ADHD and life expectancy
ADHD and life expectancy: What really lies behind the seven-year gap and the heart risk
ADHD and life expectancy: What really lies behind the seven-year gap and the heart risk
DESCRIPTION: ADHD and life expectancy: A British study involving 30,039 adults has found a reduced life expectancy of 6.78 years for men and 8.64 years for women. What these figures mean, what they do not mean, and how cardiovascular risk should be interpreted.
Seven years: the figure nobody wants to hear about ADHD
A British cohort study puts the reduced life expectancy of adults with ADHD at 6.78 years for men and 8.64 years for women. The figure is genuine, yet it is almost always misinterpreted. This article explains what a statistical difference at population level actually means, why cardiovascular risk plays a key role in this, and why this is no cause for fatalism.
Where the figure for reduced life expectancy comes from
In 2025, a matched-cohort study by Elizabeth O’Nions’ research group was published in the British Journal of Psychiatry. The study analysed GP data from 792 British practices covering around nine million adults. From this, 30,039 adults diagnosed with ADHD were matched with 300,390 control subjects without an ADHD diagnosis, at a ratio of one to ten.
Men with ADHD had an estimated life expectancy of 73.26 years, whilst men without ADHD had an estimated life expectancy of 80.03 years. The difference is 6.78 years. Women with ADHD had a life expectancy of 75.15 years, whilst those without had 83.79 years. The difference is 8.64 years. The abbreviated version circulating in the media is: people with ADHD die around seven years earlier than the general population, and women almost nine years earlier.
The figures are taken from mortality data for the years 2000 to 2019. They describe a difference between two groups. They do not prove that ADHD itself shortens life expectancy, nor do they allow any conclusions to be drawn about an individual. The increased mortality is associated with ADHD; it is therefore not directly attributable to ADHD.
Increased mortality: what the figure shows – and what it does not
The distinction between group statistics and individual prognosis is almost always blurred in media coverage. An estimated average life expectancy is not an expiry date. It says something about the distribution within a very large group and nothing about the course of an individual’s life.
There is also a second objection, which the authors themselves highlight. The study only included adults with a documented ADHD diagnosis. ADHD remains significantly underdiagnosed in adulthood. Those who come to the attention of the healthcare system at all often have a history that has led them there: greater stress, more comorbidities, and longer gaps in care. The group studied is therefore likely to be selected based on social and health factors.
The authors therefore interpret their findings as an indication of modifiable risks and inadequate medical care for co-occurring mental and physical health conditions. This is a statement about healthcare structures.
Several factors, which regularly feature in the literature, contribute to the increased mortality: cardiovascular diseases, substance misuse, accidents and suicidal behaviour. None of these is a direct consequence of attention deficit hyperactivity disorder. All are consequences of the conditions under which people with ADHD are more likely to live.
ADHD as a risk factor for cardiovascular disease
The strongest evidence for an independent association between ADHD and cardiovascular disease comes from a Swedish register-based cohort study. The study followed 5.39 million adults without pre-existing cardiovascular disease for an average of 11.8 years.
A cardiovascular diagnosis was made in 38.05 per cent of people with ADHD and 23.57 per cent of the comparison group. The difference is large enough not to be dismissed as noise.
After adjusting for education, migration, type 2 diabetes, obesity, dyslipidaemia, sleep problems and heavy smoking, ADHD remained associated with an increased risk of cardiovascular disease. The hazard ratio was 1.84. After further adjustment for psychiatric comorbidities, it stood at 1.65.
The associations were most pronounced with cardiac arrest, haemorrhagic stroke, and peripheral vascular and atherosclerotic diseases. A systematic review also found a statistically significant association, albeit with considerable variation between the individual studies.
What ‘independent risk factor’ actually means
The term is used in an epidemiological sense. ‘Independent’ means that the association persisted in a statistical model after known risk factors had been taken into account. ADHD is therefore not an isolated, directly organic heart condition.
A plausible explanation involves a cluster of overlapping pathways. Sleep disturbances, chronic stress and difficulties with emotional regulation can influence blood pressure, autonomic nervous system activity and health behaviours. ADHD is more frequently associated with smoking, problematic substance use, physical inactivity and irregular eating patterns, as well as with obesity, diabetes and high blood pressure.
Added to this is the executive function aspect. Prevention, organising appointments, adherence to medication and responding early to symptoms are precisely the tasks that prove most difficult for those with ADHD. Anyone familiar with the literature on executive functions will recognise the familiar pattern here in a new context: the appointment is forgotten because the organisation of important matters breaks down at this point.
Co-occurring psychiatric conditions and social stress reinforce one another: someone who cancels a GP appointment due to depression also misses their blood pressure check.
Why women with ADHD have a greater age gap
The difference of 8.64 years for women compared with 6.78 for men is usually overlooked in media coverage. It requires explanation.
One obvious explanation lies in the diagnosis itself. ADHD in girls and women tends to manifest itself more as inattention than as hyperactivity, and is less noticeable at school and within the family during childhood and adolescence. It is therefore recognised later, often only in adulthood and frequently following a series of misdiagnoses relating to anxiety, depression or personality disorders. Anyone who only receives a diagnosis at the age of forty has already spent two decades without a diagnosis or treatment, whether medication or psychotherapy.
Added to this is the extent of the effort required to adapt. Concealing one’s own symptoms in everyday life – known in technical terms as ‘masking’ – is more pronounced in women and takes a constant toll on their energy. The article on AuDHS in women describes where this leads: to chronic exhaustion, which is rarely treated as ADHD because it appears to be mere exhaustion.
The mortality data do not allow for definitive causal conclusions. They reveal a greater disparity among groups receiving poorer care. This is an argument about diagnosis, not about biology.
Lack of care rather than individual blame
The list of factors, such as smoking, lack of exercise, and irregular eating habits, can easily be read as a list of personal failings. Such an interpretation would be incorrect and, in practice, harmful.
Anyone who treats risk solely as a question of lifestyle overlooks the barriers that lie between realising a problem and acting on it: gaps in care, waiting times, the difficulty of organising appointments, feelings of shame when visiting the doctor, and the experience of not being taken seriously regarding one’s own symptoms. In the case of ADHD, the gap between knowledge and action is the core symptom.
This leads to a different conclusion. The figures point towards care that takes the body into account, rather than calls for greater discipline.
ADHD medication: differentiating rather than causing alarm
Stimulants and other ADHD medicines can increase heart rate and blood pressure. Therefore, a cardiovascular history, as well as measurements of blood pressure and heart rate, form part of the treatment. NICE recommends check-ups before and after dose adjustments, and subsequently every six months.
However, an elevated heart rate does not automatically imply an increased risk of heart attack, stroke or sudden cardiac death. A large meta-analysis found no statistically significant overall increase in serious cardiovascular events associated with ADHD medication. There remains some uncertainty regarding rare events and particularly vulnerable groups.
Other long-term observations suggest that prolonged cumulative use may be associated with high blood pressure and arterial diseases. This does not justify abrupt discontinuation. It argues in favour of an individual assessment of benefits and risks, careful dose management and regular physical check-ups.
The question of cholesterol remains open.
Some of the reporting presents the link between ADHD and cholesterol as settled. It is not.
Several studies have found elevated levels of LDL cholesterol in children with ADHD, some in obese children and some in non-obese children. Other studies involving children and adolescents have found the opposite, namely lower LDL levels than in the control groups.
One possible explanation lies in the treatment itself: stimulants can lower cholesterol levels. Whether untreated ADHD is associated with higher levels than treated ADHD has not yet been proven.
The hypothesis of a generational effect through maternal cholesterol levels during pregnancy is also on shaky ground. Research provides a cautionary example of such correlations: the link between maternal smoking and ADHD in children was long considered causal and has been widely documented in meta-analyses. However, when adjusted for the genetic factors underlying ADHD, this link disappears. Mothers with ADHD are more likely to smoke.
The role of genetics in comorbid conditions
ADHD is considered to be up to 80 per cent heritable. If genes contribute so much to the manifestation of the condition, it stands to reason that the same genes might also influence cardiovascular risk.
The same Swedish research group investigated this in 2024. They found a network of overlapping gene variants that influence health outcomes such as obesity and diabetes. A single gene that causes ADHD and simultaneously leads to metabolic problems was not among them. Further studies found weaker evidence of links between the genetics of ADHD and markers such as cholesterol and body mass index.
The authors’ conclusion is cautious: those genetically predisposed to ADHD carry a small, statistically significant increased risk of heart problems in adulthood.
What is interesting here is the link to behaviour. ADHD and obesity are both linked to dopamine, the neurotransmitter that regulates reward and motivation. A brain with low dopamine levels seeks out activities that release dopamine. Eating is one of them.
Diagnosis and treatment: what this means in practice
The useful message for neurodivergent adults is not that ADHD causes illness. Cardiovascular screening is an integral part of good ADHD care.
In practical terms, this means having blood pressure, resting heart rate, weight or waist circumference, blood sugar and blood lipid levels checked at appropriate intervals. Sleep, nicotine, alcohol and other substances should be discussed openly and without moral judgement. For those on ADHD medication, ensure that six-monthly pulse and blood pressure checks are organised as a matter of course, as are checks following dose adjustments. Ensure that chest pain, shortness of breath on exertion, fainting, persistent palpitations, or new arrhythmias are promptly investigated.
And: the treatment of ADHD, depression, anxiety, sleep disorders and addiction should not be artificially separated. Treating only one of these areas works against the others.
How the figure for reduced life expectancy is distorted in the press
There is a shift between the research itself and its reception that is worth examining closely. The authors write about differences between groups and gaps in care. When the findings are communicated, this becomes a statement about individual people: ADHD costs you seven years.
This shift has consequences. Anyone who receives a late diagnosis and then reads that they are seven years short experiences the explanation they have long awaited as a verdict. For people with ADHD, this is particularly sensitive, because their life experience often consists of falling behind anyway: missed deadlines, abandoned projects, the feeling of lagging behind their own potential. A figure that extends this lag to cover one’s entire life strikes at a pre-existing wound.
Figures of this kind should therefore be shared, given their scope. They describe what a healthcare system fails to provide to a large group. They say nothing about the course of an individual’s life.
Why the figure is important nonetheless
It would be easy to play down the significance of the seven years. The objection regarding the selection of the diagnostic group is valid, as is the objection regarding group statistics. Neither of these changes the fact that there is a significant, repeatedly measured gap here, which good care could help to reduce.
The figure is an argument in favour of ADHD care that takes the body into account, is accessible, and considers the executive function challenges rather than passing them back to those affected as a task to be tackled. Fatalism is the only reaction that certainly does not follow from these data.
Key points in brief
The British matched-cohort study by O’Nions (British Journal of Psychiatry, 2025) compared 30,039 adults diagnosed with ADHD with 300,390 control subjects from 792 GP practices. Estimated life expectancy: 73.26 years for men (difference of 6.78 years) and 75.15 years for women (difference of 8.64 years).
This is a statistically significant difference at the population level, based on mortality data from 2000 to 2019. It is not an individual prognosis.
As ADHD remains underdiagnosed in adults, the documented diagnostic group is likely to be socially and health-wise selected.
A Swedish register-based cohort of 5.39 million adults found a cardiovascular diagnosis in 38.05 per cent of people with ADHD, compared with 23.57 per cent in the comparison group.
After adjusting for education, diabetes, obesity, lipid metabolism, sleep problems and heavy smoking, a hazard ratio of 1.84 remained; after taking into account comorbid psychiatric conditions, the ratio was 1.65.
‘Independent risk factor’ is used in the epidemiological sense. Several factors interact: sleep, stress, health behaviours, executive function difficulties in relation to prevention and medication adherence, and comorbidities.
ADHD medication can increase heart rate and blood pressure. A large meta-analysis found no clear increase in the incidence of serious cardiovascular events. NICE recommends check-ups before and after dose adjustments, as well as every six months.
The evidence regarding cholesterol levels is conflicting. Some studies report higher LDL levels in people with ADHD, whilst others report lower levels.
The wider discrepancy in women points to late diagnosis, misdiagnosis and the long-term impact of masking.
The sensible conclusion is that ADHD care should include cardiovascular screening and address executive function difficulties rather than merely lamenting them.
Sources
Shared genetic architecture of ADHD and cardiometabolic traits – Translational Psychiatry 2024
Childhood ADHD traits and later-life health outcomes – JAMA Network Open 2026 (UCL)
The hidden way ADHD could be raising your cholesterol levels – BBC Science Focus, 4 July 2026
Meta-analysis: ADHD medicines pose no risk to the heart – SpringerMedizin
Cardiovascular safety of ADHD medication: the largest study to date – Lancet Psychiatry
Related
DESCRIPTION: ADHD and life expectancy: A British study involving 30,039 adults has found a reduced life expectancy of 6.78 years for men and 8.64 years for women. What these figures mean, what they do not mean, and how cardiovascular risk should be interpreted.
Seven years: the figure nobody wants to hear about ADHD
A British cohort study puts the reduced life expectancy of adults with ADHD at 6.78 years for men and 8.64 years for women. The figure is genuine, yet it is almost always misinterpreted. This article explains what a statistical difference at population level actually means, why cardiovascular risk plays a key role in this, and why this is no cause for fatalism.
Where the figure for reduced life expectancy comes from
In 2025, a matched-cohort study by Elizabeth O’Nions’ research group was published in the British Journal of Psychiatry. The study analysed GP data from 792 British practices covering around nine million adults. From this, 30,039 adults diagnosed with ADHD were matched with 300,390 control subjects without an ADHD diagnosis, at a ratio of one to ten.
Men with ADHD had an estimated life expectancy of 73.26 years, whilst men without ADHD had an estimated life expectancy of 80.03 years. The difference is 6.78 years. Women with ADHD had a life expectancy of 75.15 years, whilst those without had 83.79 years. The difference is 8.64 years. The abbreviated version circulating in the media is: people with ADHD die around seven years earlier than the general population, and women almost nine years earlier.
The figures are taken from mortality data for the years 2000 to 2019. They describe a difference between two groups. They do not prove that ADHD itself shortens life expectancy, nor do they allow any conclusions to be drawn about an individual. The increased mortality is associated with ADHD; it is therefore not directly attributable to ADHD.
Increased mortality: what the figure shows – and what it does not
The distinction between group statistics and individual prognosis is almost always blurred in media coverage. An estimated average life expectancy is not an expiry date. It says something about the distribution within a very large group and nothing about the course of an individual’s life.
There is also a second objection, which the authors themselves highlight. The study only included adults with a documented ADHD diagnosis. ADHD remains significantly underdiagnosed in adulthood. Those who come to the attention of the healthcare system at all often have a history that has led them there: greater stress, more comorbidities, and longer gaps in care. The group studied is therefore likely to be selected based on social and health factors.
The authors therefore interpret their findings as an indication of modifiable risks and inadequate medical care for co-occurring mental and physical health conditions. This is a statement about healthcare structures.
Several factors, which regularly feature in the literature, contribute to the increased mortality: cardiovascular diseases, substance misuse, accidents and suicidal behaviour. None of these is a direct consequence of attention deficit hyperactivity disorder. All are consequences of the conditions under which people with ADHD are more likely to live.
ADHD as a risk factor for cardiovascular disease
The strongest evidence for an independent association between ADHD and cardiovascular disease comes from a Swedish register-based cohort study. The study followed 5.39 million adults without pre-existing cardiovascular disease for an average of 11.8 years.
A cardiovascular diagnosis was made in 38.05 per cent of people with ADHD and 23.57 per cent of the comparison group. The difference is large enough not to be dismissed as noise.
After adjusting for education, migration, type 2 diabetes, obesity, dyslipidaemia, sleep problems and heavy smoking, ADHD remained associated with an increased risk of cardiovascular disease. The hazard ratio was 1.84. After further adjustment for psychiatric comorbidities, it stood at 1.65.
The associations were most pronounced with cardiac arrest, haemorrhagic stroke, and peripheral vascular and atherosclerotic diseases. A systematic review also found a statistically significant association, albeit with considerable variation between the individual studies.
What ‘independent risk factor’ actually means
The term is used in an epidemiological sense. ‘Independent’ means that the association persisted in a statistical model after known risk factors had been taken into account. ADHD is therefore not an isolated, directly organic heart condition.
A plausible explanation involves a cluster of overlapping pathways. Sleep disturbances, chronic stress and difficulties with emotional regulation can influence blood pressure, autonomic nervous system activity and health behaviours. ADHD is more frequently associated with smoking, problematic substance use, physical inactivity and irregular eating patterns, as well as with obesity, diabetes and high blood pressure.
Added to this is the executive function aspect. Prevention, organising appointments, adherence to medication and responding early to symptoms are precisely the tasks that prove most difficult for those with ADHD. Anyone familiar with the literature on executive functions will recognise the familiar pattern here in a new context: the appointment is forgotten because the organisation of important matters breaks down at this point.
Co-occurring psychiatric conditions and social stress reinforce one another: someone who cancels a GP appointment due to depression also misses their blood pressure check.
Why women with ADHD have a greater age gap
The difference of 8.64 years for women compared with 6.78 for men is usually overlooked in media coverage. It requires explanation.
One obvious explanation lies in the diagnosis itself. ADHD in girls and women tends to manifest itself more as inattention than as hyperactivity, and is less noticeable at school and within the family during childhood and adolescence. It is therefore recognised later, often only in adulthood and frequently following a series of misdiagnoses relating to anxiety, depression or personality disorders. Anyone who only receives a diagnosis at the age of forty has already spent two decades without a diagnosis or treatment, whether medication or psychotherapy.
Added to this is the extent of the effort required to adapt. Concealing one’s own symptoms in everyday life – known in technical terms as ‘masking’ – is more pronounced in women and takes a constant toll on their energy. The article on AuDHS in women describes where this leads: to chronic exhaustion, which is rarely treated as ADHD because it appears to be mere exhaustion.
The mortality data do not allow for definitive causal conclusions. They reveal a greater disparity among groups receiving poorer care. This is an argument about diagnosis, not about biology.
Lack of care rather than individual blame
The list of factors, such as smoking, lack of exercise, and irregular eating habits, can easily be read as a list of personal failings. Such an interpretation would be incorrect and, in practice, harmful.
Anyone who treats risk solely as a question of lifestyle overlooks the barriers that lie between realising a problem and acting on it: gaps in care, waiting times, the difficulty of organising appointments, feelings of shame when visiting the doctor, and the experience of not being taken seriously regarding one’s own symptoms. In the case of ADHD, the gap between knowledge and action is the core symptom.
This leads to a different conclusion. The figures point towards care that takes the body into account, rather than calls for greater discipline.
ADHD medication: differentiating rather than causing alarm
Stimulants and other ADHD medicines can increase heart rate and blood pressure. Therefore, a cardiovascular history, as well as measurements of blood pressure and heart rate, form part of the treatment. NICE recommends check-ups before and after dose adjustments, and subsequently every six months.
However, an elevated heart rate does not automatically imply an increased risk of heart attack, stroke or sudden cardiac death. A large meta-analysis found no statistically significant overall increase in serious cardiovascular events associated with ADHD medication. There remains some uncertainty regarding rare events and particularly vulnerable groups.
Other long-term observations suggest that prolonged cumulative use may be associated with high blood pressure and arterial diseases. This does not justify abrupt discontinuation. It argues in favour of an individual assessment of benefits and risks, careful dose management and regular physical check-ups.
The question of cholesterol remains open.
Some of the reporting presents the link between ADHD and cholesterol as settled. It is not.
Several studies have found elevated levels of LDL cholesterol in children with ADHD, some in obese children and some in non-obese children. Other studies involving children and adolescents have found the opposite, namely lower LDL levels than in the control groups.
One possible explanation lies in the treatment itself: stimulants can lower cholesterol levels. Whether untreated ADHD is associated with higher levels than treated ADHD has not yet been proven.
The hypothesis of a generational effect through maternal cholesterol levels during pregnancy is also on shaky ground. Research provides a cautionary example of such correlations: the link between maternal smoking and ADHD in children was long considered causal and has been widely documented in meta-analyses. However, when adjusted for the genetic factors underlying ADHD, this link disappears. Mothers with ADHD are more likely to smoke.
The role of genetics in comorbid conditions
ADHD is considered to be up to 80 per cent heritable. If genes contribute so much to the manifestation of the condition, it stands to reason that the same genes might also influence cardiovascular risk.
The same Swedish research group investigated this in 2024. They found a network of overlapping gene variants that influence health outcomes such as obesity and diabetes. A single gene that causes ADHD and simultaneously leads to metabolic problems was not among them. Further studies found weaker evidence of links between the genetics of ADHD and markers such as cholesterol and body mass index.
The authors’ conclusion is cautious: those genetically predisposed to ADHD carry a small, statistically significant increased risk of heart problems in adulthood.
What is interesting here is the link to behaviour. ADHD and obesity are both linked to dopamine, the neurotransmitter that regulates reward and motivation. A brain with low dopamine levels seeks out activities that release dopamine. Eating is one of them.
Diagnosis and treatment: what this means in practice
The useful message for neurodivergent adults is not that ADHD causes illness. Cardiovascular screening is an integral part of good ADHD care.
In practical terms, this means having blood pressure, resting heart rate, weight or waist circumference, blood sugar and blood lipid levels checked at appropriate intervals. Sleep, nicotine, alcohol and other substances should be discussed openly and without moral judgement. For those on ADHD medication, ensure that six-monthly pulse and blood pressure checks are organised as a matter of course, as are checks following dose adjustments. Ensure that chest pain, shortness of breath on exertion, fainting, persistent palpitations, or new arrhythmias are promptly investigated.
And: the treatment of ADHD, depression, anxiety, sleep disorders and addiction should not be artificially separated. Treating only one of these areas works against the others.
How the figure for reduced life expectancy is distorted in the press
There is a shift between the research itself and its reception that is worth examining closely. The authors write about differences between groups and gaps in care. When the findings are communicated, this becomes a statement about individual people: ADHD costs you seven years.
This shift has consequences. Anyone who receives a late diagnosis and then reads that they are seven years short experiences the explanation they have long awaited as a verdict. For people with ADHD, this is particularly sensitive, because their life experience often consists of falling behind anyway: missed deadlines, abandoned projects, the feeling of lagging behind their own potential. A figure that extends this lag to cover one’s entire life strikes at a pre-existing wound.
Figures of this kind should therefore be shared, given their scope. They describe what a healthcare system fails to provide to a large group. They say nothing about the course of an individual’s life.
Why the figure is important nonetheless
It would be easy to play down the significance of the seven years. The objection regarding the selection of the diagnostic group is valid, as is the objection regarding group statistics. Neither of these changes the fact that there is a significant, repeatedly measured gap here, which good care could help to reduce.
The figure is an argument in favour of ADHD care that takes the body into account, is accessible, and considers the executive function challenges rather than passing them back to those affected as a task to be tackled. Fatalism is the only reaction that certainly does not follow from these data.
Key points in brief
The British matched-cohort study by O’Nions (British Journal of Psychiatry, 2025) compared 30,039 adults diagnosed with ADHD with 300,390 control subjects from 792 GP practices. Estimated life expectancy: 73.26 years for men (difference of 6.78 years) and 75.15 years for women (difference of 8.64 years).
This is a statistically significant difference at the population level, based on mortality data from 2000 to 2019. It is not an individual prognosis.
As ADHD remains underdiagnosed in adults, the documented diagnostic group is likely to be socially and health-wise selected.
A Swedish register-based cohort of 5.39 million adults found a cardiovascular diagnosis in 38.05 per cent of people with ADHD, compared with 23.57 per cent in the comparison group.
After adjusting for education, diabetes, obesity, lipid metabolism, sleep problems and heavy smoking, a hazard ratio of 1.84 remained; after taking into account comorbid psychiatric conditions, the ratio was 1.65.
‘Independent risk factor’ is used in the epidemiological sense. Several factors interact: sleep, stress, health behaviours, executive function difficulties in relation to prevention and medication adherence, and comorbidities.
ADHD medication can increase heart rate and blood pressure. A large meta-analysis found no clear increase in the incidence of serious cardiovascular events. NICE recommends check-ups before and after dose adjustments, as well as every six months.
The evidence regarding cholesterol levels is conflicting. Some studies report higher LDL levels in people with ADHD, whilst others report lower levels.
The wider discrepancy in women points to late diagnosis, misdiagnosis and the long-term impact of masking.
The sensible conclusion is that ADHD care should include cardiovascular screening and address executive function difficulties rather than merely lamenting them.
Sources
Shared genetic architecture of ADHD and cardiometabolic traits – Translational Psychiatry 2024
Childhood ADHD traits and later-life health outcomes – JAMA Network Open 2026 (UCL)
The hidden way ADHD could be raising your cholesterol levels – BBC Science Focus, 4 July 2026
Meta-analysis: ADHD medicines pose no risk to the heart – SpringerMedizin
Cardiovascular safety of ADHD medication: the largest study to date – Lancet Psychiatry
Related