title: Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine.
abstract: The abuse of alcohol is associated with chronic cardiomyopathy, hypertension, and arrhythmia. Abstinence or using alcohol in moderation can reverse these cardiovascular problems. Alcohol is also distinguished among the substances of abuse by having possible protective effects against coronary artery disease and stroke when used in moderate amounts. Amphetamines (eg, speed, ice, ecstasy) have many of the cardiovascular toxicities seen with cocaine, including acute and chronic cardiovascular diseases. Heroin and other opiates can cause arrhythmias and noncardiac pulmonary edema, and may reduce cardiac output. Cardiovascular problems are less common with cannabis (marijuana) than with opiates, but major cognitive disorders may be seen with its chronic use. It is still controversial whether caffeine can cause hypertension and coronary artery disease, and questions have been raised about its safety in patients with heart failure and arrhythmia.
authors.affiliation: Department of Medicine, The New York Medical College/Westchester Medical Center, Valhalla, NY 10595, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Frishman
authors.forename: Alexander
authors.initials: A
authors.lastname: Del Vecchio
authors.forename: Shirin
authors.initials: S
authors.lastname: Sanal
authors.forename: Anjum
authors.initials: A
authors.lastname: Ismail
mesh_terms: D019973:Alcohol-Related Disorders / Q000150:complications* / Q000503:physiopathology; D019969:Amphetamine-Related Disorders / Q000150:complications* / Q000503:physiopathology; D002110:Caffeine / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D006556:Heroin Dependence / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D002189:Marijuana Abuse / Q000150:complications* / Q000503:physiopathology
chemical_list: D000697:Central Nervous System Stimulants; D002110:Caffeine