Pubdate: Mon, 31 May 1999
Source: United Press International
Copyright: 1999 United Press International
Author: Lori Valigra

COCAINE TRIGGERS HEART ATTACKS

DALLAS, May 31 (UPI) - The risk of heart attack is 24 times higher the first
hour after using cocaine, according to the first large study of the long
suspected tie between the drug and heart disease.

"Cocaine significantly increases the risk of heart attack in individuals who
are otherwise at low risk," said  Dr. Murray Mittleman, a researcher at the
Institute for Prevention of Cardiovascular Disease at Beth Israel Deaconess
Medical Center in Boston and head of the research study.

He added, "This confirms the fact that cocaine is dangerous to the heart,
and the risk is very large. What  we've added to previous studies is the
magnitude  of the risk, which is 24 times greater, and the duration, which
is within one hour."

The study, which was funded by the National Heart, Lung and Blood Institute
and the American Heart Association, appears in the June 1 issue of
Circulation: Journal of the American Heart Association.

In addition, people who suffered cocaine-related heart attacks were younger
than the population at large suffering heart attacks.

"The average age of people in the study who suffered heart attacks soon
after using cocaine was only 44," Mittleman said. "That's about 17 years
younger  than the average heart attack patient."

Research in the past decade has suggested there is a strong cause-and-effect
relationship between using cocaine and heart attacks and strokes. But
Mittleman  said this is the first study to examine the direct short-term
effects of cocaine on the heart.

More than 30 million Americans have tried cocaine at least once, and there
are  about 5 million regular users, according to the National Institute on
Drug  Abuse.

The study is based on interviews of 2,664 men and 1,282 women who had
suffered a non-fatal heart attack between 1989 and 1996 at 64 medical
centers across the United States. The individuals ranged in age from 20 to
92. Thirty-eight people  reported using cocaine in the year prior to having
their heart attack, and nine  reported use of the drug within an hour before
their heart attack.

Of the 38 cocaine users who had heart attacks, 29 had no previous symptoms
of heart disease.

Cocaine users tend to be male and to smoke cigarettes, another major risk
factor for heart attack. Smoking and cocaine use were accounted for when
determining the cocaine-use risk for heart attack.

The researchers said cocaine might trigger a heart attack by causing a
sudden rise in blood pressure, heart rate and contractions of the left
chamber of the  heart. Cocaine also constricts the coronary arteries that
feed blood to the  heart, possibly obstructing blood flow to the heart and
brain.

Mittleman said more research is needed to see if the risk of heart attack
varies between one-time or repeat cocaine use. He and his colleagues also
plan  a similar study on the relationship between stroke and cocaine. 
Written by Lori Valigra in Cambridge, Mass.

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