Question: Can cocaine affect my risk of heart failure?
Answer: Probably the most dangerous of all the drugs to take chronically is cocaine. We know that cocaine affects the way the sympathetic nervous system affects the heart. We know that it also causes the small blood vessels in the heart to have damage. In fact, it can lead to a heart attack. And when we as cardiologists see a heart attack in a young individual who has no family history of coronary artery disease or a minimal risk factor profile, we immediately begin to ask them about the use of cocaine.
Ultimately, if these small heart attacks occur over and over again, one can develop heart failure because of progressive damage to the heart muscle. Furthermore, it's very difficult to treat that form of heart failure, because, if you're using cocaine, one of the most important drugs we use to treat heart failure chronically, the beta blockers, can actually have life-threateningly serious effects in people who regularly use cocaine, so that we have to withhold that therapy if there is any suggestion whatsoever that the individual is using cocaine. So to summarize, I believe that cocaine, of all the illicit drugs, is the one that's most dangerous and one most likely to create heart failure.
We're hearing more and more every day about the new classes of amphetamines that are being used, particularly in rural parts of this country. And amphetamines cause the heart to beat much faster and cause the blood pressure to go up. And in overdoses of amphetamines, you can have very serious heart attacks that result from it. Amphetamines are not good for the heart at all. Although they have not been studied longitudinally to be an absolute cause of heart failure, it's easy to see how they could cause heart failure, because they essentially rev up the entire circulatory system.