Too Young For Heart Disease?
My niece, age 32, has been diagnosed with heart disease. I assume this is unusual, but I wonder if smoking, drinking alcohol or using illicit drugs might play a role.
Andrew Weil, M.D. | March 26, 2021
Recent research from Baylor College of Medicine in Texas has associated use of a number of substances with premature heart disease in young women. These include alcohol, tobacco, and cannabis as well as cocaine and amphetamines. The investigation, published February (2020) in the journal Heart, found that young women who regularly use four or more of these substances are nine times more likely to develop heart disease than those who don’t use them.
The investigators defined “extremely premature” heart disease as a heart attack, angina or stroke before the age of 40 and defined “premature” heart disease as an event before age 55 in men and before age 65 in women. They used information on cases involving these conditions gathered from the 2014-2015 nationwide Veterans Affairs Healthcare database and the Veterans with Premature Atherosclerosis (VITAL) registry. Overall, they identified 135,703 people with premature heart disease and 7,716 with extremely premature heart disease. After accounting for such potentially influential factors as high blood pressure, diabetes, and high cholesterol, the investigators concluded that those who smoked tobacco were nearly twice as likely to have premature heart disease, while those who drank recreationally were 50 percent more likely to be affected than their peers. They also reported that, compared to unaffected patients, those who had premature heart disease were more likely to smoke (63 percent compared to 41 percent) drink (32 percent compared to 15 percent), use cocaine (13 percent vs. 2.5 percent), amphetamines (three percent vs. 0.5 percent) and cannabis (12.5 percent vs. three percent).
The investigation also found that cocaine users were almost 2.5 times as likely to have premature heart disease, while those who used amphetamines were nearly three times as likely to be affected. Cannabis users were more than 2.5 times as likely to have premature heart disease.
Overall, the Baylor team reported that the higher the number of substances used recreationally, the greater the risk. This ranged from twice the risk with the regular use of a single substance to a nine-fold higher risk with reported use of four or more.
Because the investigation was observational in nature, it couldn’t establish causality. Also, the researchers were not able to gather information on other important and potentially influential factors, such as the dose and duration of the recreational substances used.
Andrew Weil, M.D.
David Ramsey et al, “Recreational substance use among patients with premature atherosclerotic cardiovascular disease,” Heart, February 15, 2021