PREVALENCE OF HYPERTENSION IN CHRONIC COCAINE USERS

The association of cocaine and acute hypertension is well known; howev er, cocaine use has not generally been linked to chronic hypertension. We hypothesized that chronic use of cocaine over time would increase the prevalence of hypertension and that cocaine induced vasoconstricti on would result in urine protein leakage, manifested by microalbuminur ia. Therefore, we studied a population of predominantly black male pat ients admitted for addiction treatment whose drug of dependence was co caine. A urine toxicology screen was considered positive if cocaine wa s detected within 24 h prior to or during admission to the hospital. A total of 301 patients with normal renal function were observed over t heir 2 week hospitalization. The majority (62%) of the patients were n ormotensive regardless of the status of their initial urine toxicology screen. Twenty percent of the population had acutely elevated blood p ressure that normalized within 1 day, whereas 18% had blood pressure c hronically >140/90 mm Hg (chronic hypertension). Levels of systolic an d diastolic blood pressures were examined at age deciles and compared to the NHANES III (Third National Health and Nutrition Examination Sur vey) data for a predominantly black population. There was no significa nt difference in blood pressure with age in the cocaine users compared to the NHANES groups. Random urine samples were screened for the pres ence of microalbuminuria and no significant elevation was detected in any of the samples tested. We conclude that chronic cocaine use is ass ociated with acute but not chronic hypertension in middle-aged black m ales. Cocaine use does not cause microalbuminuria. (C) 1998 American J ournal of Hypertension, Ltd.