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Vascular disease in cocaine addiction
Keren Bachi1, Venkatesh Mani2, Devi Jeyachandran3
1Brain Imaging Center (BIC), Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
Atherosclerosis
|April 2, 2017
Summary
Chronic cocaine use causes vascular damage, including impaired blood flow and atherosclerosis. Early detection and preventive treatments are crucial for aging individuals with cocaine use disorder to manage these silent vascular impairments.
Area of Science:
- Cardiovascular Science
- Neuroscience
- Toxicology
Background:
- Cocaine is a potent vasoconstrictor that triggers immune responses and cytokine elevation.
- Chronic cocaine use leads to functional brain impairments, potentially due to vascular pathology.
- The aging 'crack generation' now faces evident vascular consequences from past cocaine use disorder.
Purpose of the Study:
- To review postmortem and in vitro studies on cocaine-induced vascular toxicity.
- To highlight mechanisms of cocaine's vascular effects, including vasoconstriction, endothelial dysfunction, and atherosclerosis.
- To discuss early detection and treatment strategies for vascular impairments in cocaine addiction.
Main Methods:
- Systematic review of major postmortem and in vitro studies.
- Literature search using PubMed and Academic Search Complete with relevant terms.
- Analysis of findings on cocaine's acute, chronic, and secondary vascular effects.
Main Results:
- Cocaine induces vasoconstriction, endothelial dysfunction, and accelerated atherosclerosis.
- Vascular effects are multifactorial, involving hypertension, impaired hemostasis, thrombosis, and altered blood flow.
- Treatment considerations include supportive care, benzodiazepines, phentolamine, and avoidance of beta-blockers.
Conclusions:
- Cocaine's vascular toxicity, exacerbated by comorbidities and aging, necessitates early detection of vascular disease.
- There is a public health imperative to identify pre-symptomatic markers for vascular impairments in cocaine addiction.
- Preventive treatment is essential to mitigate silent disease progression in this population.