Cerebrovascular and Cardiovascular Complications of Alcohol and Sympathomimetic Drug Abuse

O’Connor, Ayrn D.; Rusyniak, Daniel E.; Bruno, Askiel

doi:10.1016/j.mcna.2005.06.010

Cited by 59 publications

(24 citation statements)

References 85 publications

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“…Drug abuse is an important preventable cause of stroke incidence and mortality among young adults [21][22][23] . Cocaine is a central nervous system (CNS) stimulant which can cause cardiac arrhythmias, hypertension, and thrombosis [21] .…”

Section: Discussionmentioning

confidence: 99%

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Recent Racial/Ethnic Disparities in Stroke Hospitalizations and Outcomes for Young Adults in Florida, 2001–2006

Pathak¹,

Sloan

2009

Neuroepidemiology

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Background: Black-white disparities in stroke mortality are well documented, but few recent studies have examined racial/ethnic disparities in stroke hospitalizations among young adults. We analyzed recent (2001–2006) trends in stroke hospitalizations and hospital case-fatality for black, Hispanic, and white adults aged 25–49 years in Florida. Methods: Hospitalization rates were calculated using population estimates from the census, and hospital discharges with a primary diagnosis of stroke (ICD-9-CM 430, 431, 434, 436) (n = 16,317). Multivariate logistic regression modeling was used to examine racial/ethnic disparities in stroke mortality prior to discharge, after adjustment for patient sociodemographics, stroke subtype, risk factors, and comorbidities. Results: Age-adjusted stroke hospitalization rates for blacks were over 3 times higher than rates for whites, while rates for Hispanics were slightly higher than rates for whites. Hemorrhagic strokes were proportionally greater among Hispanics compared with blacks and whites (p < 0.0001). Blacks were most likely to have diagnosed hypertension (62.3%), morbid obesity (10.9%) or drug abuse (13.6%). Whites were most likely to have diagnosed hyperlipidemia (21.0%), alcohol abuse (9.5%), and to be smokers (30.6%). The in-hospital fatality rate for all strokes was highest among blacks (10.0%) compared with whites (9.0%) and Hispanics (8.2%). After adjustment for age, gender, insurance status, and all diagnosed risk factors and comorbidities, the black excess was no longer observed [odds ratio (OR) 1.01, 95% confidence interval (CI) 0.88–1.15, p = 0.93]. However, the Hispanic advantage in case-fatality was strengthened (OR 0.66, 95% CI 0.55–0.79, p < 0.0001). Separate case-fatality analyses for ischemic versus hemorrhagic strokes yielded similar results. Conclusions: Our study found a strong and persistent black-white disparity in stroke hospitalization rates for young adults. In contrast, rates were similar for Hispanics and whites. Multivariate adjustment explained the 15% excess case-fatality for blacks; the short-term mortality advantage among Hispanics was strengthened after adjustment.

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Section: Discussionmentioning

confidence: 99%

“…Cocaine is a central nervous system (CNS) stimulant which can cause cardiac arrhythmias, hypertension, and thrombosis [21] . In the Baltimore-Washington Young Stroke Study, the frequency of drug-associated strokes during 1988-1991 was 12.1% for ischemic strokes [24] and 13.3% for intracerebral hemorrhages [25] .…”

Section: Discussionmentioning

confidence: 99%

Recent Racial/Ethnic Disparities in Stroke Hospitalizations and Outcomes for Young Adults in Florida, 2001–2006

Pathak¹,

Sloan

2009

Neuroepidemiology

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“…Alcoholic cardiomyopathy may develop in patients with a long history of alcoholism [4,28]. It is estimated that the equivalent of six drinks daily for longer than 10 years would significantly increase the risk of cardiomyopathy [32]. Several studies confirming the cardioprotective effect of regular light to moderate drinking found an increased risk for major coronary events in drinkers with an episodic heavy drinking pattern compared with abstainers, even when the overall volume of drinking was low [33].…”

Section: Cardiac and Vascularmentioning

confidence: 99%

“…This association is consistent with the increased clotting, lowered threshold for ventricular fibrillation, and elevation of low-density lipoproteins that occur after heavy drinking. Although the association between alcohol consumption and ventricular arrhythmia has not been quantified, 30% to 60% of patients with atrial fibrillation show a history of alcohol consumption [32]. An attempt to control for the influence of lifestyle on the development of cardiac and vascular disease associated with alcohol consumption was made in the evaluation of the incidence of cases of myocardial infarction (MI), fatal CHD, and stroke in more than 50,000 participants in the Health Professionals Follow-up Study between 1986 and 2002.…”

Section: Cardiac and Vascularmentioning

confidence: 99%

Medical comorbidity and alcohol dependence

Mannelli

Pae²

2007

Curr Psychiatry Rep

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Alcohol dependence (AD) and, more generally, alcohol use disorders (AUDs) predispose individuals to adverse consequences that extend beyond the expected damage from alcohol-direct toxicity. Research has shown that the relationship of alcohol use to health outcomes is complex, as is the etiology of AD, and that the individual and social costs of alcohol-related problems are increasing. We review advances in alcohol science that explore the role of alcohol consumption and patterns of drinking in a range of medically comorbid conditions. Although new knowledge can assist in the development of appropriate medical management strategies, AUDs account for an important percentage of the global burden of disease and require approaches that are not uniquely focused on the identification and treatment of AD.

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“…These data support the idea that cocaine use could increase the vulnerability to the development of ethanol dependence (Rubio et al, 2008) and vice versa. A careful examination of the clinical data indicates that the concurrent use of ethanol and cocaine is associated with increased mortality and morbidity resulting from cerebro-and cardiovascular complications (Cami et al, 1998;O'Connor et al, 2005;Randall, 1992;Vroegop et al, 2009) as well as hepatotoxicity and compromised mental status (Odeleye et al, 1993;Vanek et al, 1996). Taken together, these facts underscore the urgency and necessity to develop pharmacotherapeutic interventions for alcoholism and the comorbidity of alcoholism with cocaine use.…”

Section: Introductionmentioning

confidence: 99%

Cocaine reverses the naltrexone-induced reduction in operant ethanol self-administration: The effects on immediate-early gene expression in the rat prefrontal cortex

et al. 2012

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Cerebrovascular and Cardiovascular Complications of Alcohol and Sympathomimetic Drug Abuse

Cited by 59 publications

References 85 publications

Recent Racial/Ethnic Disparities in Stroke Hospitalizations and Outcomes for Young Adults in Florida, 2001–2006

Recent Racial/Ethnic Disparities in Stroke Hospitalizations and Outcomes for Young Adults in Florida, 2001–2006

Medical comorbidity and alcohol dependence

Cocaine reverses the naltrexone-induced reduction in operant ethanol self-administration: The effects on immediate-early gene expression in the rat prefrontal cortex

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