[no subject]

Cardiac cost of a rock lifestyle
Medical Briefing by Dr Thomas Stuttaford

The police have reported that there was no evidence of
drugs in the hotel room in which the musician John
Entwistle, of the Who, died in Las Vegas. Entwistle
was 57. Perhaps the clue to his comparatively early
death lies in studying the changes in his photographs.

When he was a rocker in the Seventies he appeared
youthful and vital. By the time he was in his late
forties he looked ten years older than his real age.
There can be few lifestyles more ageing than that of a
Seventies rock star. Constant travel, little sleep,
drugs, alcohol and tempestuous marriages are not
likely to produce a latter-day Dorian Gray. 

Research published in the BMJ some years ago showed
that the best guide to someones expectancy of life
was how young they looked  better even than knowing
their cigarette-smoking habits or their blood
pressure, although both make important contributions
to a patients appearance. 

The suggestion is that Entwistle died from a heart
attack. Although there is no evidence that drugs were
an immediate cause of death, this doesnt exclude the
possibility that cannabis smoking and/or cocaine
smoking in the past may not have contributed to his
eventual death from cardiovascular disease. 

The prestigious journal Circulation reported last year
that not only is the incidence of heart attacks nearly
five times higher in the hour after smoking cannabis,
but that cannabis also has a long-term effect on the
coronary arteries. Research has shown that it
increases the amount of atheroma, the soft plaques of
fatty material which line and narrow the blood vessels
supplying the muscles of the heart and, it is
suggested, alters their consistency. 

The atheromatous plaques in cannabis smokers are
softer and more liable to rupture than those of
contemporaries who dont smoke the drug. The increase
in blood pressure after smoking cannabis may
precipitate the rupture in these blood vessels. 

But cannabis smoking is not the only recreational drug
which increases the chance of dying from a heart
attack. In the hour or two after snorting cocaine, the
chance of having a fatal thrombosis increases by a
factor of 25. 

Both cocaine and cannabis increase heart rate and
blood pressure, but cocaine also causes spasm in the
coronary blood vessels. This spasm may restrict the
blood supply to the heart muscle, but may also induce
a heart attack. Similar troubles in the cerebral blood
vessels may bring on a stroke. 

Cocaine is also notorious for inducing cardiac
arrhythmia  an irregular action of the heart, which
can be another cause for a stroke. 

At the age of 25, when the risk of having a heart
attack is very low, raising the risk factor by five or
even 25 times may not present the drug user with any
great hazard. However, by the time a person reaches
their late fifties, voluntarily raising any such risk
by five, let alone 25 times, makes it a major
consideration.


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-Brian in Atlanta
The Who This Month!
http://www.thewhothismonth.com
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