Recreational Substance Use Linked to Premature Atherosclerotic CVD

TUESDAY, Feb. 16, 2021 -- Recreational substance use is associated with an increased likelihood of premature and extremely premature atherosclerotic cardiovascular disease (ASCVD), according to a study published online Feb. 15 in Heart.

Dhruv Mahtta, D.O., from the Baylor College of Medicine in Houston, and colleagues examined the association between all recreational substances and premature and extremely premature ASCVD. Data were compared for 135,703 patients with premature ASCVD; 7,716 with extremely premature ASCVD; and 1,112,455 with nonpremature ASCVD.

The researchers found that patients with premature ASCVD had significantly higher use of tobacco, alcohol, cocaine, amphetamine, and cannabis compared with patients with nonpremature ASCVD. In adjusted models, independent associations were seen for use of tobacco, alcohol, cocaine, amphetamine, cannabis, and other drugs with premature ASCVD (odds ratios, 1.97, 1.50, 2.44, 2.74, 2.65, and 2.53, respectively). Polysubstance use was associated with graded response, with the highest risk for premature ASCVD seen for patients with use of four or more recreational substances (odds ratio, 8.85). Among patients with extremely premature ASCVD, trends were similar. There were significant gender interactions noted with substance use, with stronger associations between recreational substance use and premature ASCVD observed for women than for men.

"Apart from optimization of metabolic risk factors, young adults and especially women with premature ASCVD should be screened thoroughly for the use of recreational substances, appropriately risk-stratified, and directed towards multidisciplinary pathways (pharmacological and nonpharmacological) to achieve and maintain cessation," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: February 2021