COCAINE CAN TRIGGER HEART ATTACKS

Middle-aged, hypertensive, overweight, under-exercised men who smoke
and, increasingly, post-menopausal women with similar characteristics
are the most likely candidates for coronary heart disease.

They are not likely to be cocaine snorters, which is just as well
since recent research from Harvard Medical School, published in
Circulation and The Lancet, has shown that the risk of having a heart
attack in the first hour of taking cocaine is nearly 24 times greater
than at other times. This may be an underestimate as, even after a
coronary, patients are reluctant to admit to the doctor that they have
been taking illegal drugs.

Dr Murray Mittleman, who led the research team, says that the
interesting point of the research is that cocaine has been shown to be
one of the most powerful triggers of a heart attack uncovered so far.
The effect of cocaine on the coronary arteries is thought to be
related to its effect of increasing the heart rate while constricting
the coronary arteries. This restricts the supply of blood to the heart
muscles when they need it most.

The same combination of effects could also result in the rupture of an
atheromatous plaque in a coronary artery, which could lead to a fatal
thrombosis.

The Lancet quotes Dr Richard Lange at the University of Texas in
Dallas, who says: "At one time cocaine was thought to be a very safe
drug but more recently it has been implicated as a trigger of acute
myocardial infarction (a coronary thrombosis resulting in destruction
of the heart muscle).

"Much of the data of this study corroborates what has been shown
previously but we haven't before now had an estimate of the risk."