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 Previous research in animals and humans has tied meth abuse to a
variety of potentially fatal cardiovascular problems including heart
failure, as well as damage to blood vessels in the brain, stroke,
high blood pressure and irregular heartbeat.
“Methamphetamine users and their communities should be aware that
stroke can occur in young people within hours or days of use, and
also as a long-term consequence,” said lead study author Dr. Julia
Lappin of the University of New South Wales in Australia.
“A key feature to look out for is the sudden development of a
headache, which is often extreme,” Lappin said by email. “Other
signs include confusion, numbness or loss of function down one side
of the body, and problems with speech and vision.”
For the current study, researchers reviewed results from 77
previously published reports of strokes associated with meth and
found that most are what’s known as hemorrhagic strokes, a less
common type that is caused by a ruptured blood vessel in the brain.
More often, strokes are caused by clots in the arteries that carry
blood to the brain. So-called ischemic strokes can strike at any age
but are far more common in the elderly.
Lappin’s team focused on strokes in people under age 45.
Altogether, the studies in the current analysis included 81
hemorrhagic strokes and 17 ischemic strokes, the researchers report
in the Journal of Neurology, Neurosurgery and Psychiatry.
Both types of stroke were roughly twice as common in men as in
women.
Eighty percent of strokes associated with the use of methamphetamine
were hemorrhagic strokes.
Hemorrhagic strokes typically account for only 40 percent to 50
percent of strokes in people under the age of 45 and just 15 percent
to 20 percent of strokes in older people, researchers note.
In one third of the cases, hemorrhagic stroke was associated with
vascular abnormalities, such as high blood pressure and inflamed
blood vessels, the study found. Repeated use of methamphetamine can
drive up blood pressure even in those whose blood pressure is normal
to start with, the study authors point out.
The risk of death was higher after a hemorrhagic stroke: one in four
people recovered completely, but one in three died. This compares
with complete recovery for one in five meth users and death in one
in five after an ischemic stroke.
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The study looked largely at individual cases of strokes, so it
didn’t offer fresh evidence on rates of stroke among methamphetamine
users.
While the study wasn’t a controlled experiment designed to prove
whether or how methamphetamine causes strokes, it’s possible that
spikes in blood pressure associated with the drug may make users
more susceptible to stroke, Lappin said.
Methamphetamine use can also make blood vessel walls weak and more
prone to rupture.
The results suggest that as methamphetamine use becomes more common
worldwide, it will also become a growing cause of stroke in young
adults, said Dr. Stephan Schurer of the University of Leipzig in
Germany.
“Stopping the abuse and more efforts in the prevention of abuse
could prevent fatal consequences,” Schurer, who wasn’t involved in
the study, said by email.
Quitting may help lower the stroke risk, but the long-term impact of
methamphetamine abuse still isn’t clear, doctors say.
“The risk for stroke will almost certainly go down with abstinence,”
said Dr. James Januzzi of Massachusetts General Hospital and Harvard
Medical School in Boston.
“While it is hard to predict a longer term risk, given short term
benefits from a heart and brain perspective, the faster a person can
avoid use of methamphetamine, the better,” Januzzi, who wasn’t
involved in the study, said by email.
SOURCE: http://bit.ly/2wT1Prq Journal of Neurology, Neurosurgery and
Psychiatry, online August 23, 2017.
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