meta-analyses many times.
“But it turns out that if you control for ADHD genetics, the association goes away. And the reason is, mothers with ADHD are more likely to smoke.”
What the researchers once thought was a consequence of smoking was, in reality, just a genetic trait being handed down from mother to child.
It’s possible that the same thing is going on with maternal cholesterol. Again, we’re lacking the data, but it’s certainly true that the genetics of ADHD and metabolic disease share some common ground.
Overlapping genetics
ADHD itself is thought to be as much as 80 per cent hereditary. Given that genetics account for so much of an individual’s likelihood of having these traits, it makes sense that those genetics may also influence the risk of heart disease.
In 2024, the same team of Swedish researchers who identified ADHD as an independent risk factor for cardiovascular disease went looking for genetic clues that might explain the link.
They found a lot of them.
Rather than a single gene that causes ADHD and also puts people at risk of metabolic issues, what they found was a tangle of overlapping gene variants affecting health outcomes like obesity and diabetes.
Other research has also found evidence, albeit slightly weaker, linking the genetics of ADHD with other markers, including cholesterol and body mass index.
The researchers concluded that people genetically predisposed to ADHD had a small but significant increase in their risk of heart health problems in adulthood.
This genetic detective work is about more than filling in the gaps in our textbooks, though. It goes some way to explain not just the biology linking ADHD and metabolic issues but also the behaviour.
For example, both ADHD and obesity are associated with the neurotransmitter dopamine, which controls reward and motivation in the brain. People with ADHD have dopamine-deficient brains, and so seek out stimulating activities that will release more. Overeating is one such activity.
Read more:
- What to eat if you have ADHD, according to experts
- Here's what actually causes high cholesterol (and how to cut it)
- The anti-ageing diet: 6 science-backed changes to protect your skin, body and brain from getting older
Tension rises
High blood pressure is another example of a cardiovascular risk factor often found alongside ADHD. Faraone’s research has shown that people with ADHD are almost twice as likely to have hypertension as the general population.
The association is present even in children with ADHD, so again there is likely a genetic component.
But as with other risk factors for heart disease, there are also behaviours and environmental components that exacerbate the connection. People with ADHD are more likely to smoke and suffer chronic stress, both of which can increase the chances of high blood pressure.
There have also been well-publicised studies suggesting that some of the medications people take for ADHD, like stimulants, can raise blood pressure, especially when used over long periods of time. But the largest study to date, conducted by researchers at the University of Southampton, found only a small effect. The team concluded that the benefits outweigh the risks.
“There is an ADHD drug effect [with blood pressure],” Faraone says. “It's been reviewed over and over again by the FDA, the EMA [health regulators in the US and Europe]. Both have concluded that there's no increased risk for cardiac problems due to the medications.”
One of the recommendations for people who take stimulants regularly is that they monitor their blood pressure.
This speaks to broader advice. Anyone with an increased risk of heart trouble would do well to track important markers such as blood pressure, cholesterol and heart rate variability.
Given how many of those markers seem to be elevated in people with ADHD, one of the most proactive things you can do is to keep visiting your GP or monitoring signs yourself. “I think it's particularly important for people with ADHD because of the cardiometabolic risk,” Faraone says.
The good news is that many of these risk factors can be managed and counteracted with certain lifestyle changes. In other words, people have the power to lower their own risks, even when there’s a genetic predisposition.
Here are some of the most powerful ways to manage heart risks with an ADHD brain.
Brain food that’s also good for the heart
People with ADHD are more prone to certain nutritional deficiencies, though the exact reason is still uncertain.
A recent review of evidence found that protein, omega-3 fatty acids, magnesium, iron, zinc and some vitamins are all common deficiencies.
Many of these also play a role in lowering cholesterol and blood pressure, so making an effort to include them in your diet can help with both ADHD symptoms and heart health.
However, planning meals and shopping for the right ingredients is notoriously difficult for ADHD brains. Feeling overwhelmed, they often fall back on ultra-processed foods, which are a lot easier to deal with but have been shown to exacerbate both ADHD traits and cardiac risks.
“There are tools these days that can help,” says Professor Ellie Dommett, a neuroscientist who studies ADHD at King’s College London. “You can add things to a shopping list as they pop into your head.”
Phone reminders, regular baskets in supermarket apps or simply relying on partners or family for food shops can all help to ensure you’re getting nutrition that helps your ADHD symptoms and your cardiovascular risk, not the other way around.
Getting the heart pumping
Regular exercise is another well-established strategy that improves cardiovascular risk and also manages symptoms of ADHD.
Rather than being prescriptive about which specific style of exercise works best, do the thing you enjoy because that’s more likely to become a regular habit. That’s the most important thing.
In 2025, researchers reviewed over 100 studies on the link between exercise and ADHD. They concluded that regular exercise can help people with ADHD to improve their impulse control and sustain their attention, while longstanding research shows that exercise is vital for cardiovascular health.
Also consider buying a fitness tracker or wearable device designed for ADHD. These provide vibrations to remind users to stay on task or to get out for a workout.
Therapy for your head and your heart
While medications are the main intervention used for people with ADHD, “CBT (cognitive behavioural therapy) is also recognised in the NICE guidelines,” Dommett says.
“Mindfulness isn’t yet in the guidelines, but anything that reduces stress is good for physical and mental health and there’s evidence mindfulness may improve some ADHD symptoms, or at least the depression and anxiety that come with it.”
CBT can help with time and task management as well as impulse control for unhealthy behaviours like binge eating or smoking. Addressing these makes it much easier to manage longer-term heart risks.
Join the club
Support groups for ADHD can increasingly be found in some settings, including schools and universities, as well as in communities.
“Anything that can help people with ADHD be organised, like a club, is a great idea,” says Faraone. This might include running clubs or team sports as well.
There are also a growing number of ADHD coaches who offer one-on-one support.
“Coaching is unregulated in most countries, so the quality of a given coach is unknown,” Faraone says. “But if you don't have access to a cognitive behavioural therapist, try to find an ADHD coach that you have a good rapport with. That’s important. That kind of person can help you with day-to-day organisational tips.”
Don’t forget your medication
Medication is often the most impactful way to manage ADHD traits. Likewise, prescribed drugs like statins are vital for some cardiovascular risks, including high cholesterol.
However, research shows that in people with ADHD, staying on any kind of medication is a frequent problem. Adults in particular are more likely to stop taking medications for their cardiovascular issues if they also have ADHD.
To improve this, researchers suggest some of the same strategies listed above: digital reminders and support from family, therapists or clinicians.
There certainly is a connection between heart health and ADHD, but exactly what that connection and how risks can be better managed is still being explored. But whether it’s behavioural or biological, having ADHD doesn’t have to mean a broken heart.
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