While heart disease deaths have decreased overall, there has been a notable rise in those related to substance use.
In a new study published in the Journal of the American Heart Association, researchers reveal a concerning trend of substance use-related cardiovascular disease deaths in the United States, showing a steady annual increase of 4% from 1999 to 2019. This revelation comes despite an overall decrease in cardiovascular disease deaths during the same period, presenting a complex challenge for healthcare professionals and public health initiatives. Several factors can contribute to the development of heart disease, including high blood pressure, high cholesterol levels, and smoking. Alcohol and many different drugs of abuse can also negatively impact the heart. In this case, the research team focused solely on SUD induced heart disease.
Dr. Dmitry Abramov, the study’s senior author and a cardiologist at Loma Linda University Health, highlighted the consistency between the study results and the real-world observations in clinical settings. Notably, alcohol and opioids were identified as the substances most commonly associated with cardiovascular deaths. However, the study underscored a particularly pronounced rise in cardiovascular deaths related to stimulants, primarily amphetamines, indicating a growing concern that demands attention.
The researchers delved into publicly available data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) database, which compiles death certificate data across the U.S. from the National Vital Statistics System. Their analysis revealed several key findings:
- The overall rate of SUD related cardiovascular deaths surged from 9.9 per 100,000 population in 1999 to 21.4 per 100,000 population in 2019, equating to an average annual increase of 4%.
- Substantial increases in substance use-related deaths were noted across various subgroups, with significant impacts observed among women, American Indian or Alaskan individuals, younger adults (25-59), those residing in rural areas, cannabis users, and psychostimulant users.
- Alcohol accounted for 65% of cardiovascular disease deaths related to substance use, followed by opioids (13.7%), cocaine (9.8%), stimulants (6.5%), sedatives (4.1%), and cannabis (0.5%).
- The highest rate of change was observed in adults aged 25-39 (5.3%), followed by adults aged 55-69 (4.9%).
- While cardiovascular disease mortality rates related to substance use were higher in men than women, women demonstrated larger increases during the study period.
- Noteworthy increases were found among individuals ages 25 to 39, with specific attention drawn to racial and ethnic groups, including white adults and American Indian/Alaska Native adults.
The study’s findings highlighted the unexpected rise among specific demographic groups, emphasizing the need to identify high-risk populations for targeted preventive measures. The significant increases in SUD related cardiovascular deaths in rural areas were linked to socioeconomic vulnerabilities and differences in healthcare access and substance abuse treatment.
However, the study acknowledged limitations, including potential miscoding errors on death certificates and the absence of information regarding cardiovascular disease risk factors or family histories in the analyzed data.
Dr. Abramov emphasized the necessity for additional public health efforts to comprehensively address substance use in the U.S. These efforts should encompass clinician and patient education while addressing socioeconomic factors contributing to substance use. The hope is that such initiatives will not only reverse the concerning trends in cardiovascular disease deaths associated with substance use but also contribute to an overall reduction in the burden of heart disease and stroke.