Whitney Houston Autopsy Reveals Heart Disease

“But even single use of cocaine can cause spasm of the arteries, can cause heart attacks, stroke, and sudden cardiac death,” she told MedPage Today.

She said it is unclear whether cocaine can accelerate development of cardiovascular disease. “We think that cocaine does cause dysfunction of the arteries such that when an artery should normally relax it instead constricts. Chronic use may cause stressors on the heart such as hypertension, it can cause vasospasm that can cause damage the artery and allows for cholesterol-related atherosclerosis to develop,” she said.

Smoking a major risk factor for Coronary heart disease:

1.  A smoker has a 2 to four fold greater risk of sudden heart attacks and sudden cardiac death than a non smoker.

2.  If you have already heart attack but still you are smoking your chance of having next heart attack within one year is doubled.

3.  Smoking leads to frequent angina attacks in CHD patients, whereas, quit smoking reduces angina attacks.

4.  Men under 45 years of age who smoke 25 or more cigarettes a day are 15 times as likely to die from CHD as compared to non smokers of the same age

5.  Smoking- itself a great risk factor for heart attack. In women the incidence of heart attack and death is higher as compared to men among the smokers Women who smoke even 1-4 cigarettes a day had a 2, 5 fold increased risk of fatal CHD.

6.  Using of contraceptive pills and smoking at a time increases the risk for CHD in women 30 times higher as compared to the women using contraceptives alone.

7.  Passive smoking is that when the nonsmokers inhale other people’ smoke. Heavy passive smoking is very harmful to our heart. Secondhand smoke could increase the risk of coronary heart disease, a major cause of heart attacks,” said Dr Timo Kuusi of Helsinki University in Finland, reporting in the journal Circulation. Passive smoking has a serious and is a real killer.

“Whitney Houston was relatively young, but people have to realize that coronary disease starts early in life - even in the first two decades of life,” Foody said. “Everyone has to understand the risk factors for heart disease, and particularly women have to recognize symptoms that could be responsible for heart disease.”

Donna Arnett, PhD, president-elect of the American Heart Association, and chairman of epidemiology at the University of Alabama at Birmingham, told MedPage Today that numerous studies indicate that cardiovascular disease occurs as early as 8 years of age where fatty streaks - the first signs of cardiovascular disease have been observed.

“So the finding of 60% blockages in the coronary arteries of a 48-year-old woman - such as Whitney Houston - is really not that surprising,” she said. “The link between cocaine and atherosclerosis is not well defined, but there certainly is a link between cocaine and myocardial infarction. That has been reported as far back as the mid-1990s. These myocardial infarcts can be caused by arrhythmias, not necessarily by atherosclerosis.”

Arnett suggested that if a person with atherosclerosis was using cocaine “it would be a bad combination.” If a person has narrowed arteries and takes a drug that causes vasospasm, it would not take a major spasm, to occlude and artery, she suggested.

“Atherosclerotic disease remains the leading killer of men and women,” said Gregg Fonarow, MD, director of the Ahmanson-UCLA Cardiomyopathy Center and associate chief of the UCLA Division of Cardiology. “Usually women in their 40s and 50s who present with coronary artery disease have traditional risk factors such as high blood pressure, obesity, smoking, diabetes or a family history of cardiovascular disease.”

“But it is also known that chronic cocaine use can accelerate the cardiovascular disease process,” Fonarow told MedPage Today. “And you can find much more extensive coronary artery disease than you would expect. There are multiple mechanisms by which cocaine can lead to sudden, unexpected sudden death. Arteries that are narrowed are more likely to have spasms.”

Fonarow also said that amphetamines are also considered potential accelerators of cardiovascular disease. He said narcotics such as morphine and sedatives can affect the heart in other ways such as by suppressing respiration, causing respiratory arrest and subsequently cardiac arrest.

He said these drugs can also cause an irregularities in heart rate such as QTc prolongation.

He suggested that a patient with a 60% narrowing in coronary arteries would not likely be a candidate for a percutaneous coronary intervention, but would likely be treated with lifestyle changes or treatment with statin or other medications.

“In Whitney Houston’s case, there a multiple potential contributors to her death, but how it all ties together and what was the actual mechanism still has not been determined,” said Fonarow, a spokesperson for the American Heart Association. “It may never be fully sorted out.”

“The lesson here is that these recreational drugs such as cocaine can cause serious damage to the heart, and even with single use can be fatal,” Fonarow said. “There are risks to these drugs.”

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By Ed Susman, Contributing Writer, MedPage Today

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