Khat and Alcohol Interaction

Among men specifically, alcohol consumption's association with hypertension was modified by khat chewing status, with an interaction adjusted odds ratio of 4.38. Khat contains cathinone, a stimulant that activates the sympathetic nervous system and constricts blood vessels. Cathinone acts as a sympathomimetic agent, raising myocardial contractility and peripheral resistance through presynaptic norepinephrine release. Ethanol can induce systemic vasoconstriction, stimulate the hypothalamic-pituitary-adrenal axis, and raise cortisol and catecholamine levels. Alcohol may increase oral mucosal permeability, potentially enhancing cathinone bioavailability and accelerating its systemic absorption when khat is chewed simultaneously. Combined alcohol drinking and khat chewing were associated with higher odds of undiagnosed hypertension than using neither substance.