According to a study published in the Journal of Addiction Medicine, it is now a proven fact that people who choose to use cocaine are at much greater cardiovascular risk. The study shows that stopping or reducing cocaine use is associated with decreased levels of endothelin-1 (ET-1). ET-1 is a protein that plays a key role in the development of coronary artery disease. The Journal of Addiction Medicine is the official journal of the American Society of Addiction Medicine and is published by Wolters Kluwer.

The latest findings explain the high rate of atherosclerosis or the hardening of the arteries associated with cocaine use. Funded by the National Institute on Drug Abuse, part of the National Institutes of Health, the study focused on how stopping or reducing cocaine use affected levels of the cardiovascular risk marker ET-1.

In previous research, Dr. Shenghan Lai and colleagues of Johns Hopkins School of Medicine found that ET-1 levels are notably higher in chronic cocaine users. The researchers found that stopping or reducing cocaine use effectively prevents the endothelial damage that marks the first step in the hardening of the arteries and advanced cardiovascular disease.

"The findings of this study revealed a possible association of cocaine abstinence/reduction with lowered ET-1 levels, which suggests that such changes in cocaine use might be beneficial for preventing endothelial damage," Dr. Lai said.

The study focused on 57 African-American patients with long-term cocaine use, most of whom had HIV infection. On initial imaging scans, all had less than 50% narrowing of the coronary arteries. After six months, 28 of the patients remained abstinent from cocaine. The abstinence was confirmed by urine testing. This group had significantly reduced ET-1 levels, compared to those who continued to use cocaine. Patients who reduced but did not stop their cocaine use also had lower ET-1 levels.

Cocaine users are at high risk of premature atherosclerosis and cardiovascular disease. Despite extensive research, the mechanisms linking cocaine use with the development and progression of atherosclerosis have not been well explained. More research will be needed to determine if the lower levels of endothelial damage markers reduce the high rates of cardiovascular disease and death associated with cocaine use.