CARDIAC COST OF A ROCK LIFESTYLE

T he police have reported that there was no evidence of drugs in the hotel
room in which the musician John Entwistle, of the Who, died in Las Vegas.
Entwistle was 57. Perhaps the clue to his comparatively early death lies in
studying the changes in his photographs.

When he was a rocker in the Seventies he appeared youthful and vital. By
the time he was in his late forties he looked ten years older than his real
age. There can be few lifestyles more ageing than that of a Seventies rock
star. Constant travel, little sleep, drugs, alcohol and tempestuous
marriages are not likely to produce a latter-day Dorian Gray.

Research published in the BMJ some years ago showed that the best guide to
someone's expectancy of life was how young they looked a " better even than
knowing their cigarette-smoking habits or their blood pressure, although
both make important contributions to a patient's appearance.

The suggestion is that Entwistle died from a heart attack. Although there
is no evidence that drugs were an immediate cause of death, this doesn't
exclude the possibility that cannabis smoking and/or cocaine smoking in the
past may not have contributed to his eventual death from cardiovascular
disease.

The prestigious journal Circulation reported last year that not only is the
incidence of heart attacks nearly five times higher in the hour after
smoking cannabis, but that cannabis also has a long-term effect on the
coronary arteries. Research has shown that it increases the amount of
atheroma, the soft plaques of fatty material which line and narrow the
blood vessels supplying the muscles of the heart and, it is suggested,
alters their consistency.

The atheromatous plaques in cannabis smokers are softer and more liable to
rupture than those of contemporaries who don't smoke the drug. The increase
in blood pressure after smoking cannabis may precipitate the rupture in
these blood vessels.

But cannabis smoking is not the only recreational drug which increases the
chance of dying from a heart attack. In the hour or two after snorting
cocaine, the chance of having a fatal thrombosis increases by a factor of 25.

Both cocaine and cannabis increase heart rate and blood pressure, but
cocaine also causes spasm in the coronary blood vessels. This spasm may
restrict the blood supply to the heart muscle, but may also induce a heart
attack. Similar troubles in the cerebral blood vessels may bring on a stroke.

Cocaine is also notorious for inducing cardiac arrhythmia, " an irregular
action of the heart, which can be another cause for a stroke.

At the age of 25, when the risk of having a heart attack is very low,
raising the risk factor by five or even 25 times may not present the drug
user with any great hazard. However, by the time a person reaches their
late fifties, voluntarily raising any such risk by five, let alone 25
times, makes it a major consideration.