Recreational Cocaine Use Linked To Heart Attack Conditions

Alan McStravick for — Your Universe Online

I said to a guy, “Tell me, what is it about cocaine that makes it so wonderful,” and he said, “Because it intensifies your personality.” I said, “Yes, but what if you’re an [expletive deleted]?”

Bill Cosby, in his seminal stand up performance ℠Bill Cosby: Himself´, talked about what it is about cocaine that attracts an often loyal audience that uses the drug recreationally.

When cocaine is ingested or inhaled, its effects are almost immediate and the user experiences dissipation anywhere from a few minutes to an hour afterwards. When consumed in small doses, the user can experience feelings of euphoria, increased energy and become excessively talkative and mentally alert. The physiological drives for food and sleep are typically subverted, as well.

The addictive nature of cocaine is very strong. Individuals trying it for the first time, therefore, might be unable to predict or control the extent to which they might continue to want or use the drug. There have been studies that show that even during long periods of abstinence, the memory of the initial cocaine experience can trigger a tremendous craving for the drug, leading to relapse.

Physiologically, the effects of cocaine use include constricted blood vessels, dilation of the pupil, increased body temperature, heart rate and also blood pressure. When users begin using larger amounts of the drug, their high may be intensified but not at the expense of experiencing adverse effects. While a certain someone may have thought he was “WINNING”, he was, in fact, presenting the known effects of bizarre, erratic and even violent behavior associated with the prolonged use of cocaine. If help is not sought during this time, it is not unlikely that the user would experience a cardiac arrest or seizure followed by respiratory arrest. These are, too often, fatal in nature for the user.

A new study out of Australia has focused on the recreational user and the cardiovascular abnormalities they experience even long after the immediate effects of the cocaine have worn off. They presented their findings this week at the American Heart Association´s Scientific Sessions 2012 in Los Angeles.

Individuals who have a social relationship with cocaine, meaning they use regularly but recreationally, typically have stiffer arteries, higher blood pressure and a thicker heart wall muscle than do non-users, according to the study.

The study, comprised of 20 subjects who were chronic cocaine users and 20 non-users, used magnetic resonance imaging (MRI) to measure the effects of cocaine use on the otherwise healthy adults. When compared to the 20 non-users, the researchers determined that the users had higher rates of multiple factors associated with higher risks of heart attack and stroke. These include a 30 to 35 percent increase in aortic stiffening, an elevated systolic blood pressure and an 18 percent increase in the thickness of the heart´s left ventricle wall.

“It´s so sad,” said Gemma Figtree, M.B.B.S., D.Phil., lead researcher of the study. “We are repeatedly seeing young, otherwise fit individuals suffering massive heart attacks related to cocaine use. Despite being well-educated professionals, they have no knowledge of the health consequences of regularly using cocaine.”

“It´s the perfect heart attack drug,” she said.

She pointed out how the combined effects of greater blood clotting, increased heart stress and more blood vessel constriction puts users at a higher risk of a spontaneous heart attack. Figtree, as well as being the lead researcher, is also an associate professor of medicine at Sydney Medical School at the University of Sydney in Australia.

It wasn´t until after a surge of cocaine-related infarcts at Sydney´s Royal North Shore Hospital that the team decided to launch the study into the incidences of cardiovascular abnormalities in what would otherwise appear to be healthy, regular cocaine users.

To conduct the study, the researchers had to recruit recreational users who had reported using cocaine at least one time a month for the previous year. This group was comprised of 17 men and 3 women. They each completed a questionnaire that delved into their drug use, cardiovascular risk factors and socioeconomic statuses.

Then, at least 48 hours after their last encounter with cocaine, the volunteers would have their blood pressure taken and then undergo a cardiac MRI to assess heart mass and levels of heart and aortic functioning. The non-user group also underwent similar comparison. They were assessed also for certain health conditions, like a history of diabetes, smoking and other drug use.

What the study showed, conclusively, was that the user group presented with higher systolic blood pressure and increased arterial stiffness. They also were able to determine that there was a significant thickening of the heart wall.

“Stiffer vessels are known to be associated with elevated systolic blood pressure.  As a result, the heart is required to work harder, and its walls become hypertrophied or thicker,” Figtree said.

This study is the first instance of documentation of persistent hypertension and vascular stiffness in cocaine users, long after the initial acute effects have dissipated. Previous studies had focused on the immediate effects of cocaine on the heart muscle. Also, those studies observed cocaine addicts, primarily, and not the social user.

The current data doesn´t properly explain how repeated social cocaine use causes the blood vessels to stiffen, but researchers are investigating if there is a signaling pathway that might be activated to cause this response.

Overall, Figtree states that the outcomes of the study underscore the need for education about short- and long-term effects of cocaine use to help prevent heart attack and stroke.

Co-authors are Ravinay Bhindi, M.B.B.S., Ph.D.; Stefan Buchholz, M.B.B.S.; Shane Darke, Ph.D.; Stuart Grieve, M.B.B.S., D.Phil.; Sharlene Kaye, Ph.D.; and Rebecca Kozor, M.B.B.S.

The North Shore Heart Research Foundation funded the study.