ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2021
Cocaine Use and White Matter Hyperintensities in Homeless and Unstably Housed Women.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Does illicit drug use increase stroke risk? A systematic review, meta-analyses, and Mendelian randomization analysis.International journal of stroke : official journal of the International Stroke Society · 2026Pooled it
- Psychosis in the Context of Travel, Substance Use, and Media Exposure: A Stress-Diathesis Perspective.Cureus · 2026Article
- Article
- Addressing the Health Needs of People Who Inject Drugs: A Descriptive Analysis of an Inpatient Integrated Care Team Within an Acute Hospital in Scotland.Open forum infectious diseases · 2025Article
- Multiple substance use and blood pressure in women experiencing homelessness.Addictive behaviors reports · 2023Article
- Methamphetamine use increases the risk of cerebral small vessel disease in young patients with acute ischemic stroke.Scientific reports · 2023Article
- A Chronic Condition Disguised as an Acute Event: the Case for Re-thinking Stimulant Overdose Death.Journal of general internal medicine · 2022Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
objectivesCocaine use has been linked to stroke in several studies. However, few studies have considered the influence of cocaine use on stroke mechanisms such as small vessel disease (SVD). We conducted a study to assess associations between the toxicology-confirmed use of multiple drugs, including cocaine, and a marker of SVD, white matter hyperintensities (WMH). MATERIALS AND
methodsWe conducted a nested case-control study (n = 30) within a larger cohort study (N = 245) of homeless and unstably housed women recruited from San Francisco community venues. Participants completed six monthly study visits consisting of an interview, blood draw, vital sign assessment and baseline brain MRI. We examined associations between toxicology-confirmed use of multiple substances, including cocaine, methamphetamine, heroin, alcohol and tobacco, and WMH identified on MRI.
resultsMean study participant age was 53 years, 70% of participants were ethnic minority women and 86% had a history of cocaine use. Brain MRIs indicated the presence of WMH (i.e., Fazekas score>0) in 54% (18/30) of imaged participants. The odds of WMH were significantly higher in women who were toxicology-positive for cocaine (Odd Ratio=7.58, p=0.01), but not in women who were toxicology-positive for other drugs or had several other cerebrovascular risk factors.
conclusionsOver half of homeless and unstably housed women showed evidence of WMH. Cocaine use is highly prevalent and a significant correlate of WMH in this population, while several traditional CVD risk factors are not. Including cocaine use in cerebrovascular risk calculators may improve stroke risk prediction in high-risk populations and warrants further investigation.
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