Associations of Alcohol and Substance Use With Risk Factors of Cardiovascular Disease

Changes in life expectancy rates have largely been attributed to the rise in mortality associated with "deaths of despair" which include suicide, drug overdose, and liver cirrhosis. Recent evidence suggests that increased cardiovascular (CVD) deaths better explain the reduction of life expectancy. CVD has a complex etiology and is mediated by risk factors such as hypertension, inflammation, and lipid profiles. The purpose of this thesis was to examine the associations of alcohol and substance use with underlying risk factors of CVD in order to establish pathways through which substance use behavior contributes indirectly to mortality through increased risk of CVD. The two risk factors of interest were inflammation and hypertension. Data were retrieved from NHANES and analyzed using a multivariate linear regression to determine associations between alcohol and other substance use and inflammation. Next, data from NHIS were analyzed to examine associations between alcohol use and hypertension using a multivariate logistic regression. Binge drinking over the 13-day threshold was associated with a 14.9% in CRP levels and each additional substance used was associated with a 3.3% increase in CRP. Binge drinking was associated with elevated odds of hypertension and the 13-day threshold had further elevated odds that were greater than smoking. These results suggest that "deaths of despair" may not be limited to acute causes of death and likely contribute to deaths indirectly through CVD.