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Stimulant-involved cardiovascular disease (CVD) mortality sharply increased from 2014-2023, particularly with methamphetamine and cerebrovascular disease. This trend highlights urgent needs for targeted prevention and intervention strategies.

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Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Toxicology

Background:

  • Cocaine and methamphetamine are potent cardiotoxic stimulants.
  • These drugs elevate risks for hypertension, coronary artery disease, arrhythmias, cardiomyopathy, and stroke.

Purpose of the Study:

  • To analyze trends in stimulant-involved cardiovascular disease (CVD) mortality in the U.S. from 2014 to 2023.
  • To examine CVD subtypes, stimulant types, population characteristics, and years of life lost (YLL).

Main Methods:

  • Utilized National Vital Statistics System data (2014-2023).
  • Analyzed age-adjusted mortality rates (AAMRs) for CVD as the underlying cause with stimulant contribution.
  • Employed Joinpoint regression for trend analysis (AAPC) and calculated YLL.

Main Results:

  • Stimulant-involved CVD mortality surged by 10.1% annually, contrasting with stable overall CVD mortality (0.2%).
  • Methamphetamine-involved deaths rose faster (13.8%) than cocaine-involved deaths (6.5%).
  • Cerebrovascular disease showed the steepest increase (15.9%), followed by hypertensive (12.1%) and ischemic heart diseases (7.9%).
  • Older adults (≥65 years) saw the highest increase (20.2%); non-Hispanic American Indian/Alaska Native populations had the highest AAPC (18.1%).
  • Nearly 1 million years of life lost (YLL) were attributed to stimulant-involved CVD, primarily among middle-aged males and non-Hispanic White individuals.

Conclusions:

  • Stimulant-involved CVD mortality has significantly increased, particularly affecting older adults and specific racial/ethnic groups.
  • Cerebrovascular disease demonstrated the most substantial rise among CVD subtypes.
  • Findings underscore the critical need for targeted prevention, screening, and intervention strategies to mitigate this growing public health crisis.