Heart Rate Variability and Cocaine: a Systematic Review of Human Studies

Context: Cocaine affects the autonomic nervous system (ANS). Cardiovascular effects of cocaine have been extensively studied by measures of mean heart rate (HR) or blood pressure (BP). The present systematic review aims to summarize the current evidence on the effects of cocaine on heart rate variability (HRV) in human subjects.Evidence Acquisition: A systematic search of electronic databases (PUBMED, PSYNDEX and EMBASE) based on the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” statement was employed. Studies were screened for eligibility based on pre-specified inclusion criteria. The search revealed a total of 48 papers after removing duplicates.Eleven studies fitting the inclusion criteria were included in the systematic review. Evidence on the effects of cocaine on HRV is rare. Existing studies either address the impact of acute cocaine administration in adults or the effect of prenatal cocaine exposure on infants in various age groups. However, HRV is a promising index to study ANS function within this particular field of research. Several suggestions for future research are provided.