Cocaine-Associated Accelerated Hypertension and Renal Failure

Thakur, Vashu; Godley, Clifford; Weed, Sherrolyn G.; Cook, M. Eileen; Hoffman, E P.

doi:10.1016/s0002-9629(15)41845-2

Cited by 24 publications

(9 citation statements)

References 17 publications

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“…In addition, one half of patients with known coronary artery disease who presented to 29 community acute care hospitals with cocaine‐associated myocardial infarctions carried the diagnosis of hypertension 12 . Acute cocaine use has also been associated with the development of renal failure and intracerebral hemorrhage in patients with long‐standing hypertension 14–16 …”

Section: Discussionmentioning

confidence: 99%

“…12 Acute cocaine use has also been associated with the development of renal failure and intracerebral hemorrhage in patients with long-standing hypertension. [14][15][16] The extreme increases in arterial pressures after cocaine use that we observed in this cohort is likely accountable for the higher incidence of CV emergencies among individuals with hypertension. Cocaine use resulted in an average increase in systolic and diastolic BPs of 74 mm Hg and 30 mm Hg, respectively, with 8 of 10 patients reaching diastolic pressures !110 mm Hg.…”

Section: Discussionmentioning

confidence: 99%

“…Although long‐term cocaine use has not been associated with the development of chronic hypertension, the prevalence of hypertension in the cocaine‐using population remains as high as 18% in some studies 10,11 . Additionally, cocaine use in hypertensive patients has been associated with increased incidence of acute myocardial infarction, aortic dissection, renal failure, and intracerebral hemorrhage 12–17 …”

mentioning

confidence: 99%

“…10,11 Additionally, cocaine use in hypertensive patients has been associated with increased incidence of acute myocardial infarction, aortic dissection, renal failure, and intracerebral hemorrhage. [12][13][14][15][16][17] Despite these associations, the hemodynamic and arrhythmogenic effects of cocaine use have not been well described in the hypertensive population. The purpose of this study was to characterize variations in BP, heart rate, and ambulatory electrocardiograms (AECGs) in patients with hypertension during cocaine use.…”

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confidence: 99%

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Hemodynamic and Arrhythmogenic Effects of Cocaine in Hypertensive Individuals

Secemsky¹,

Lange²,

Waters³

et al. 2011

The Journal of Clinical Hypertension

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J Clin Hypertens (Greenwich). 2011;13:744–749. ©2011 Wiley Periodicals, Inc. Despite the increased risk of myocardial infarction, aortic dissection, and arrhythmias in patients with hypertension who use cocaine, the hemodynamic and arrhythmogenic effects of cocaine use have not been well characterized in this population. The authors hypothesized that patients with hypertension demonstrate extreme, transient changes in arterial pressures as well as new arrhythmic activity during cocaine use. Ambulatory blood pressures, heart rates, and electrocardiograms (AECGs) were recorded for 48 hours in 10 patients with a history of hypertension who smoke cocaine. Active cocaine use was identified through patient diaries and manual activation of the blood pressure cuff. Of the 10 patients studied (6 men, 7 African Americans, age 49±8 years), 8 were taking antihypertensive medications. The mean blood pressure prior to cocaine use was 126/77 mm Hg and average increase in systolic, diastolic, and mean arterial pressure after use was 74 mm Hg, 30 mm Hg, and 45 mm Hg, respectively (P<.0001 for all). There was no significant change in heart rate. AECGs demonstrated arrhythmic activity during cocaine use, including 6 patients with increased atrial and ventricular ectopy, 2 patients with episodes of nonsustained atrial tachycardia, and 1 patient with 3 episodes of nonsustained monomorphic ventricular tachycardia. Cocaine use resulted in extreme elevations in arterial pressures in patients with hypertension taking medication. Cocaine use was also associated with an increase in arrhythmic activity. These findings may underlie the heightened risk of myocardial infarction, aortic dissection, and potentially lethal arrhythmias in patients with hypertension who use cocaine.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Hemodynamic and Arrhythmogenic Effects of Cocaine in Hypertensive Individuals

Secemsky¹,

Lange²,

Waters³

et al. 2011

The Journal of Clinical Hypertension

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“…Another potential risk factor for severe hypertension or hypertensive emergency is abuse of vasoactive drugs such as cocaine or methamphetamine. 30,31 Using multivariate analysis, Shea et al demonstrated that illicit drug use among innercity populations is a significant risk factor for the development of hypertensive emergency. 27 In our study, 20% of patients reported the use of cocaine or other illicit drugs during the 72 hours prior to study enrollment.…”

Section: Discussionmentioning

confidence: 99%