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This paper examines the range of pathophysiological processes, clinical presentations and treatment options involving the heart and cardiovascular system both in the acute setting and where long\u2010term effects of psychostimulant use have affected the cardiovascular system. A common feature of these drugs is their effect on the cardiovascular system, where their major action is that of sympathomimetic amines with short\u2010 and long\u2010term stimulation of the adrenergic system and consequent effects on blood pressure, cardiac modelling, atherogenesis and cellular calcium signalling. Cocaine additionally exhibits a variety of prothrombotic effects, effects on inflammatory mediators and alterations in myocardial gene expression. Persistent psychostimulant use results in progressive cardiovascular pathology, largely in the form of accelerated atherosclerosis, hypertension and myocardial ischaemia. Abstinence results in at least partial reversal of pathology. To a large extent, an assumption is made that treatment protocols used for cocaine\u2010associated cardiovascular pathology apply to the amphetamines and other phenylethylamines, but there appears to be little research in this area, despite acknowledgement that cocaine and the better\u2010known amphetamines have different modes of action.<\/jats:p>","DOI":"10.1111\/add.14713","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T06:13:39Z","timestamp":1563516819000},"page":"175-183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Psychostimulant use disorder and the heart"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5863-635X","authenticated-orcid":false,"given":"Johan","family":"Duflou","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  NSW Australia"},{"name":"Sydney Medical School University of Sydney  NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.12.025"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.18356\/d29e3f27-en"},{"key":"e_1_2_11_4_1","first-page":"134","article-title":"Mortality among individuals with cannabis, cocaine, amphetamine, MDMA, and opioid use disorders: a nationwide follow\u2010up study of Danish substance users in treatment","volume":"114","author":"Arendt M.","year":"2014","journal-title":"Drug Alcohol Depend"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302843"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2007.02.016"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2008.05.024"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90484-U"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/09595230801923702"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881108089809"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0942"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.615318"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000240"},{"key":"e_1_2_11_14_1","volume-title":"Pharmacology and abuse of cocaine, amphetamines, ecstasy and related designer drugs","author":"Freye E.","year":"2009"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2005.04.003"},{"key":"e_1_2_11_16_1","volume-title":"Karch's Pathology of Drug Abuse","author":"Karch S. 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