Whitney Houston and Atherosclerosis

The LA Coroner's office released a summary of Whitney Houston's autopsy report yesterday. You can read it here.

She did not die from a lethal combination of cocaine and xanax as many people assumed at the time. While there were traces of Xanax, Flexeril (a muscle relaxer) and Benadryl (an antihistamine) and marijuana in her system, they did not contribute to her death. Alcohol was not a factor.

She drowned following a cardiac event in the bathtub. The official cause of death was:

1. Drowning
2. Effects of Atheroschlerotic Heart Disease and Cocaine Use

Translation: Her chronic use of cocaine over the years exacerbated the hardening of her arteries and heart disease. The hardening of the arteries caused her to have a cardiac event in the tub and she slipped underwater and drowned. [More...]

No cocaine was found in the room and reports that someone removed it are just gossip right now. Cocaine and metablolites can stay in your system for days, although the coroner says toxicology reports indicate she ingested some just before getting into the tub.

The exact cause of arteroschlerosis is unknown. What is known is that there are risk factors that make it more likely a person will develop it.

The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors.

You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease.

Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke....he main treatment for atherosclerosis is lifestyle changes.

More on atheroschlerosis here and here. The Mayo Clinic says it is a treatable and preventable condition. The American Heart Association says it can begin in childhood. Smoking greatly aggravates it.

In some people this disease progresses rapidly in their third decade. In others it doesn't become threatening until they're in their 50s or 60s.

Exactly how atherosclerosis begins or what causes it isn't known, but some theories have been proposed. Many scientists think atherosclerosis starts because the innermost layer of the artery becomes damaged. This layer is called the endothelium. Three possible causes of damage to the arterial wall are:

  • Elevated levels of cholesterol and triglyceride in the blood
  • High blood pressure
  • Cigarette smoke

Cigarette smoke greatly aggravates and speeds up the growth of atherosclerosis in the coronary arteries, the aorta and the arteries of the legs.

Whitney Houston was a long-time smoker. So cocaine was just another contributing factor to the hardening of her arteries, and it was the hardening of her arteries that triggered a cardiac event. Her arteries were 60% blocked according to the coroner's press statement.

Atherosclerosis is "a type of arteriosclerosis that affects only the inner lining of an artery. It is characterized by plaque deposits that block the flow of blood."

Atheroschlerosis is a leading cause of death. Many people who were not cocaine users or current smokers die from heart attacks caused by arteroschlerosis -- Tim Russert, for example. It is progressive and develops over time.

The takeaway from Whitney Houston's death should not be that she used cocaine before she died. It should be the educational opportunity for everyone to learn more about the risk factors for developing heart disease and ways to minimize them.

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  • Display: Sort:
    Cause and effect. (5.00 / 2) (#1)
    by Anne on Fri Mar 23, 2012 at 01:57:10 PM EST
    The summary report clearly states that cocaine and metabolites were identified and were contributory to the death.  In a person whose arteries were in better shape - as hers undoubtedly were at some point - maybe this doesn't happen to her, but that kind of life catches up to most people, eventually.

    All of our lives catch up to us; we're all living a form of Russian roulette - we never know when we do what we do - smoke, drink, take drugs - legal and otherwise - or don't do what we should - whether this time we are creating the perfect storm that is going to take us out, or try to take us out.

    Houston may have had money and fame, but she lived a hard life that doesn't seem like it was especially happy, all things considered.  I don't have an exciting life by anyone's definition, but I wouldn't trade Houston's brand of "exciting" for what I have, not when I see the toll it took and the price she paid.

    I hope people can let her be now.

    Memento mori n/t (none / 0) (#10)
    by desertswine on Fri Mar 23, 2012 at 07:31:46 PM EST
    Of course (5.00 / 1) (#2)
    by Edger on Fri Mar 23, 2012 at 02:08:57 PM EST
    if you google "Whitney Houston"  the #1 search result - from 23 minutes ago - is from Entertainment Inquirer/AFP, Associated Press, with the objective journalism (sic) title: Whitney Houston: Death by drowning, cocaine.

    No peace even in death... :-/

    When I think about Whitney as I remember her (5.00 / 3) (#6)
    by andgarden on Fri Mar 23, 2012 at 04:17:58 PM EST
    I smile. I am happy she was able to share with us what she could.

    Cocaine is a risk factor for (5.00 / 1) (#7)
    by KeysDan on Fri Mar 23, 2012 at 04:35:17 PM EST
    cardiac disease.  Indeed, when young people present with advanced atherosclerosis, the use of cocaine needs to be questioned.  Cocaine is a cardio-toxic drug in both acute and chronic doses, either by direct effect on the heart musculature or by reducing coronary blood flow, by inducing electrical abnormalities, increased heart rate and increased blood pressure. These effects decrease the myocardial oxygen supply and increase demand on already diminished capacity due to constricted vessels--chronic usage of cocaine hastens  atherosclerosis.  The cardiac "event" in the bathtub may have been either a myocardial infarction ( M.I. or "heart attack") or a ventricular arrhythmia--either of which may cause unconsciousness.    

    Wow, I can only speculate about what (none / 0) (#15)
    by Militarytracy on Fri Mar 23, 2012 at 10:39:47 PM EST
    Your day job is :)  I didn't know any of this tbough.  Thank you for the information.

    It Didn't make Sense (none / 0) (#3)
    by ScottW714 on Fri Mar 23, 2012 at 02:17:25 PM EST
    The news people were saying it was cocaine but couldn't define how it enabled the drowning.  Your analysis exceeds the doctors on TV, sad.  Because to me, cocaine isn't know for it sleepiness and aiding the sliding into drowning as the 'experts' were suggesting.  

    Thanks for the break down.

    And I get what you are saying, but the point is more if even if drugs had killed her, big deal, no different that if butter and deep fried Skittles had killed Russert.  Everyone knows they are bad, just like they know McDonald's is bad, smoking is bad, mountain climbing is bad, booze is bad, but the point should be that she choose them of her own free will, because let's face, like everyone with vices, she liked them.

    Thank you (none / 0) (#4)
    by Towanda on Fri Mar 23, 2012 at 03:30:19 PM EST
    for what apparently, probably, will be the most balanced and informative -- and instructive -- reporting on the cause of death.  Or, actually, the combination of causes of death, as you clarify, with no one vice (or virtue; ought we avoid bathing? hot water?) the immediate trigger.  

    All of it caught up to her, and too soon.  

    Live fast, die young. (none / 0) (#5)
    by Donald from Hawaii on Fri Mar 23, 2012 at 03:31:28 PM EST
    Substance abuse is a great equalizer between the rich and famous and everyone else, because its toxic effects don't discriminate. Frankly, the coronoer's findings don't surprise me, but I'm still saddened all the same.

    And now that we no longer have any real reason to further speculate, I hope that we can finally allow Whitney Houston to rest in peace, and grant her grieving family a long-overdue respite from all the macabre public attention.

    Aloha, Whitney.

    In broad strokes the media at the time that said she died of drugs, and various others used her death as an anti-drug message.

    It seems to me that these people were pretty much exactly on point.

    geez, that's kind of sad, actually. (none / 0) (#9)
    by cpinva on Fri Mar 23, 2012 at 06:02:12 PM EST
    her high class lifestyle notwithstanding, her death turns out to be totally middle-class. in a way, i suppose there's something to be said for that, when all is said and done, we're all equal under the skin.

    One Moment In Time (none / 0) (#11)
    by Edger on Fri Mar 23, 2012 at 07:50:37 PM EST
    Whitney's performance at the 1989 Grammy Awards

    One Moment In Time

    Lyrics here...

    simply put (none / 0) (#12)
    by rise hillary rise on Fri Mar 23, 2012 at 09:48:15 PM EST
    cocaine use was basically the cause of her heart/blood vessel disease. that and cigarettes. basically it aged her. not the other way around. unfortunately a far too common sequence of events. the message is clearly: "crack is whack. stay away from it!"

    my read of the coroner's report is drugs>event.
    direct cause>effect.
    -a doc

    cocaine (none / 0) (#13)
    by diogenes on Fri Mar 23, 2012 at 09:51:34 PM EST
    You're trying to say that she randomly suffered from a heart attack while she was in the tub.  The coroner's report could just as easily say that she suffered from a heart attack caused by acute cocaine use while she was in the tub.  
    Whitney Houston's fame and fortune meant that she in effect had access to cocaine without risk of arrest and without the barrier of high cost.  Just what would happen in the general population if cocaine were legalized.  Sure, there would be a lot fewer people in prison...but legalization does come with a cost.

    You assume that use of illegal drugs (5.00 / 2) (#14)
    by observed on Fri Mar 23, 2012 at 10:26:13 PM EST
    would go up after legalization.
    Are YOU going to snort coke if it's legal?
    I know I won't.
    What about heroin?
    Cigarette use in the US has been steadily declining for decades, presumably in response to the public awareness of the dangers of smoking.
    Furthermore, is drugs are decriminalized, people can get into treatment earlier, lessening the deleterious effects of use.
    Portugal's very broad decriminalization law has led to measurable harm reduction.

    Any approach to drug policy should be fact-based.
    That means in particular, that legalizing or decrminalizaing marijuana use is justified, immediately. Are there reasons people shouldn't smoke pot? I believe so, but the risk is addressed best through accurate public health information and not by the application of draconian laws.


    Education not prison. (none / 0) (#16)
    by womanwarrior on Fri Mar 23, 2012 at 10:53:59 PM EST
    Amen, alleluia.