ArticleCureus2022
Hypertension in the Setting of Hypertrophic Obstructive Cardiomyopathy and Cocaine Use.
Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hypertrophic obstructive cardiomyopathy (HOCM) is most commonly an inherited genetic condition where hypertension can be challenging to treat as many antihypertensive medications cannot be used in this patient population. Any agent that decreases preload or afterload should be avoided in this condition, leaving beta-adrenergic receptor antagonists as the preferred agent of choice in these patients. However, a patient with HOCM and cocaine use can pose a significant challenge due to the risks associated with initiating beta-adrenergic receptor antagonists in cocaine users because of the unopposed alpha receptor effect of the treatment, which would in turn cause worsening hypertension. The fact that cocaine itself causes hypertension further complicates the issue. The only remaining class of medications that can be used are non-dihydropyridine calcium channel blockers, which may not be effective on their own against the vasoconstrictive properties of cocaine. Hence, it is paramount to educate all patients with HOCM to avoid cocaine use even more so than other patients.
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