In the 24 hours after using cocaine,
a young adult's risk of a stroke increases almost sevenfold, according to a new
The risk for stroke associated with cocaine
use is much higher than with other stroke risk factors, such as diabetes, high
blood pressure and smoking, said the researchers from the University of
Maryland School of Medicine.
"Cocaine is not only addictive, but it
can also lead to disability or death from stroke," said lead researcher
Yu-Ching Cheng, an assistant professor of medicine at the University of
Maryland School of Medicine.
Cheng said physiological reasons might
account for the increased risk of stroke.
"Cocaine use can result in the
constriction of blood vessels; increased heart rate, body temperature and blood
pressure; and decreased oxygen supply to the brain," said Cheng, who also
is a research scientist at the Baltimore Veterans Affairs Medical Centre.
"These physiological effects may boost the
risk of stroke."
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It is estimated that about 13 000 Americans
aged 15 to 44 suffer a stroke each year, Cheng said.
"Based on the data in our study, we
estimated that about 300 young stroke cases are associated with acute cocaine
use each year, but the estimate may vary depending on the prevalence of cocaine
use in different sub-populations," she said.
With few exceptions, every young stroke
patient should be screened for drug abuse when admitted to the hospital, Cheng
said. Only a third of these patients currently get tested for drug use,
according to the study.
The findings were scheduled to be presented at the American Stroke Association International Stroke Conference in
San Diego. Research presented at medical meetings should be viewed as
preliminary until published in a peer-reviewed journal.
Dr Scott Krakower, assistant unit chief of
psychiatry at Zucker Hillside Hospital in Glen Oaks, New York, said, "Cocaine
is a very potent substance, and is often sought out by young adults for its
thrills and extreme highs."
Some young adults battling anxiety, mood
disorders or ADHD
may attempt to use the drug to ease social anxiety, improve their mood or stay
alert, he said.
"They do not realise the paradoxical
effects it may have, including worsening mood, anxiety and behaviour,"
Krakower said. "In addition, it may lead to serious consequences at any
time, like acute stroke."
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For the study, Cheng's team compared more
than 1000 people aged 15 to 49 who had strokes between 1991 and 2008 with a
similar number of people in the general population.
More than 25% of the people in both groups
said they had a history of using cocaine. Men were twice as likely to have used
the drug as women, the researchers said.
Similar for whites and blacks
Although a history of cocaine use was not
linked with the risk of having a stroke, using cocaine in the previous 24 hours
was associated with an increased risk of having a stroke, they found.
The risk of having a stroke was six to
seven times higher within 24 hours of using cocaine. The risk was similar for
both whites and blacks, the researchers said.
Although the study found an association
between using cocaine and an increased risk of stroke in younger adults, it did
not prove a cause-and-effect link.
One expert, however, noted the strength of
"Cocaine comes up over and over as
being implicated in stroke in people of all ages," said Dr Richard Libman,
vice chairman of neurology at Long Island Jewish Medical Centre in New Hyde
Park, New York.
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Decrease of blood to the brain
Cocaine wreaks havoc on the heart, Libman
said. "It can cause all kinds of abnormal rhythms that can cause blood
clots to form and cause a stroke," he said.
"In addition, cocaine may also have a
direct effect on blood vessels in the brain, causing them to go into spasm and
narrow, resulting in a decrease of blood to the brain," Libman said.
"Cocaine may even cause inflammation in the blood vessels of the brain,
and cause stroke."
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