Arrange pulse and blood pressure checks
Guideline advice, not formally gradedADHD evidence
Routine cardiovascular checks help your clinician spot medication effects symptoms may miss.
Start with the time you have
1 minute
Check your calendar: do you know when your next pulse and blood pressure check is?
5 minutes
Look at your appointment record, and if the next check isn't clear, contact the service in charge.
15 minutes
Write a short note for your clinician on heart symptoms, family history and recent treatment changes.
A plan
Keep monitoring connected to prescribing
- Confirm the monitoring service and schedule.
- Attend the arranged checks and report relevant symptoms.
- Make sure the prescriber receives the results.
How sure the science is
Guideline advice, not formally graded, ADHD evidence
- Recommended by ADHD clinical guidelines, but nobody has pooled the trials and graded how sure they are.
- Guideline advice is a considered judgement, not a measured certainty.
- Measured in people with ADHD.
NICE NG87 1.7.4 and 1.8.9; evidence review D: consensus schedule, safety evidence mostly very low to moderate quality.
The number, drawn
Why it matters
- ADHD medicines can change heart rate and blood pressure, sometimes in different directions.
- NICE recommends checking both before treatment, before and after each dose change, and every 6 months, though its own evidence review calls that schedule committee consensus, because most trials were short.
- Monitoring does not mean everyone needs an ECG, and one odd reading does not prove a medicine is unsuitable.
How to do it
- Find out who is responsible for your pulse and blood pressure checks.
- Make sure the checks around any recent changes your clinician made have been done.
- Tell the clinician about fainting, palpitations, or heart problems in you or your family.
- Ask how the results reach the prescriber and when the next check is due.
- New chest pain, fainting or significant palpitations need prompt medical assessment.
- A clinician should interpret readings and decide whether further tests are needed.
Putting it into practice
In real life
- Ask whether your primary care team or the ADHD clinic is doing the next check.
- Bring up any fainting or family heart problems at the monitoring appointment.
Watch out for
- Common mistakeFeeling fine does not replace the scheduled checks. Confirm when yours are due.
- Common mistakeOne reading needs a clinician to interpret it, so share it instead of changing treatment yourself.
Trusted guides
How we rated it
- Evidence grade
- A Moderate or high certainty evidence in people with ADHD, or an explicit ADHD guideline recommendation.
- The number
- Check pulse and blood pressure every 6 months (NICE, 2019)
- Benefit
- 76/100 An editorial priority for the general list, weighted by certainty. It does not predict what will happen for you.
- Effort
- Quick win
Sources
- Tier 1 guidelineAttention deficit hyperactivity disorder: diagnosis and management (NG87), recommendationsNICE, 2019
- Tier 1 guidelineClinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and AdolescentsAmerican Academy of Pediatrics, 2019
- Tier 1 guidelineADHD evidence review D: pharmacological safety (NG87)NICE, 2018
- General information about ADHD, not a diagnosis or an individual treatment plan.
- Tailoring changes the order of suggestions; it does not assess you.
- Medication decisions belong with you and a qualified clinician.