Psychiatry Services, Southcoast Health, 101 Page Street, New Bedford, MA, USA.
Child and Adolescent Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
Child Adolesc Psychiatr Clin N Am. 2022 Jul;31(3):437-448. doi: 10.1016/j.chc.2022.02.002. Epub 2022 May 11.
The cardiovascular (CV) impact of stimulants has been examined for decades, with investigations ranging from small sample targeted studies of heart rate (HR) and blood pressure (BP), to large scale epidemiologic investigations. The preponderance of evidence is reassuring, albeit generally based on healthy samples using variable methodology, excluding those at theoretic high risk (eg, comorbid cardiac illness). Screening for theoretically vulnerable patients are recommended, as well as monitoring for CV symptoms and BP/HR, with shared inquiry/further evaluation if concerned. Future investigations to support the identification of risk are needed, while attention to stimulant-associated CV risk is an opportunity for clinicians to engage in general CV risk identification and intervention.
几十年来,人们一直在研究兴奋剂对心血管(CV)的影响,研究范围从针对心率(HR)和血压(BP)的小样本靶向研究,到大规模的流行病学调查。虽然大多数证据令人安心,但通常基于使用不同方法的健康样本,排除了理论上高风险的人群(例如,合并心脏疾病)。建议对理论上易受影响的患者进行筛查,并监测 CV 症状和 BP/HR,如果有问题,进行共同询问/进一步评估。需要进一步调查以支持风险识别,同时关注与兴奋剂相关的 CV 风险,这为临床医生提供了一个机会,使其能够识别和干预一般 CV 风险。