Believe it or not, misusing tobacco, alcohol, cocaine, cannabis, or similar substances can contribute to the development of heart failure. This chronic condition affects 6.7 million adults ages 20 and older in the United States.
Heart failure is the leading cause of hospitalizations in people over 65. It, and other heart disease complications, are leading causes of death.
This article explores how substance misuse contributes to congestive heart failure (CHF) and comprehensive approaches to address this critical issue.
[signup]
Understanding Congestive Heart Failure
Congestive heart failure (CHF) is an important topic to discuss, as heart disease is a prevalent health concern in the United States.
What is Congestive Heart Failure?
CHF is a type of heart disease in which the heart is unable to pump blood efficiently enough to meet the body's demands. When not treated, blood and fluids can collect in the feet, legs, and lungs over time.
Examples of the types of congestive heart failure include:
- Left-sided heart failure: the left side of your heart fails to function properly
- Right-sided heart failure: the heart's right ventricle doesn't pump enough blood
- High-output heart failure: your heart can't keep up with increasing demands for more blood
High-output heart failure is a rare form of the disease.
CHF Symptoms
The hallmark symptoms of CHF include:
- Chest pain
- Shortness of breath
- Waking in the night due to shortness of breath
- Heart palpitations
- Irregular heartbeat
- Swelling in the stomach, legs, or ankles
- Bloated or hard stomach
- Reduced appetite
- Upset stomach
- Nausea
- Fatigue during exercise
- Weight gain
- Dry, hacking cough
- Need to urinate at night
You might initially have mild to severe symptoms—or sometimes none. Symptoms sometimes come and go, though CHF tends to worsen gradually over time.
If you experience these symptoms, consult your provider for a proper diagnosis.
Complications of CHF
Complications linked to CHF include a heart attack, heart valve problems, fluid collection in the lungs, and pulmonary hypertension. You could develop malnutrition, kidney damage, or liver damage.
Diagnosis of CHF
Diagnosing CHF involves a discussion about medical history, lifestyle (including drug, alcohol, and tobacco use), symptoms, and medications—as well as a physical exam and diagnostic tests.
Examples include blood tests, genetic testing, an electrocardiogram (EKG), stress tests, cardiac catheterization, and imaging procedures (X-rays, echocardiogram, MRI, CT scan, MUGA scan, etc.).
Causes and Risk Factors of CHF
Potential causes and risk factors for congestive heart failure include:
Lifestyle Factors
- Tobacco use
- Cocaine and other recreational drug use
- Heavy alcohol consumption
- Alcohol use disorder
- Unhealthy eating habits (diets high in sodium and saturated fats)
- Lack of exercise
- Being over 65
Medical Conditions
- Coronary artery disease (CAD)
- Heart attack
- Congenital heart disease
- Cardiomyopathy
- High blood pressure
- Diabetes
- Kidney disease
- Metabolic syndrome
- Arrhythmias
- Lung problems
- Rheumatic fever
- Obesity (BMI higher than 30)
- Chemotherapy and other cancer drugs
A family history of congestive heart failure also increases the risk of developing the disease.
The Link Between Drug Abuse and Heart Health
Drug misuse and heart health are linked based on the following information.
How Drugs Affect the Heart
Studies suggest that substances such as cocaine, cannabis, tobacco, alcohol, and methamphetamines are particularly harmful to the heart and associated with heart failure or worsening clinical outcomes.
These substances affect the heart in various ways. For example, researchers suggest that heavy alcohol use can cause dilated cardiomyopathy, tobacco increases the risk of heart failure via coronary artery disease, and continued smoking worsens CHF outcomes.
The researchers also found that the intoxicating parts of cannabis (delta-9-tetrahydrocannabinol) increase the risk of vascular dysfunction and heart attacks. At the same time, cocaine may contribute to heart arrhythmias, heart attacks, and dilated cardiomyopathy.
Drugs can affect the heart by stimulating the central nervous system (CNS), increasing blood pressure and heart rate, reducing blood flow to the heart, damaging heart tissues—and increasing the risk of heart disease, other vascular diseases, a heart attack, or stroke.
When left untreated, substance abuse boosts the chance of long-lasting cardiovascular damage. Some types of heart problems are reversible after stopping substance misuse.
Specific Drugs Linked to CHF
Specified drugs linked to congestive heart failure include:
Cocaine
Cocaine can damage heart tissues and increase the risk of a heart attack, stroke, heart failure, or an aneurysm. It reduces blood flow to the heart, raises blood pressure, creates stiffer arteries, and increases heart rate.
Cocaine may boost the chance of heart infections and arrhythmias—and cause dysfunction on the left side of the heart.
Opioids
Opioids, including hydrocodone, oxycodone, morphine, codeine, heroin, fentanyl, and others, have been associated with an increased risk of infection in the heart's lining (infective endocarditis), particularly in individuals who inject drugs.
They're linked to cardiac arrest, may negatively affect individuals with acute coronary syndrome, and interfere with some medicines used to manage stroke and heart disease.
Alcohol
Heavy alcohol consumption (4 drinks for women and 5 drinks for men daily) is linked to arrhythmias, high blood pressure, heart failure, atrial fibrillation, alcoholic cardiomyopathy, stroke, cardiomyopathy, coronary heart disease, and peripheral artery disease (PAD).
In fact, heavy drinkers are 1.5 times more likely to die from a stroke than non-drinkers.
Methamphetamines
Amphetamines (including methamphetamines) can stimulate the central nervous system. They increase heart rate and blood pressure and boost the risk of heart failure and pulmonary hypertension.
Marijuana
Smoking marijuana can elevate heart rate, blood pressure, and the risk of heart disease and stroke. The longer-term and potentially more severe effects on the heart aren't fully clear (more research is needed).
Tobacco
Heavy and long-lasting tobacco use can also damage the heart. The American Heart Association suggests it increases the risk of heart attack, stroke, blood clots, coronary heart disease, high blood pressure, PAD, and aneurysms.
Mechanisms of Drug-Induced Congestive Heart Failure
Examples of the mechanisms of drug-induced congestive heart failure include:
Pathophysiology of CHF in Drug Abuse
Some of the many ways drug-induced congestive heart failure may occur involve harmful substances' contribution to:
- Abnormal heart rate
- Heart attacks
- Collapsed veins
- Bacterial infections of heart valves and blood vessels
- Changes in the central nervous system
- High blood pressure
- Arrhythmias
- Potential exposure to herbicides, poisons, talc, or other toxins
- Cardiomyopathy
- PAD
- Coronary heart disease
- Arterial plaque formation
- Atrial fibrillation
- Blood clotting
- Ischemia
- Endocarditis (inflammation)
- Stroke and other acute coronary events
- Alcoholic cardiomyopathy
- Aneurysms
- Pulmonary hypertension
Substance misuse can damage blood vessels and the heart muscle, contributing to many of these heart-failure-causing conditions. Other mechanisms of drug-induced heart failure include structural and electrical remodeling of heart tissues, leading to arrhythmias.
Individuals with pre-existing heart disease have a higher risk of mortality when misusing drugs and other harmful substances.
Case Studies and Clinical Evidence
Numerous research studies support a link between heart failure hospital visits and substance abuse.
One study suggests that substance misuse, particularly methamphetamine, opioid, and alcohol use, is common among individuals with heart failure. The researchers also found that methamphetamine and opioid abuse are associated with heart failure readmissions.
Studies demonstrate that drugs of abuse can cause early-onset heart disease in young patients.
For example, a case study involving a 23-year-old man with a history of illicit drug use experienced heart failure. He confirmed his history of cocaine use and tested positive for ecstasy and benzodiazepine.
Other cases include a 21-year-old male with amphetamine-induced acute decompensated heart failure (with an eight-year history of illicit methamphetamine drug use) and a 37-year-old patient admitted to the hospital with CHF caused by methamphetamine abuse-induced high blood pressure.
Researchers suggest that more than 15% of unique heart failure patients have been diagnosed with substance abuse.
Diagnosis and Treatment of CHF Caused by Drug Abuse
Diagnosing CHF caused by drug abuse requires an assessment of medical history, lifestyle habits, medications, and symptoms— and a discussion of prescription opioids, illicit drugs, tobacco, and alcohol use.
A physical exam and additional diagnostic tests are essential. Tests physicians may order drug testing, blood tests, chest X-rays, cardiac catheterization, MRIs, CT scans, and echocardiograms. Electrocardiograms, MUGA scans, stress tests, and genetic testing are also helpful.
Treatment Options
Treatment options for drug abuse-induced chronic heart failure depend on the severity of heart failure and may consist of medications, infusions, dietary changes, reduced dietary sodium, controlled fluid intake, body weight tracking, and other healthy lifestyle changes.
Some patients require heart surgery, an implanted device, or a heart transplant.
It's also essential to address substance abuse in treatment plans via additional medications or psychotherapy and lifestyle adjustments that promote sobriety.
Integrative and Functional Approaches
Functional medicine approaches for combating heart disease caused by substance abuse include eating heart-healthy foods, reducing sodium and sometimes fluids, diminishing stress, exercising regularly, and maintaining a healthy body weight.
If advised by a medical professional, take dietary supplements and manage any other underlying medical concerns.
It's important to avoid tobacco products, alcohol, and recreational drugs. Seek help from a mental health specialist, social support network, and support groups to maintain sobriety.
Prevention and Public Health Strategies
Prevention strategies are critical to reduce the risk of drug-related congestive heart failure.
Preventing Drug Abuse to Protect Heart Health
Education and awareness programs in schools and workplaces may help prevent drug abuse to protect the heart.
Community support initiatives and resources are highly beneficial to ensure people at risk of drug abuse or currently struggling with it have access to the programs needed to achieve and maintain lasting sobriety.
Policy and Healthcare Interventions
Government policies on drug control are essential, as eliminating easy access to illicit drugs and other addictive substances can reduce the risk of misuse and drug-related heart problems.
Healthcare professionals also play a role in heart disease prevention, as effective diagnoses are crucial to effectively treat heart failure caused by drugs, tobacco, or alcohol.
[signup]
Key Takeaways
- Drug abuse and congestive heart failure are linked, as substance misuse increases the risk of an array of heart problems and other chronic diseases.
- Proper diagnosis using drug testing, blood tests, imaging, and heart function testing is critical.
- Treatment includes medications, infusions, surgical procedures, drug abuse treatment programs, healthy lifestyle changes, and prevention efforts.
- Addressing substance abuse by recognizing its symptoms and providing resources for sobriety is critical to improving heart health outcomes and overall public safety.
- For more information about substance misuse or congestive heart failure, read our related articles, subscribe to our newsletter for updates on health topics, and leave comments or share your experiences below!
%201.svg){kind=logo}
