The observational study, published in the journal Heart, looked at nationwide Veterans Affairs health-care data covering 1.2 million patients who receive primary care from the federal department. Researchers focused on heart attack, stroke or angina in men 55 and under and women 65 and under.
About 135,000 of the veterans experienced an early cardiac event, and 7,700 of those had an event before they turned 40.
The researchers found an association between recreational use of legal and illicit substances and premature heart disease. Tobacco users were almost twice as likely to develop early heart disease than nonsmokers, and amphetamine users were almost three times as likely. Alcohol, cocaine and cannabis use were associated with early heart disease, as well.
The likelihood of an early stroke, heart attack or other cardiac event rose dramatically for those who used multiple substances. People who regularly used four or more substances were nine times more likely to be affected than those who didn’t.
Women who used substances were more likely to get premature heart disease than men, although their cutoff age was later and they made up less than 1 percent of the sample size.
Although the study controlled for factors such as gender, race, diabetes and hypertension, it didn’t incorporate data about the dosage of substances used or how long the patients had used them. Observational studies can show correlations, but they don’t prove cause and effect.
“We are only young once, and we should do everything in our power to maintain that state as long as we can,” write a group of LSU Shreveport researchers in a linked editorial. They point to substance use’s links to premature aging in cells, arteries and blood vessels.
For a better picture of just how substance use and early cardiovascular disease are linked, they write, it is essential to develop better methods of gathering data about the duration and dosage of people’s substance use and broaden education and screening nationwide.