Topline
A new study found substance use-related heart disease deaths increased annually between 1999 and 2019, and women, Native Americans and Alaskans, those in rural communities and adults between 25 and 49 were among the most vulnerable groups.
Key Facts
Substance use-related cardiovascular disease deaths more than doubled between 1999 and 2019, despite overall cardiovascular disease deaths decreasing by 25%, according to a new study published Tuesday in the Journal of the American Heart Association.
These increases were more notable in those who used psychostimulants like cocaine (16.8), and cannabis (12.7%), as well as among American Indians or Alaskans (5.4%), adults between 25 and 49 (5.3%), people in rural areas (5%) and women (4.8%), though overall there were more deaths in men.
Alcohol was the most prominent substance and contributed to 65% of these deaths, followed by opiods (13.7%), cocaine (9.8%), stimulants (6.5%), sedatives (4.1%) and cannabis (0.5%)—smoking and tobacco use weren’t included as factors in the study.
The most common age range for substance use-related cardiovascular disease deaths was 55 to 69 (39.1%), followed by 40 to 54 (36.8%) and 70 to 84 (12.1%), the JAAA study reports.
Around 10% of the U.S. population, or 23 million adults, will at some point develop substance use disorder, and about one-third of Americans will have alcohol use disorder at some point, though only a small fraction will receive treatment, a 2021 study published in the Journal of Clinical Pharmacology found.
Crucial Quote
“We would like to see additional public health efforts to support comprehensive evaluation and management of substance use in the U.S. that includes clinician and patient education, as well as attention to socioeconomic factors that contribute to substance use,” cardiologist at Loma Linda University Health and the study’s senior author Dmitry Abramov said in a statement.
Key Background
Although American Indians and Native Alaskans only account for 1.7% of the U.S. population, they have high rates of substance abuse compared to other ethnic and racial groups. Some of the factors that may contribute to this include trauma, poverty, racism, discrimination, violence and lack of health insurance. They also have a higher risk of developing heart disease. Limited resources, poverty, unemployment, low education rates and isolation are factors that contribute to those in rural areas having higher rates of substance abuse versus urban areas, according to the Rural Health Information Hub, an arm of the Health Resources and Services Administration. Participants who lived in rural areas were five times more likely to misuse prescription opioids than those from urban areas, a 2009 study found. The JAAA study researchers believe women may “face unique societal risks” that contribute to the increases in the study. These barriers include a higher rate in comorbid mood disorders (like anxiety and depression) and more challenges to get treatment for substance use, they said. They also believe the prevalence of substance use-related cardiovascular disease deaths in younger populations relates to an increase in substance use in these groups.
Tangent
Substance use has negative effects on heart health. Overall substance abuse can cause an irregular heartbeat, heart attack, issues pumping blood and inflammation of the heart, according to the American Addictions Centers. Researchers examined 11,268 patients with heart failure and found 15.2% were diagnosed with substance abuse, and methamphetamine, opioids and alcohol contributed the most. Heavy alcohol use increases the risk of stroke, hypertension, coronary heart disease, peripheral arterial disease, and cardiomyopathy, an Alcohol Research study found. Though consistent heavy drinking has an impact on heart health, binge drinking (heavy episodic drinking) can also cause stroke, heart attack, hypertension and sudden death. Researchers label cocaine as the “perfect heart attack drug” because it increases the risk of factors that contribute to heart attack and stroke, like an increase in blood pressure and the thickening of the heart’s wall. Opioids can cause low blood pressure, slow heart rate and fainting. Misusing and abusing prescription opioids can lead to dangerously low heart rate, heart attack and stroke.
