Heart attacks and substance abuse
Heart attacks, or myocardial infarctions, occur when blood flow to the heart is abruptly interrupted, leading to damage or death of heart muscle due to lack of oxygen. A key contributor to heart attacks is coronary heart disease, often caused by plaque buildup in the coronary arteries. Certain substances, particularly tobacco, alcohol, cocaine, and methamphetamine, significantly increase the risk of developing coronary heart disease, thereby heightening the likelihood of a heart attack.
Tobacco use, whether through smoking or chewing, greatly elevates the risk by contributing to artery-clogging plaque and raising blood pressure. In contrast, moderate alcohol consumption may offer some heart protection, but excessive drinking can severely harm heart health. Cocaine abuse is particularly dangerous, as it can cause heart attacks shortly after use by constricting arteries and increasing the heart's oxygen demands. Similarly, methamphetamine abuse leads to severe cardiovascular issues, including a rapid heartbeat and damage to blood vessels, contributing to a higher long-term risk of heart attacks. Understanding these connections is crucial for both prevention and recovery, particularly for individuals engaging in or recovering from substance use.
Heart attacks and substance abuse
- ALSO KNOWN AS: Myocardial infarction
- DEFINITION: A heart attack is an abrupt interruption of the flow of blood to the heart that results in damage to the heart or death because of a lack of oxygen to the heart muscle. The foods and substances one takes in are significant contributors to coronary heart disease. Abuse of four addictive substances in particular—tobacco, alcohol, cocaine, and methamphetamine—increases the risks of a person developing coronary heart disease.
Heart Attack
A heart attack occurs when one of the coronary arteries (the vessels that supply blood to the heart) becomes blocked, thus preventing oxygen-rich, or oxygenated, blood from reaching the heart. A lack of oxygenated blood damages heart muscle and kills cells. The severity of a heart attack depends on how much heart muscle dies. For the patient, this could mean a long recovery period, permanent disability, or death. Coronary heart disease, the precursor of heart attack, is the leading cause of death for both women and men in the United States (US).
Coronary heart disease, also called coronary artery disease, atherosclerosis, or hardening of the arteries, is caused by deposits called plaques that form on the inside walls of coronary arteries. Plaques are a mixture of fat, calcium, cholesterol, and certain white blood cells. Plaques develop gradually over time. All adults have some plaques in their coronary arteries. Coronary heart disease develops when plaques are dense enough to restrict the normal, healthy flow of oxygenated blood to the heart. When a section of a plaque deposit suddenly ruptures, blood clots form naturally to seal the crack. A heart attack follows when a clot is large enough to block most of the entire artery.
Heart Attack and Tobacco
Cigarette smoking increases the amount of artery-clogging plaque. An international study published in 2019 found that chewing tobacco more than doubles the risk of heart attack, and smoking and chewing quadruples the risk. The study also found that cigarette smoking triples the risk of heart attack, and the risk increases with every cigarette smoked. Even after quitting, heavy smokers continue to be at risk of heart attack up to twenty years later, although quitting can reduce the risk. Within a year of quitting, former smokers have half the risk of developing coronary heart disease that smokers have.
When combined with other risk factors for heart attack, smoking and chewing become even more lethal. Smoking raises blood pressure, increases the likelihood of blood clot formation, lowers the body’s ability to benefit from exercise, and decreases high-density lipoprotein (HDL), the good cholesterol. HDL helps to remove bad cholesterol from arteries.
Heart Attack and Alcohol
A number of studies have suggested that moderate alcohol consumption, especially red wine, actually benefits the heart by reducing plaques in the coronary arteries and increasing HDL cholesterol. How this happens is unclear. Moderate consumption is one drink per day for women and two for men. One drink is generally established as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits. However, these assertions have been debated as most studies were observational and did not take into account genetic and individual variability, as well as differences in other lifestyle factors.
However, consuming more than three drinks per day or binge drinking has a toxic effect on the heart. In addition, heavy drinking over time adds fat to the blood, which increases cholesterol that can settle in the coronary arteries. Heavy drinking also leads to alcoholic cardiomyopathy, a condition in which the heart muscles are weakened, and the heart becomes less efficient in pumping oxygenated blood throughout the body and back to the heart. Furthermore, heavy drinking causes high blood pressure, one of the major risks for coronary heart disease.
Heart Attack and Cocaine
Cocaine abuse, whether long-term use or binging, also can lead to a heart attack. One study found that about 66 percent of heart attacks associated with cocaine abuse occurred within three hours of taking the drug, whether by inhaling it or taking it intravenously. A heart attack can occur anywhere from one minute to four days after consuming cocaine.
Cocaine triggers a heart attack in several ways. First, cocaine constricts the coronary arteries, thus reducing the amount of oxygenated blood flowing to the heart. There is no way to measure the amount of cocaine in the system or the duration of use before the constriction becomes so severe that it completely impedes the blood flow. Second, cocaine increases the heart’s need for oxygen by speeding up the heart rate and raising blood pressure. Third, cocaine adds to the deposits of plaques in the coronary arteries and fourth, cocaine produces changes in the blood that make the blood more likely to clot and block arteries.
Heart Attack and Methamphetamine
Methamphetamine (meth) is dangerous to the heart. Prolonged use or binging leads to rapid heartbeat, irregular heartbeat, inflammation of the heart muscle, inflammation of the lining of the heart, and inflammation of blood vessels within the heart. Meth increases blood pressure and damages blood vessels throughout the body. It also constricts coronary arteries, the major cause of heart attack.
Furthermore, meth’s damage to the heart and the entire cardiovascular system is often irreversible. Even after years of abstaining from the drug, meth users still run a higher risk of suffering a heart attack than the general population. Furthermore, because meth is so detrimental to every major organ in the body, meth abusers go through a much more difficult and longer recovery period from heart attack than do nonusers.
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