Cocaine Use Major Risk Factor for Sudden Cardiac Death

Man with chest pain

Sudden cardiovascular death is a term sometimes used to describe fatal cases of the abrupt heart stoppage associated with cardiac arrest. The stimulant drug cocaine is known for its ability to significantly alter heart function in both experienced and inexperienced users. In a study scheduled for publication in 2014 in the journal Addiction, a team of Spanish researchers explored the role cocaine plays in elevating the risks for sudden cardiac death. The researchers concluded that recent cocaine consumption is clearly associated with heightened chances of this fatal heart function change.

Sudden Cardiac Death

Sudden cardiac death is also known as sudden cardiovascular death. People affected by this condition develop fatal, unpredicted cases of cardiac arrest; cardiac arrest happens when the network of natural electrical impulses that powers your heartbeat loses its ability to keep your heart actively pumping blood to the rest of your body. Within minutes, a person in cardiac arrest will lose vital blood flow to the brain. Unless cardiac function is quickly restored through emergency medical treatment, the affected individual will die.

In most cases, the immediate underlying cause of cardiac arrest and sudden cardiac death is a severely irregular heartbeat. Known contributing factors to the risks for cardiac arrest and sudden cardiac death include having a history of heart attacks, having a history of atherosclerosis (hardening of the arteries), being a survivor of a previous episode of cardiac arrest, having diminished heart function (i.e., heart failure), having diabetes and having a history of unexplained fainting. Consumption of illicit/illegal drugs is also a known potential contributing factor.

Cocaine and Cardiac Health

Cocaine is a powerful stimulant that substantially increases the baseline level of activity in your central nervous system. Since your central nervous system controls the basic function of your cardiovascular system (heart and blood vessels), cocaine consumption will invariably lead to significant changes in your cardiac health. Short-term changes associated with intake of the drug include increases in your heart rate, increases in your blood pressure during your heart’s active phase, increases in your blood pressure during your heart’s resting phase, increases in the amount of oxygen needed to keep your cardiovascular system running properly, decreases in the amount of oxygen supplied to your cardiovascular system, an irregular heartbeat, reduced contraction strength in your heart muscle and atherosclerosis. Longer-term use of cocaine brings additional cardiovascular alterations that can include an enlarged heart and slowed release of blood from the heart’s two pumping chambers.

Link to Sudden Death

In the study scheduled for publication in Addiction, researchers from three Spanish institutions used an examination of 437 Spanish residents between the ages of 15 and 49 to explore the connection between cocaine use and sudden cardiac death. Of these individuals, 311 died from sudden cardiac arrest at some point between the beginning of 2003 and the end of 2009; 126 died from causes unrelated to the status of their cardiovascular health. The researchers used toxicology reports to detect any recent substance use in the members of both of these groups. In addition to cocaine, substances under consideration included alcohol, marijuana/cannabis, opioid drugs or medications, amphetamines and sedative-hypnotic medications called benzodiazepines. The researchers also looked at basic demographic information (age, gender, etc.) and the presence of any other known heart-related risk factors.

The researchers found that roughly 9 percent of those individuals who died as a result of sudden cardiac death had recently consumed cocaine before going into cardiac arrest. Conversely, only 2 percent of those individuals who died from non-cardiovascular-related causes had recently consumed the drug. When the researchers assessed the relative importance of all of the known heart-related risks factors for the people affected by sudden cardiac death, they concluded that recent cocaine consumption was the single most important variable. Intake of the drug increased the odds of dying suddenly from cardiac arrest by more than 300 percent.

The researchers also compared the frequency of cocaine use in the 15- to 49-year-olds affected by sudden cardiac death to the frequency of cocaine use in the same-age general population of the region of Spain under consideration. They concluded that the people who died from cardiac arrest were at least 13 times more likely to use cocaine than their age contemporaries in the general population, and possibly as high as 58 times more likely to use the drug.

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