Supplementary Material for: The key role of a Psychoactive Substance Use History in comprehensive cardiovascular risk assessment, diagnosis, treatment, and prevention

Abstract Background: Psychoactive substances have toxic effects resulting different cardiovascular and non-cardiovascular organ damage. Through a variety of mechanisms, they can trigger the onset of various forms of cardiovascular disease: acute or chronic, transient or permanent, subclinical or symptomatic. Hence, a thorough knowledge of the patient’s drug habits is essential for a more complete clinical-etiopathogenetic diagnosis and consequent therapeutic, preventive, and rehabilitative management. Summary: The prime reason for taking a Psychoactive Substance Use History in the cardiovascular context is to identify those people who use substances (whether habitual or occasional users, symptomatic or not) and adequately assess their overall cardiovascular risk profile in terms of user status and type of substance used. And, finally, to assess the likelihood of persistence in the habit or relapse, which would maintain their cardiovascular risk profile high. A psychoactive substance history could also alert the physician to suspect, and eventually diagnose, cardiovascular disease related to the intake of psychoactive substances, so optimizing the medical management of users. Taking such a history should be mandatory when a causal connection is suspected between intake of psychoactive substances and the observed symptoms or pathology, regardless of whether the individual is a declared user or not. Key Messages: The purpose of this article is to provide practical information on when, how and why to perform a Psychoactive Substance Use History.

摘要 背景：精神活性物质（Psychoactive Substance）具有毒性作用，可引发不同类型的心血管与非心血管器官损伤。其通过多种病理机制诱发各类心血管疾病，涵盖急性或慢性、一过性或永久性、亚临床或有症状的病变类型。因此，全面掌握患者的药物使用习惯，对于实现更完整的临床-病因发病学诊断，以及后续开展治疗、预防与康复管理均至关重要。
总结：在心血管临床场景中采集精神活性物质使用史的核心目的，是识别存在精神活性物质使用行为的人群（无论为规律使用者或偶发使用者，无论是否出现相关症状），并结合其使用状态与摄入物质的类型，全面评估其整体心血管风险概况。最终还需评估其持续使用或复吸的可能性——此类情况将持续维持较高的心血管风险水平。此外，精神活性物质使用史还可协助临床医师警惕并最终确诊与精神活性物质摄入相关的心血管疾病，从而优化使用者的临床诊疗方案。当怀疑精神活性物质摄入与观测到的症状或病理存在因果关联时，无论个体是否为自述使用者，采集该使用史均为强制性操作。
核心要点：本文旨在为临床医师提供关于何时、如何以及为何需要采集精神活性物质使用史的实用指导信息。