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Young Hearts No Match for Cocaine

Drug boosts risk of heart attack by 25 percent

FRIDAY, June 8, 2001 (HealthDayNews) -- Think you're too young for a heart attack?

Think again -- if you use cocaine.

Using cocaine even a dozen times before you turn 45 could increase your risk of a heart attack by 25 percent, according to a recent study.

Among other things, the drug appears to damage the heart muscle, leading to an increased risk of youthful heart attacks among users.

"The magnitude of the association was rather surprising," says Dr. Adnan I. Qureshi, an assistant professor of neurosurgery at the University of Buffalo in New York.

Qureshi led research for the study, which looked at the health and nutrition of more than 10,000 people between the ages of 18 and 45.

Among those 10,000, researchers identified 532 people who were classified as frequent cocaine users, meaning they had used the drug more than 10 times.

Frequent users had seven times the rate of heart attacks as nonusers, the study concluded.

And even after accounting for other heart-attack risks -- such as smoking, high cholesterol or a family history of heart disease -- the researchers found that frequent cocaine users under the age of 45 were 25 percent more likely to have a heart attack than nonusers.

"The number of 25 percent, I think, is important," says Dr. Richard Stein, chief of cardiology at Brooklyn Hospital Center in New York. "You're looking at a young population where heart attacks are unlikely.

"If you say to a young person in their 30s, 'Look, your risk of a heart attack is small, but it's 25 percent greater if you use cocaine' -- that is a very powerful statement."

Emergency-room doctors have long known that cocaine use is often in the picture when a young person comes in with a heart attack.

But the new findings will help doctors understand just how widespread the problem may be.

"What's nice is they've given us actual numbers," says Stein.

Qureshi's study did not look specifically at how cocaine causes heart attacks, but the mechanisms are already well known.

The drug speeds up nerve impulses, increasing the force of heart contractions and putting more strain on the heart muscle.

It narrows blood vessels, reducing blood flow to the heart. Cocaine is so effective at this, in fact, that doctors sometimes use it on surgical patients to help stop bleeding.

Cocaine can cause arrhythmia, or an erratic heartbeat. And the drug also can increase the aggregation of platelets, which act to clot the blood. That can block arteries.

Dr. David Gorelick has worked with cocaine users and addicts for more than 20 years. Now chief of the clinical pharmacology section for the National Institute on Drug Abuse (NIDA), Gorelick has seen the damage cocaine can do.

"It certainly has adverse physical, psychological and social consequences," Gorelick says, adding that NIDA is funding more research to find out what makes some people more vulnerable to those consequences.

"The same things that have been addressed for the past 50 years with cigarette smoking need to be looked at for cocaine use," he says.

"Certainly this study doesn't surprise me, if you know what cocaine does to the body. It's been shown in both animal and human studies."

Qureshi says the next step is to look more carefully at the actual mechanisms by which cocaine induces heart attacks.

"This could give us some indications of the underlying mechanisms of heart attacks in general," he says.

He also plans to follow up leads indicating that cocaine use may be linked to an increased number of strokes in young patients.

"The numbers we have for strokes are not as valid statistically, but we are working on that, too," he says.

Stein, the Brooklyn cardiologist, says such studies are a good investment.

"With health care amounting to 14 to 18 percent of the gross national product, these kinds of studies -- about our society, its behaviors and what they contribute to -- are an intelligent use of the country's money," he says.

What To Do

Find more information on cocaine's effects from the National Institute on Drug Abuse. Read a summary of Qureshi's study in Circulation, a publication of the American Heart Association.

Or you can read these HealthDay stories on cocaine by clicking here.

SOURCES: Interviews with Adnan I. Qureshi, M.D., assistant professor of neurosurgery, University of Buffalo, N.Y.; Richard Stein, M.D., chief of cardiology, Brooklyn (N.Y.) Hospital Center; David Gorelick, M.D., chief of clinical pharmacology section, National Institute on Drug Abuse
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