Stimulants Blood pressure 199/101, and HR 117

[Båtmannen]

The idea this behaviour isn't causing your heart permanent damage is delusional. I strongly dislike a number of posts in this thread that downplay the well-documented risks of meth abuse on the cardiovascular system (both acute and chronic).

However OP it sounds like you don't care, given your continued abuse of stimulants. If you can't stop this, you need to ask for help and/or drug rehab.

Where did I say that my heart doesn't take damage from this?

I did an EKG just a few hours ago. No problems.

 

[Slow_Mobius]

However OP it sounds like you don't care, given your continued abuse of stimulants. If you can't stop this, you need to ask for help and/or drug rehab.

I think this is really good advice. You had a hypertensive crisis from using amps. Having another could kill you regardless of your EKG results. I think you need to consider getting help before you kill yourself abusing stims.

 

[keeping]

I think you need to consider getting help before you kill yourself abusing stims.

real talk

 

[CFC]

I did an EKG just a few hours ago. No problems.

Unfortunately an EKG is not a comprehensive measure of direct heart damage. It won't even necessarily reveal electrophysiological changes either, as it's a very brief 'snapshot' of heart behaviour. A measure of troponin levels might be more revealing in the short-term.

But still neither can determine whether you're causing underlying electrophysiological damage or the development of cardiac fibrosis, valvular damage, a small clot (could lead to stroke/thrombosis), aortic enlargement, ventricular tachycardia/fibrillation (among a number of other potential risks). The latter could kill you pretty quick.

 

[CFC]

You didn't damage anything, that's your heart complaining that its "moment of glory" is coming to an end. Just a normal muscle pain response to decreasing neurotransmitters. Like when you go to the gym, you don't feel the muscle pain until the next day, that doesn't mean you torn something. When you tear a muscle you'll know it in seconds.

Chest pain after an amphetamine abuse episode is so common that even talking about a potential heart damage is day dreaming and perhaps the result of amphetamine induced paranoia. Within 100,000 amphetamine chest pain cases maybe 1 or 2 would have sustained heart damage and that's most likely due to a genetic flaw that was triggered by the abuse. Your heart is there to deliver in extreme, burst effort situations, like running away from a lion, it's genetically programmed to be brutalized. Humans who could so easily damage their heart through amphetamine abuse are already long dead through natural selection, you are alive and selected by nature as someone with a heart that can deliver in even the most extreme situations, unless you have a genetic flaw.

Tired of people complaining about heart issues while using amphetamines. Forget about the idea that it can fail, it won't. Something else will fail, willing to bet tons of money on it.

This is unhelpful advice. Harm can be cumulative and not just acute. While some using meth do indeed become unduly paranoid or suffer panic attacks, regardless heart pain is absolutely not normal or something to be dismissed lightly. Many people have suffered terrible acute and/or chronic cardiovascular problems from the abuse of meth and other stimulants - particularly cocaine with its directly toxic effect, but there's plenty of literature on meth as well.

 

[Båtmannen]

I think this is really good advice. You had a hypertensive crisis from using amps. Having another could kill you regardless of your EKG results. I think you need to consider getting help before you kill yourself abusing stims.

real talk

As I wrote a few days ago, I really want to stop this. I will never stop using drugs recreationally, but what I have been doing lately is clearly abuse.

BUT it's not like I haven't tried treatment. As a matter of fact, I have been in almost contant treatment since winter 2015. No more than 3 weeks without it. I have tried every possible kind of treatment/rehabilitation you can come up with (well, ALMOST every kind).

I haven't gone more than 1 day without amph since at least 1,5 months. I will start now with at least going 2 full days without.

Unfortunately an EKG is not a comprehensive measure of direct heart damage. It won't even necessarily reveal electrophysiological changes either, as it's
a very brief 'snapshot' of heart behaviour. A measure of troponin levels might be more revealing in the short-term.

But still neither can determine whether you're causing underlying electrophysiological damage or the development of cardiac fibrosis, valvular damage, a small clot (could lead to stroke/thrombosis), aortic enlargement, ventricular tachycardia/fibrillation (among a number of other potential risks). The latter could kill you pretty quick.

:/

So my EKG was good for nothing then?

What's the best, fairly normal/regular, test for heart health? Is it the troponin levels?


PS. If you wonder how I'm able to abuse while being in treatment: I cheat at the urine tests. Yeah I'm a cheater and this is not something I'm proud of.


EDIT: the bolded - I have that every time I OD on amph. Can I find out how close I've been?

EDIT:

 

[CFC]

Ventricular tachycardia is not the same as tachycardia, but you're clearly sensitive to the effects of stimulants and are putting yourself at risk of triggering VT and VF. Over 80% of people whose heart goes into VF will die - even in hospital more than half will die, it's very difficult to resolve.

There is no standard test to measure the damage you may be causing from meth use. A combination of tests and scans (eg echo, MRI) would give a better indication, but they're costly, not standard, and you're unlikely to be given them in any elective capacity.

You need to come clean and admit you're cheating to them, so that they can help you deal with this

 

[CFC]

There are drugs you can be given that would block the effect of meth. Perhaps you could ask about those? Alpha-1 blockers and neuroleptics are particularly effective, but even use of drugs like modafinil will dampen meth down and reduce cravings.

 

[Slow_Mobius]

If you really want to stop like you say, you need to be 100% honest with the people treating you. Otherwise, they're going to have a difficult time really helping you.

 

[Speed King]

OP- Systolic (top number) refers to the amount of pressure in your arteries during contraction of your heart muscle.
Diastolic (bottom number) refers to your blood pressure when your heart is inbetween beats.

Long story short, your origional numbers are classified by the American Heart Association.

Both numbers are important in determining the state of your heart health

Numbers greater then the ideal range
(Normal is considered less then 120/80,
stage 2 hypertension is 160 or greater, bottom number 100 or greater.

Hypertensive crisis* Emergency care needed. 180/110

* don't argue AHA numbers

IMO, your numbers were dangerously high, even briefly.

Glad ekg checked out. Get your numbers during a stress test, for more realistic numbers.

Point is, the more you do in the future may be too much. Your numbers suggest you were close to an ambulance call.

Nobody gave the numbers for when a heart attack occurs.

This post applies to everyone. Stupid high numbers are the hospital or risk of death in individuals without strong hearts. Please everyone, take this seriously.

 

[Ksa]

Well, if you have a look at this government paper you can read:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1956334/pdf/canmedaj01528-0043.pdf

http://www.cmaj.ca/content/112/3/299

"The world medical literature contains 43 reports of deaths associated with amphetamines in a 35-year period. These included seven cerebrovascular accidents, six sudden cardiac deaths, three cases of hyperpyrexia, eight poisonings of uncertain mechanism and seven cases of medical complications of intravenous injection; the remainder were of uncertain cause. In contrast, in Ontario alone, in 1972 and 1973 there were 26 deaths in amphetamine users, of which 16 were due to accident suicide or homicide. Of the remaining cases, two were cardiac, two hepatic and the rest were mixed drug overdose. Pulmonary granulomata, subacute hepatitis and other lesions resulting from intravenous drug use were common findings at autopsy. On the basis of the estimated number of regular users of intravenous amphetamine in Ontario, the mortality rate in such users is at least four times as high as in the general population of the same age, and is comparable to that in alcoholics and heroin addicts. However, the absolute number of alcohol-related deaths is far greater than the number of deaths in amphetamine or heroin users. "

And I would like to bring your attention to the phrase common findings. That text was written by professionals, every word has its place. Common findings means? A dude dies from amphetamines: What can we expect? What? We expect this:

Pulmonary granulomata, subacute hepatitis and other lesions resulting from intravenous drug use.

Yes there are some heart cases but one dude was fricken 55 y.o., probably banging a girl too young for his age, and the other one 40, probably with a heart defect. We're talking about 26 deaths in a year for Ontario.

For the sake of harm reduction you can say YES IT DOES THIS AND IT DOES THAT AND IT'S BAD...but...autopsy says otherwise. When you open the dead dude up, the heart is ok, in the vast majority of cases.

I hope this settles the uncertainty.

 

[Slow_Mobius]

Well, if you have a look at this government paper you can read:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1956334/pdf/canmedaj01528-0043.pdf

http://www.cmaj.ca/content/112/3/299

"The world medical literature contains 43 reports of deaths associated with amphetamines in a 35-year period. These included seven cerebrovascular accidents, six sudden cardiac deaths, three cases of hyperpyrexia, eight poisonings of uncertain mechanism and seven cases of medical complications of intravenous injection; the remainder were of uncertain cause. In contrast, in Ontario alone, in 1972 and 1973 there were 26 deaths in amphetamine users, of which 16 were due to accident suicide or homicide. Of the remaining cases, two were cardiac, two hepatic and the rest were mixed drug overdose. Pulmonary granulomata, subacute hepatitis and other lesions resulting from intravenous drug use were common findings at autopsy. On the basis of the estimated number of regular users of intravenous amphetamine in Ontario, the mortality rate in such users is at least four times as high as in the general population of the same age, and is comparable to that in alcoholics and heroin addicts. However, the absolute number of alcohol-related deaths is far greater than the number of deaths in amphetamine or heroin users. "

And I would like to bring your attention to the phrase common findings. That text was written by professionals, every word has its place. Common findings means? A dude dies from amphetamines: What can we expect? What? We expect this:

Pulmonary granulomata, subacute hepatitis and other lesions resulting from intravenous drug use.

Yes there are some heart cases but one dude was fricken 55 y.o., probably banging a girl too young for his age, and the other one 40, probably with a heart defect. We're talking about 26 deaths in a year for Ontario.

For the sake of harm reduction you can say YES IT DOES THIS AND IT DOES THAT AND IT'S BAD...but...autopsy says otherwise. When you open the dead dude up, the heart is ok, in the vast majority of cases.

I hope this settles the uncertainty.

Well, I would consider it settled if that data wasn't from the 1950s. I'll try to find some more recent literature on the topic when I have time.

Something else to keep in mind is that many stimulant-induced cardiomyopathies can be reversed with treatment and cessation of stimulant use. And with hypertensive crises, the biggest cardiovascular concerns are not going to directly affect the heart, but you could give yourself a stroke, aneurysm, etc.. It wouldn't surprise me if deaths attributable to cardiomyopathies are rare, but I'm sure cardiovascular issues are fairly common with amp use, and those cardiovascular issues can cause more problems if left untreated.

 

[Ksa]

Well, I would consider it settled if that data wasn't from the 1950s. I'll try to find some more recent literature on the topic when I have time.

Humans are the same so I'm not sure what your argument is. If you're that into deaths by heart attack, nevermind googling amphetamines, just google bodybuilding. You'll find astonishing numbers of bodybuilders who died due to heart failure or heart attack. Amphetamine abusers will never be able to compete with bodybuilders in terms of cardiac deaths. Never.

I'm trying to keep the peace here and maintain a scientific environment because it's easy for this section of the forum to fall into the grandma "don't do it honey" domain and this site will become just another "I was an addict, I recovered, don't do it man, drugs are bad" kind of speech they brainwash our kids with in highschool to "raise awareness". We're all here to understand, use logic and know things for a fact. The richness of this site is all into its exact knowledge. So let's keep it exact and not throw stones at amphetamines without truth nor certain knowledge for the sake of harm reduction.

If there's a new adverse effect discovered on amphetamine use, I would be the FIRST to want to know about it because I'm directly concerned. I would be all eyes and ears trust me. It's just that your concerns over cardiac issues with amphetamines seem unrealistic and lacking foundation. OP's BP is ER grade, I've said it, and it has fkall to do with his heart sustaining damage. Brain might, liver might, kidneys might, but not the heart. Heart goes last.

 

[Slow_Mobius]

Humans are the same so I'm not sure what your argument is. If you're that into deaths by heart attack, nevermind googling amphetamines, just google bodybuilding. You'll find astonishing numbers of bodybuilders who died due to heart failure or heart attack. Amphetamine abusers will never be able to compete with bodybuilders in terms of cardiac deaths. Never.

I'm trying to keep the peace here and maintain a scientific environment because it's easy for this section of the forum to fall into the grandma "don't do it honey" domain and this site will become just another "I was an addict, I recovered, don't do it man, drugs are bad" kind of speech they brainwash our kids with in highschool to "raise awareness". We're all here to understand, use logic and know things for a fact. The richness of this site is all into its exact knowledge. So let's keep it exact and not throw stones at amphetamines without truth nor certain knowledge for the sake of harm reduction.

If there's a new adverse effect discovered on amphetamine use, I would be the FIRST to want to know about it because I'm directly concerned. I would be all eyes and ears trust me. It's just that your concerns over cardiac issues with amphetamines seem unrealistic and lacking foundation. OP's BP is ER grade, I've said it, and it has fkall to do with his heart sustaining damage. Brain might, liver might, kidneys might, but not the heart. Heart goes last.

I would just defer to my edit. I'm also confused why you think my concerns for his heart are unrealistic, because I never even mentioned major concerns for his heart. I actually said the opposite (more likely for his BP to cause problems elsewhere).

However, it's not true at all that hypertensive crises have nothing to do with potential damage to the heart. It can cause issues with the valves.

At any rate, hopefully we can all agree that OPs BP was a serious concern and future problems like that should mean a direct trip to the ER. It's unlikely he sustained permanent damage to his heart, but it's impossible to say without an echocardiogram.

 

[Ksa]

^ Right, I agree on that. Op should definitely do something to prevent that BP from happening again, with that crazy BP it's not even a matter of if something will happen, it's when. I'm also trying to avoid the mental space of "my heart is ok so I'm ok" because if their urine is brown, they're dying, even if they're not having a heart attack. Why should someone begin abusing amphetamines with the mindstate "I'm trying not to have a heart attack"? Why not start abusing saying "I'm trying not to get meningitis so I'll keep everything clean and wash my hands". See what I mean?

Chances are what will kill you will never cross your mind, and it HAS TO because you have no second chance. So that's why focusing on one organ or condition is the wrong approach, especially if it's the wrong one to focus on.

Doctors see it all the time, patient abusing amphetamines in their home gets meningitis, then they google "amphetamine, migraine", and Oh boy! Do they get some material! Amphetamines cause migraines, of course! Why not! They're bad! Bad drug! Then his infection gets worse guess what, his mates on bluelight tell him it's a bad comedown so he takes some hydro "for the comedown", wakes up dead the next morning, or, if he's lucky enough to go to the ER in time it sounds like:

- Doctor! I abused amphetamines and look what happened, I will never do it again, please help me, I'm a pathetic loser help!

Then the doctor goes like:

"this has nothing to do with the drugs you take, lie still"

Injects him with antibiotics, IV fluids, saves his life. So you see what I mean? The approach is, I take drugs...so what? I should be in PERFECT health. And if I'm not, what's wrong with me? Objective analysis.

His blood pressure is too high? He has to go his doctor and say hey, my blood pressure is too high, I had 20/11 last time. And the doctor will give him pills for high blood pressure. See? Doctor is there to fix health issues.

 

[CFC]

Well, if you have a look at this government paper you can read:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1956334/pdf/canmedaj01528-0043.pdf

http://www.cmaj.ca/content/112/3/299

"The world medical literature contains 43 reports of deaths associated with amphetamines in a 35-year period. These included seven cerebrovascular accidents, six sudden cardiac deaths, three cases of hyperpyrexia, eight poisonings of uncertain mechanism and seven cases of medical complications of intravenous injection; the remainder were of uncertain cause. In contrast, in Ontario alone, in 1972 and 1973 there were 26 deaths in amphetamine users, of which 16 were due to accident suicide or homicide. Of the remaining cases, two were cardiac, two hepatic and the rest were mixed drug overdose. Pulmonary granulomata, subacute hepatitis and other lesions resulting from intravenous drug use were common findings at autopsy. On the basis of the estimated number of regular users of intravenous amphetamine in Ontario, the mortality rate in such users is at least four times as high as in the general population of the same age, and is comparable to that in alcoholics and heroin addicts. However, the absolute number of alcohol-related deaths is far greater than the number of deaths in amphetamine or heroin users. "

And I would like to bring your attention to the phrase common findings. That text was written by professionals, every word has its place. Common findings means? A dude dies from amphetamines: What can we expect? What? We expect this:

Pulmonary granulomata, subacute hepatitis and other lesions resulting from intravenous drug use.

Yes there are some heart cases but one dude was fricken 55 y.o., probably banging a girl too young for his age, and the other one 40, probably with a heart defect. We're talking about 26 deaths in a year for Ontario.

For the sake of harm reduction you can say YES IT DOES THIS AND IT DOES THAT AND IT'S BAD...but...autopsy says otherwise. When you open the dead dude up, the heart is ok, in the vast majority of cases.

I hope this settles the uncertainty.

It's hard to tell if you're being serious about your stance or just seeking to elicit a response/argument. I'm not trying to be a doomsayer regarding meth - the harms can be wildly overrated, certainly, and much literature (especially of the mainstream media variety) is patent hyperbole.

However you're quoting a paper from 1975 surveying deaths in the period 1940-75 - decades before many of the potential harms of meth became more clearly understood and recorded (indeed many of the mechanisms we still don't fully understand). Even the idea that the abuse of sympathomimetic amines isn't substantially harmful to the cardiovascular system - even just from a theoretical standpoint - is an odd one to hold, given what we already know.

Based on the paper you quote, I assume you think the focus of concern should be restricted to imminent and direct morbidity from meth. But while acute risks are indeed worrying, they're certainly not the only concern for most meth/amp/stimulant users (although in OP's case, given his/her evident sensitivity to the acute intropic and chronotropic effects of meth, death is clearly a potential outcome (!), hence the HR advice given).

Nevertheless the dominant cardiovascular concern for meth/amp and other stimulant users is more typically the chronic harms - ones that build slowly over time like cardiomyopathies, valvular damage, aortic dilatation and so on. These can increase the risk of premature death, potentially taking years or even decades off a person's normal lifespan, despite not being obviously and directly related to morbidity at the time of death - and so inconveniently not registering in any coroner's report (assuming one's even written - which is rarely the case).

Despite that, and the consequent inadequacy of information we have to hand, even a tip-of-the-iceberg analysis suggests meth use is present in at least 5% of all patients presenting to the ER with heart failure [https://www.ncbi.nlm.nih.gov/pubmed/18940295] and 40% of patients under the age of 45 admitted to hospital with cardiomyopathy [https://www.ncbi.nlm.nih.gov/pubmed/17275458]. Acute coronary syndrome (ie unstable angina and acute myocardial infarction) was diagnosed in 25% of US emergency department patients presenting with chest pain following meth use [https://www.ncbi.nlm.nih.gov/pubmed/12745036]

A selection of reports and studies discussing heart attacks (MI) resulting from meth/amp abuse can be found here:

https://www.ncbi.nlm.nih.gov/pubmed/15011896
https://www.ncbi.nlm.nih.gov/pubmed/12745036
https://www.ncbi.nlm.nih.gov/pubmed/10978660
https://www.ncbi.nlm.nih.gov/pubmed/10097363
https://www.ncbi.nlm.nih.gov/pubmed/17565561

Acute aortic dissection, another well-known complication of meth use, can be read about here:

https://www.ncbi.nlm.nih.gov/pubmed/9987866
https://www.ncbi.nlm.nih.gov/pubmed/10097363
https://www.ncbi.nlm.nih.gov/pubmed/7815027

Meth/amp is also strongly associated with cardiac arrhythmias and sudden cardiac death. You can read more about these cases here:

https://www.ncbi.nlm.nih.gov/pubmed/10344175
https://www.ncbi.nlm.nih.gov/pubmed/7588189
https://www.ncbi.nlm.nih.gov/pubmed/6482074
https://www.ncbi.nlm.nih.gov/pubmed/2979169
https://www.ncbi.nlm.nih.gov/pubmed/7840041
https://www.ncbi.nlm.nih.gov/pubmed/2293467
https://www.ncbi.nlm.nih.gov/pubmed/12877759
https://www.ncbi.nlm.nih.gov/pubmed/6519024

As for the more chronic pathologies, they also include underlying processes and mechanisms that lead to many of the acute outcomes listed above. So for example aortic dissection typically involves prolonged and repeated exposure to elevated BP and heart rate, leading to aortic dilatation, which slowly expands and weakens for years before the aorta finally ruptures in an acute episode. And prolonged tachycardia and catecholamine exposure can modify the behaviour of the heart's pacemaker and its elecrophysiological behaviour (affecting pulse conductivity, for example), leading to atrial fibrillation, which can then lead to clots, thrombus and ultimately MI, sudden death and so on.

However the classic chronic issues are coronary artery disease (CAD) and cardiomyopathy. Minimal to severe CAD is found in around 1-in-5 (20%) of meth users compared to 1-in-20 of the normal population, and occurs at a significantly younger age [https://www.ncbi.nlm.nih.gov/pubmed/17565561].

But as quoted in that paper: "cardiac pathology takes time to develop [and] there may be a long ‘incubation’ period prior to methamphetamine-related death." As already suggested, this implies many of the harms inevitably go unrecorded or get blamed on traditional causes like ageing, poor genetics, a lack of exercise and unhealthy Western diets.

These concerns about the largely under-reported cardiovascular harms aren't just limited to American researchers either:

In a series of 371 Australian coronial cases of methamphetamine-related deaths, cardiovascular complications were the leading direct cause of death after drug toxicity/overdose, responsible for death in 14% of cases. Fifty-four per cent of the cohort exhibited cardiovascular pathology. Notably, this data from 2008 precedes the current rise in methamphetamine use and purity. From 2011/12 - 2012/13, there was an 88% increase in methamphetamine-related ambulance callouts in metropolitan Melbourne and a 109% increase in rural Victoria. Methamphetamines are now the second most common culprit after opioids for drug-related hospital attendances. Methamphetamine-related mortality has also doubled from 2001 to 2009

[https://www.ncbi.nlm.nih.gov/pubmed/26706652]

In Crystal Methamphetamine‐Associated Cardiomyopathy: Tip of the Iceberg? [https://www.ncbi.nlm.nih.gov/pubmed/14705845], the authors summarise the cardiovascular-related harms quite nicely:

The most common cardiovascular manifestations of amphetamine‐related compounds include chest pain, tachycardia, and hypertension. At higher doses tachyarrhythmias may occur. Amphetamines are also linked with coronary artery disease, myocardial ischemia and infarction, acute pulmonary edema, necrotizing vasculitis, endocarditis, pulmonary hypertension, acute aortic dissection, ischemic stroke, cerebrovascular hemmorhage, acute rhabdomyelosis, and sudden cardiac death.

Autopsy studies have demonstrated the occurrence of cardiomyopathy in patients with methamphetamine‐related deaths. Histological analysis of myocardial tissue from methamphetamine users has shown the presence of contraction band necrosis, which usually is an indicator of catecholamine toxicity and a recognized feature in the hearts of cocaine abusers.

Several experimental studies have shown the development of myocyte atrophy, hypertrophy, contraction bands, patchy cellular infiltration, eosinophilic degeneration, cellular edema, myocytolysis, fibrosis, and vacuolization when animals and cultured myocytes are exposed to methamphetamine. The accompanying ultra structural features include sarcolemmal injury, mitochondrial degeneration, myofibrillar hypercontraction, and loss of myofilaments.

The plausible mechanisms for the development of dilated cardiomyopathy in chronic methamphetamine users include recurrent coronary artery spasm, small vessel disease, or diffuse myocardial toxicity due to repeated stimulation of alpha and beta‐adrenergic receptors in the heart. Thus, the adverse pathogenetic role of adrenergic receptor stimulation in this setting is likely similar to that of cocaine and catecholamine‐induced cardiomyopathy.

Evidence for all those harms/claims can be linked directly through the paper (I had to remove the messy hyperlinks unfortunately).

In Cardiovascular Responses Elicited by the “Binge” Administration of Methamphetamine [https://www.ncbi.nlm.nih.gov/pubmed/11907169], the authors have begun to investigate the impact of repeated binge dosing of meth on the cardiovascular system, since this more accurately reflects typical usage patterns, noting that:

The binge administration of METH can produce significant cardiac pathology. In rats subjected to this dosing regimen, we observed myocardial foci of predominantly mononuclear inflammatory infiltrates (primarily monocytes/macrophages) with areas of disrupted architecture and occasional myofibril necrosis. Mast cells, normally present in the rat myocardium (Majeed, 1994), were not increased in rats receiving METH.

One potential mechanism suggests that a METH-induced increase in peripheral catecholamines is responsible for the cardiotoxicity (see Jiang and Downing, 1990). It is known that catecholaminergic stimulation can produce myocardial necrosis and infiltration similar to that observed after administering METH. The mechanisms mediating catecholamine-induced cardiac damage may include ischemia due to catecholamine-mediated coronary vasoconstriction, calcium overload, and the production of oxygen free radicals by either the auto-oxidation of catecholamines or their degradation by monoamine oxygenase. Reactive oxygen species may also be produced by catecholamine degradation, mitochondrial dysfunction, leukocyte activation, and/or xanthine oxidization during the reperfusion of ischemic areas.

METH may produce cardiac damage by direct effects on the myocytes. METH is cytotoxic to myocytes in culture systems devoid of catecholamines. METH may also damage cardiac cells by initiating apoptosis. Apoptotic processes occur in several pathological conditions including myocardial ischemia and reperfusion, infarction, and cardiomyopathy.

The binge administration of METH can produce significant changes in cardiovascular and cardiovascular reflex function and result in significant cardiac pathology. During the binge administration of METH, there was an increase in sensitivity to the pressor actions of the drug and decreases in sensitivity to the depressor actions of NP, Iso, and Ach.

I bring this tendency for binging to aggravate the heart's reaction to meth's pressor effect up as it's of direct concern to OP, who's heart is clearly quite sensitive as it is. Which is a very good reason for OP to further ponder the gravity of his/her addiction to meth, and to try even harder to stop. And all without even needing to consider the escalating risks to the brain, other organs, long-term mental health, intensified addiction and so on.

 

[CFC]

Amphetamine abusers will never be able to compete with bodybuilders in terms of cardiac deaths. Never.

That's not accurate.

I'm trying to keep the peace here and maintain a scientific environment because it's easy for this section of the forum to fall into the grandma "don't do it honey" domain

If there's a new adverse effect discovered on amphetamine use, I would be the FIRST to want to know about it because I'm directly concerned. I would be all eyes and ears trust me. It's just that your concerns over cardiac issues with amphetamines seem unrealistic and lacking foundation. OP's BP is ER grade, I've said it, and it has fkall to do with his heart sustaining damage. Brain might, liver might, kidneys might, but not the heart. Heart goes last.

You contradict yourself with those two statements. Suggesting OP is doing no harm to his heart is irresponsible, and you're resorting to 'grandma' language to support it. Please stop.

 

[xbandit07x]

Hello

I have used some amphetamine today, but actually less than I usually use. It seems my tolerance is getting LOWER when I frequently use this drug. Anyone got an idea what the eff is up?

To the point: at the moment, my blood pressure is 199/101 with a HR of 117. This was resting, sitting down. We ran it thrice and this was the mean result.


Is this dangerous?

Do not lower your dose, that is dangerous. It creates sensitation. This makes certain parts of the process fuck up your head. And nervous system

 

[Slow_Mobius]

It's hard to tell if you're being serious about your stance or just seeking to elicit a response/argument. I'm not trying to be a doomsayer regarding meth - the harms can be wildly overrated, certainly, and much literature (especially of the mainstream media variety) is patent hyperbole.

However you're quoting a paper from 1975 surveying deaths in the period 1940-75 - decades before many of the potential harms of meth became more clearly understood and recorded (indeed many of the mechanisms we still don't fully understand). Even the idea that the abuse of sympathomimetic amines isn't substantially harmful to the cardiovascular system - even just from a theoretical standpoint - is an odd one to hold, given what we already know.

Based on the paper you quote, I assume you think the focus of concern should be restricted to imminent and direct morbidity from meth. But while acute risks are indeed worrying, they're certainly not the only concern for most meth/amp/stimulant users (although in OP's case, given his/her evident sensitivity to the acute intropic and chronotropic effects of meth, death is clearly a potential outcome (!), hence the HR advice given).

Nevertheless the dominant cardiovascular concern for meth/amp and other stimulant users is more typically the chronic harms - ones that build slowly over time like cardiomyopathies, valvular damage, aortic dilatation and so on. These can increase the risk of premature death, potentially taking years or even decades off a person's normal lifespan, despite not being obviously and directly related to morbidity at the time of death - and so inconveniently not registering in any coroner's report (assuming one's even written - which is rarely the case).

Despite that, and the consequent inadequacy of information we have to hand, even a tip-of-the-iceberg analysis suggests meth use is present in at least 5% of all patients presenting to the ER with heart failure [https://www.ncbi.nlm.nih.gov/pubmed/18940295] and 40% of patients under the age of 45 admitted to hospital with cardiomyopathy [https://www.ncbi.nlm.nih.gov/pubmed/17275458]. Acute coronary syndrome (ie unstable angina and acute myocardial infarction) was diagnosed in 25% of US emergency department patients presenting with chest pain following meth use [https://www.ncbi.nlm.nih.gov/pubmed/12745036]

A selection of reports and studies discussing heart attacks (MI) resulting from meth/amp abuse can be found here:

https://www.ncbi.nlm.nih.gov/pubmed/15011896
https://www.ncbi.nlm.nih.gov/pubmed/12745036
https://www.ncbi.nlm.nih.gov/pubmed/10978660
https://www.ncbi.nlm.nih.gov/pubmed/10097363
https://www.ncbi.nlm.nih.gov/pubmed/17565561

Acute aortic dissection, another well-known complication of meth use, can be read about here:

https://www.ncbi.nlm.nih.gov/pubmed/9987866
https://www.ncbi.nlm.nih.gov/pubmed/10097363
https://www.ncbi.nlm.nih.gov/pubmed/7815027

Meth/amp is also strongly associated with cardiac arrhythmias and sudden cardiac death. You can read more about these cases here:

https://www.ncbi.nlm.nih.gov/pubmed/10344175
https://www.ncbi.nlm.nih.gov/pubmed/7588189
https://www.ncbi.nlm.nih.gov/pubmed/6482074
https://www.ncbi.nlm.nih.gov/pubmed/2979169
https://www.ncbi.nlm.nih.gov/pubmed/7840041
https://www.ncbi.nlm.nih.gov/pubmed/2293467
https://www.ncbi.nlm.nih.gov/pubmed/12877759
https://www.ncbi.nlm.nih.gov/pubmed/6519024

As for the more chronic pathologies, they also include underlying processes and mechanisms that lead to many of the acute outcomes listed above. So for example aortic dissection typically involves prolonged and repeated exposure to elevated BP and heart rate, leading to aortic dilatation, which slowly expands and weakens for years before the aorta finally ruptures in an acute episode. And prolonged tachycardia and catecholamine exposure can modify the behaviour of the heart's pacemaker and its elecrophysiological behaviour (affecting pulse conductivity, for example), leading to atrial fibrillation, which can then lead to clots, thrombus and ultimately MI, sudden death and so on.

However the classic chronic issues are coronary artery disease (CAD) and cardiomyopathy. Minimal to severe CAD is found in around 1-in-5 (20%) of meth users compared to 1-in-20 of the normal population, and occurs at a significantly younger age [https://www.ncbi.nlm.nih.gov/pubmed/17565561].

But as quoted in that paper: "cardiac pathology takes time to develop [and] there may be a long ‘incubation’ period prior to methamphetamine-related death." As already suggested, this implies many of the harms inevitably go unrecorded or get blamed on traditional causes like ageing, poor genetics, a lack of exercise and unhealthy Western diets.

These concerns about the largely under-reported cardiovascular harms aren't just limited to American researchers either:


[https://www.ncbi.nlm.nih.gov/pubmed/26706652]

In Crystal Methamphetamine‐Associated Cardiomyopathy: Tip of the Iceberg? [https://www.ncbi.nlm.nih.gov/pubmed/14705845], the authors summarise the cardiovascular-related harms quite nicely:



Evidence for all those harms/claims can be linked directly through the paper (I had to remove the messy hyperlinks unfortunately).

In Cardiovascular Responses Elicited by the “Binge” Administration of Methamphetamine [https://www.ncbi.nlm.nih.gov/pubmed/11907169], the authors have begun to investigate the impact of repeated binge dosing of meth on the cardiovascular system, since this more accurately reflects typical usage patterns, noting that:



I bring this tendency for binging to aggravate the heart's reaction to meth's pressor effect up as it's of direct concern to OP, who's heart is clearly quite sensitive as it is. Which is a very good reason for OP to further ponder the gravity of his/her addiction to meth, and to try even harder to stop. And all without even needing to consider the escalating risks to the brain, other organs, long-term mental health, intensified addiction and so on.

Wow. This might be one of the best posts I've ever seen. Thank you for an extremely thorough report CFC

That's a good point with the BP too. Repeated incidents of high blood pressure may continually increase your risk of having a aneurysm

 

[Båtmannen]

I'm using amphetamine, which most likely isn't meth-. That doesn't exist on the street where I'm from. Does this make any difference?


AND: why did the ambulane personal not take me seriously then? If I was in such a mortal danger, why did they just tell me off as If i were wasting their time and the tax payers' money?`I had to ask several times to even take an EKG-test. They were like "well of course your pulse and BP is high, you've taken amphetamine, but there's nothing wrong with you" and then I started holding my breaeth and my pulse raised to 175 to show them that this is not right. They told me to stop playing with their machines.