Risk of cardiovascular diseases in relation to substance use disorders

Drug Alcohol Depend. 2021 Dec 1;229(Pt A):109132. doi: 10.1016/j.drugalcdep.2021.109132. Epub 2021 Oct 27.


Background: Substance use disorder (SUD) has become increasingly prevalent worldwide, this study investigated the associations of SUD and alcohol, cannabis, opioid, or stimulant use disorder with cardiovascular disease (CVD) and 11 major CVD subtypes.

Methods: This study was based on a 20% random sample of residents in British Columbia, Canada, who were aged 18 - 80 years at baseline on January 1, 2015. Using linked administrative health data during 2010 - 2014, we identified people with various SUDs and prevalent CVDs at baseline, and examined the cross-sectional associations between SUDs and CVDs. After excluding people with CVDs at baseline, we followed the cohort for 4 years to identify people who developed incident CVDs, and examined the longitudinal associations between SUDs and CVDs.

Results: The cross-sectional analysis at baseline included 778,771 people (mean age 45 years, 50% male), 13,279 (1.7%) had SUD, and 41,573 (5.3%) had prevalent CVD. After adjusting for covariates, people with SUD were 2.7 (95% confidence interval [CI], 2.5 - 2.8) times more likely than people without SUD to have prevalent CVD. The longitudinal analysis included 617,863 people, 17,360 (2.8%) developed incident CVD during the follow-up period. After adjusting for covariates, people with SUD were 1.7 (95% CI, 1.6 - 1.9) times more likely than people without SUD to develop incident CVD. The cross-sectional and longitudinal associations were more pronounced for people with opioid or stimulant use disorder.

Conclusions: People with SUD are more likely to have prevalent CVD and develop incident CVD compared with people without SUD.

Keywords: Alcohol-induced disorder; Cardiovascular disease; Cocaine-related disorder; Marijuana abuse; Opioid-related disorder; Substance-related disorder.

MeSH terms

  • British Columbia / epidemiology
  • Cardiovascular Diseases* / epidemiology
  • Central Nervous System Stimulants*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Substance-Related Disorders* / epidemiology


  • Central Nervous System Stimulants