Regular cocaine use is associated with increased systolic blood pressure, aortic stiffness and left ventricular mass in young otherwise healthy individuals.
BACKGROUND
The cardiovascular impact of cocaine use in otherwise healthy individuals who consider themselves 'social' users is not well established.


RESULTS
Twenty regular cocaine users and 20 control subjects were recruited by word-of-mouth. Cardiovascular magnetic resonance was performed to assess cardiac and vascular structure and function. Cocaine users had higher systolic blood pressure compared to non-users (134±11 vs 126±11 mmHg, p = 0.036), a finding independent of age, body surface area, smoking and alcohol consumption. Cocaine use was associated with increased arterial stiffness - reflected by reduced aortic compliance (1.3±0.2 vs 1.7±0.5 cm2×10-2.mmHg-1, p = 0.004), decreased distensibility (3.8±0.9 vs 5.1±1.4 mmHg-1.10-3, p = 0.001), increased stiffness index (2.6±0.6 vs 2.1±0.6, p = 0.005), and higher pulse wave velocity (5.1±0.6 vs 4.4±0.6 m.s-1, p = 0.001). This change in aortic stiffness was independent of vessel wall thickness. Left ventricular mass was 18% higher in cocaine users (124±25 vs 105±16 g, p = 0.01), a finding that was independent of body surface area, and left atrial diameter was larger in the user group than controls (3.8±0.6 vs 3.5±0.3 cm, p = 0.04). The increased left ventricular mass, systolic blood pressure and vascular stiffness measures were all associated with duration and/or frequency of cocaine use. No late gadolinium enhancement or segmental wall motion abnormalities were seen in any of the subjects.


CONCLUSIONS
Compared with the non-user control cohort, cocaine users had increased aortic stiffness and systolic blood pressure, associated with greater left ventricular mass. These measures are all well known risk factors for premature cardiovascular events, highlighting the dangers of cocaine use, even in a 'social' setting, and have important public health implications.
North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
Rebecca
R
Kozor
North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Sydney, Australia.
Stuart M
SM
Grieve
Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
Stefan
S
Buchholz
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Sharlene
S
Kaye
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Shane
S
Darke
North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
Ravinay
R
Bhindi
North Shore Heart Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
Gemma A
GA
Figtree
D000328:Adult; D001013:Aorta, Thoracic / Q000187:drug effects / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects*; D016022:Case-Control Studies; D003042:Cocaine / Q000009:adverse effects*; D005260:Female; D006262:Health; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size / Q000187:drug effects; D013599:Systole / Q000187:drug effects*; D059289:Vascular Stiffness / Q000187:drug effects*; D016276:Ventricular Function
D003042:Cocaine