ECSTASY RAISES HEART BEAT, BLOOD PRESSURE

The increasingly popular ``club drug'' ecstasy may increase the risk
of cardiovascular complications, researchers report.

In a new study, modest doses of the illegal stimulant ecstasy, or
MDMA, increased heart rate, blood pressure and the heart's workload
as much as a medication used to stimulate the heart.

The increases in heart rate and blood pressure are similar to what
occurs during vigorous exercise, the study's principal investigator,
Dr. John Mendelson, of the University of California at San Francisco,
told Reuters Health.

``Although most people, especially young people, should have no
problem with this level of increase in heart rate and blood pressure,
anyone with...heart disease could have trouble,'' he said.

The study included eight people who had used ecstasy at least several
times in the past. In the first of four weekly sessions, participants
received an increasing intravenous dose of the drug dobutamine, which
has heart-stimulating effects.

During administration of the medication, patients underwent
echocardiography, which produces images of the heart in motion.

On three later occasions, the participants received one of two doses
of ecstasy or a placebo that did not contain any of the drug.

Heart rate and blood pressure were measured before and after each
dose. One hour after receiving the drug or a dummy pill, each person
underwent echocardiography.

The higher dose of ecstasy (which corresponds to an average dose of
the drug) increased heart rate by about 28 beats per minute, the
researchers report in the December 19th issue of the journal Annals
of Internal Medicine. And blood pressure also increased, with the
upper number (systolic pressure) rising by 25 millimeters of mercury
(mm Hg) and the lower number (diastolic pressure) rising by 7 mm Hg.
The increases in blood pressure and heart rate were similar to those
produced by dobutamine.

The lower dose of ecstasy did not raise blood pressure or heart rate.

When heart rate and blood pressure rise in natural situations, such
as while exercising, the heart becomes more efficient by pumping more
forcefully, according to Mendelson. But this did not happen when the
participants took ecstasy, he pointed out.

``What this means is that the heart is working harder but with less
efficiency,'' Mendelson explained. ``This probably decreases the
amount of 'cardiac reserve,' meaning that additional demands on
cardiac function may not be met.''

He noted that these changes may not have much of an effect on healthy
young people, but in older people or those with undiagnosed heart
disease, the effect could be ``quite serious.''

In the report, Mendelson and his colleagues note that the testing
conditions of the study varied a great deal from how ecstasy is
usually taken. They point out that many users take the drug while
dancing in hot, crowded nightclubs, and they may take more than one
dose or drink or take other drugs at the same time.

In addition, the effects of the drug may be different in people with
cardiovascular disease than in the people in the study, who were all
healthy.

In his remarks to Reuters Health, Mendelson commented that physical
activity like dancing may compensate for the lack of ecstasy's effect
on the heart's efficiency.