A large-scale analysis involving more than 100 million people has found strong links between recreational drug use and an increased risk of stroke, including among younger adults.
The study, conducted by researchers at the University of Cambridge, found that cocaine use was associated with a 96 percent increase in stroke risk, while amphetamine use was linked to a 122 percent increase.
Cannabis use was associated with a 37 percent higher risk.
The findings, published in the International Journal of Stroke, add to growing evidence that recreational drug use may be an important and potentially preventable risk factor for stroke.
Stroke remains one of the world’s leading causes of death and disability. While established risk factors include: high blood pressure, poor diet and physical inactivity, the researchers say substance use may also contribute significantly to the disease burden.
The researchers separately examined people under 55 and found particularly strong associations between some recreational drugs and stroke.
Among younger adults, amphetamine use was associated with a 174 percent increase in stroke risk, while cocaine use was linked to a 97percent increase. Cannabis was associated with a more modest 14percent increase.
The study drew on data from multiple cohort studies and combined their findings through a meta-analysis, enabling researchers to examine evidence involving more than 100 million participants.
The researchers also used Mendelian randomisation, a genetic analysis technique, to investigate whether the observed relationships could indicate a causal connection rather than simply an association.
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The genetic evidence provided further support for a link between cocaine use and certain types of stroke, particularly brain haemorrhage and cardioembolic stroke. Cannabis use disorders were associated with stroke overall and, in particular with large-artery stroke.
Scientists say several biological mechanisms could explain the increased risk.
Recreational drugs may trigger sudden spikes in blood pressure, blood-vessel spasms, abnormal heart rhythms, increased blood clotting and inflammation, all of which can contribute to stroke.
The genetic analysis further suggested that cocaine and cannabis may have a causal relationship with certain types of stroke, rather than merely being associated with them.
The study also found links between problematic alcohol use and certain types of stroke, although alcohol was analysed separately from the recreational drugs examined.
Dr Megan Ritson of the University of Cambridge Stroke Research Group said the findings represented the most comprehensive analysis to date of recreational drug use and stroke risk.
Dr Eric Harshfield, an Alzheimer’s Society Research Fellow at Cambridge’s Department of Clinical Neurosciences, said the results suggested that the drugs themselves, rather than only other lifestyle factors associated with drug use, could be contributing to the increased risk.
The researchers said the findings could help guide future research and inform public health strategies aimed at reducing substance use and, consequently, the risk of stroke.
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