Cardiovascular Effects of Cocaine: Focus on Hypertension

Cocaine, a naturally occurring alkaloid, has increasingly been implicated in a myriad of medical complications. The majority of these relate to cardiovascular effects of the drug, a potent sympathomimetic. In addition, cocaine has effects on endothelin-1, the sodium channel, and nitric oxide which further enhance its untoward cardiovascular effects. The cardiovascular effects of cocaine include myocardial ischemia or infarction, ventricular arrhythmias and sudden death, cardiomyopathy, cerebral infarction or hemorrhage, and acute hypertension. Although hypertension has been described in the offspring of cocaine using mothers, two recent studies have not found an increased prevalence of chronic hypertension in adults. Nonetheless, long term abuse of cocaine can lead to the various forms of target organ damage usually associated with untreated essential hypertension, presumably due to frequent intermittent and severe elevations in blood pressure. (c)1999 by Le Jacq Communications, Inc.