By Dr. S. P. Pradhan on 17th November, 2023
Substance abuse by young population puts a very high risk on cardiovascular system and heart attack.
Substance abuse refers to excessive use of a drug in such a way that is detrimental to self, society, or both. This includes both physical dependence and psychologic dependence. Physical dependence caused by prolonged use of a drug resulting an altered withdrawal symptoms develop when the drug is discontinued.
Psychologic dependence refers to a state of intense craving to take the drug in the absence of physical dependence. Alcohol is a drug that can cause both physical and psychologic dependence. Some other common abusive drugs are tobacco, cocaine, marijuana, amphetamines, opioids.
What are most common Heart Problems in Substance Abuse?
Hypertension (high blood pressure)
Cocaine can cause dangerous and sudden high blood pressure due to vasoconstriction. Alcohol may cause chronic hypertension, which can lead to other health consequences, including stroke, heart failure, and kidney problems.
Coronary heart disease.
Coronary heart disease occurs when the arteries cannot deliver enough oxygen-rich blood to the heart because of gradual narrowing of vessels due to plaque formation within the arteries. Alcohol over intake can contribute to an increase in plaque or atherosclerosis. Chronic smokers are also at risk of causing coronary heart disease.
Peripheral artery disease
Peripheral artery disease (PAD) linked to tobacco use as a big risk factor. It is due to buildup of plaque formation that reduces blood flow in the peripheral arteries; the vessels that carry blood away from the heart to other parts of the bod. It is very commonly seen in legs.
Cardiomyopathy
Cardiomyopathy is the condition with the weakened heart muscle that compromise its ability to function properly and make it harder for it to pump blood. Alcohol abuse is a leading cause of alcoholic cardiomyopathy, especially dilated cardiomyopathy.
Endocarditis
Infective endocarditis occurs due to an inflammation of the endocardium of the heart. It can be caused by injection drug use leading to arrhythmias, thrombosis, endocardial valve damage, or heart failure.
Arrhythmias
Arrhythmia means irregular heartbeat which can mean that the heart is beating too fast or tachycardia, too slow or bradycardia, or irregularly. Few drugs such as cocaine and methamphetamine can cause various degrees of arrhythmias. It can lead to life-threatening conditions like heart attack or cardiac arrest, if left untreated.
Stroke
A stroke occurs when the brain is deprived of oxygen due to a blocked blood vessel. This occurs due to thrombosis or atherosclerotic plaques. A stroke leads to lasting brain damage, long-term disabilities, cognitive dysfunction and death.
Heart attack
It is also called a myocardial infarction or a heart attack. It occurs when there is an imbalance between the heart’s need for oxygen and the oxygen available to the working heart. Some drugs cause an increased demand for oxygen in the heart or a decreased ability for the heart to supply, or both at the same time.
Recreational cocaine users may have higher blood pressure, stiffer arteries and thicker heart muscle walls than non-users and all of which can cause a heart attack.
An Australian study presented at the American Heart Association’s Scientific Sessions in 2012 was the first to document these cardiovascular abnormalities in regular cocaine users long after the immediate effects of cocaine have worn off.
Researchers who called cocaine “the perfect heart attack drug” – showed how users had higher rates of multiple factors associated with higher risks of heart attack and stroke:
- 30% to 35 % increase in aortic stiffening;
- 8 mm Hg rise in systolic blood pressure; and
- 18 % greater thickness of the heart’s left ventricle wall.
