Acute and Chronic Effects of Cocaine on Cardiovascular Health

Abstract

Cardiac complications resulting from cocaine use have been extensively studied because of the complicated pathophysiological mechanisms. This study aims to review the underlying cellular and molecular mechanisms of acute and chronic effects of cocaine on the cardiovascular system with a specific focus on human studies. Studies have consistently reported the acute effects of cocaine on the heart (e.g., electrocardiographic abnormalities, acute hypertension, arrhythmia, and acute myocardial infarction) through multifactorial mechanisms. However, variable results have been reported for the chronic effects of cocaine. Some studies found no association of cocaine use with coronary artery disease (CAD), while others reported its association with subclinical coronary atherosclerosis. These inconsistent findings might be due to the heterogeneity of study subjects with regard to cardiac risk. After cocaine use, populations at high risk for CAD experienced coronary atherosclerosis whereas those at low risk did not experience CAD, suggesting that the chronic effects of cocaine were more likely to be prominent among individuals with higher CAD risk. Studies also suggested that risky behaviors and cardiovascular risks may affect the association between cocaine use and mortality. Our study findings highlight the need for education regarding the deleterious effects of cocaine, and access to interventions for cocaine abusers.

Demographic and cardiovascular risk factors associated with drug use in truck drivers

“…In this study, body fat and hypertension were significantly related to the reported consumption of illicit drugs, and the lower percentage of fat for users of illicit drugs is consistent with what was found in the literature, since amphetamine and cocaine have proven effects on metabolic functions and are anorectic agents 15,31,35 . Although the prevalence of hypertension found among those who declared they had already used illicit drugs (9.8%) was lower than that found among those who had never used illicit drugs (15.2%), it should be considered that this factor may also be directly linked to a low percentage of body fat and the young average age.…”

“…Another possible effect is the blocking of sodium/potassium channels, causing cardiovascular changes, which may present increased and prolonged risks when there is an association between cocaine and alcohol. 15 In a review including a range of studies on the effects of the drug, it was found that its frequent use may be strongly associated with an increased risk of acute cardiovascular complications, such as hypertension, coronary aneurysms, arrhythmias and myocardial infarction 14,15,18,37 .…”

“…Cocaine and its metabolites also affect behavior regarding food intake and suppress appetite, which can lead to the disruption of metabolic and neuroendocrine regulation, resulting in an increased risk of developing body weight problems, diabetes and metabolic syndrome 15 . Studies with humans have also shown anorexigenic effects of cocaine, and the low caloric intake, together with abnormal metabolic and gastrointestinal functions, can lead to malnutrition among drug users 15 .…”

“…14 There are also reports that cocaine use and abuse are associated with an increased risk of cardiovascular complications, such as systemic arterial hypertension (SAH), coronary artery spasm, arrhythmias, acute myocardial infarction (MI), cardiomyopathy and atherosclerotic coronary artery disease. 15 In turn, tetrahydrocannabinol (THC), the main active component of marijuana, causes an acute dosedependent increase in blood pressure (BP) and heart rate. A review explored a series of studies on the topic, and there was evidence to suggest that increasing the frequency of marijuana use increases the risk of cardiac arrhythmias and MI.…”

Blood and Plasma Volumetric Absorptive Microsampling (VAMS) Coupled to LC-MS/MS for the Forensic Assessment of Cocaine Consumption

“…Recreational COC consumption can result in several kinds of short-and long-term health damage, as well as psychological and physical dependence, and addiction. For example, exhaustion, somnolence, irritability, and judgment impairment are typical short-term effects, while stroke or ictus, paranoid psychosis and mucosal necrosis can appear over the long term [3,4]. For these reasons, COC is included in the lists of controlled substances of most States [5,6].…”