Farzad Masoudkabir
1,2 
, Reza Malekzadeh
3, Negin Yavari
2 , Kazem Zendehdel
4, Arya Mani
5, Ali Vasheghani-Farahani
1, Andrew Ignaszewski
6, Mustafa Toma
6, Pegah Roayaei
1, Karam Turk-Adawi
7, Nizal Sarrafzadegan
8,9* 1 Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
4 Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
5 Yale Cardiovascular Genetics Program, Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
6 Division of Cardiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
7 QU Health, College of Health Science, Qatar University, Al Jamiaa St, Doha, Qatar
8 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
9 School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Abstract
Although atherosclerotic cardiovascular disease (ASCVD) and cancer are seemingly different types of disease, they have multiple shared underlying mechanisms and lifestyle-related risk factors like smoking, unhealthy diet, excessive alcohol consumption, and inadequate physical activity. Opium abuse is prevalent in developing countries, especially the Middle East region and many Asian countries. Besides recreational purposes, many people use opium based on a traditional belief that opium consumption may confer protection against heart attack and improve the control of the risk factors of ASCVD such as diabetes mellitus, hypertension, and dyslipidemia. However, scientific reports indicate an increased risk of ASCVD and poor control of ASCVD risk factors among opium abusers compared with nonusers. Moreover, there is accumulating evidence that opium consumption exerts potential carcinogenic effects and increases the risk of developing various types of cancer. We conducted a review of the literature to review the current evidence on the relationship between opium consumption and ASCVD as well as various kinds of cancer. In addition, we will discuss the potential shared pathophysiologic mechanisms underlying the association between opium abuse and both ASCVD and cancer.