An alarming number of people nationwide are developing infections of either the heart’s inner lining or valves, known as infective endocarditis, in large part, due to the current opioid epidemic. This new trend predominantly affects young, white, poor men who also have higher rates of HIV, hepatitis C and alcohol abuse, according to new research published in the Journal of the American Heart Association, the open access journal of the American Heart Association.

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Infective endocarditis occurs when bacteria or fungi in the blood stream enter the heart’s inner lining or valves. Nearly 34,000 people receive treatment for this condition each year, of which approximately 20% die. One of the major risk factors for infective endocarditis is drug abuse.

“Infective endocarditis related to drug abuse is a nationwide epidemic,” said the study’s senior author Serge C. Harb, M.D., assistant professor of medicine at Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. “These patients are among the most vulnerable—young and poor, and also frequently have HIV, hepatitis C and alcohol abuse.”

Researchers analyzed data in the National Inpatient Sample registry from 2002–2016 on nearly one million hospitalized patients diagnosed with infective endocarditis to compare patients with heart infections related to drug abuse to those with heart infections from other causes. The registry is the largest publicly available database of U.S. hospitalizations.

During the 14 years studied, researchers found that the prevalence ratio for drug-abuse-related heart infections nearly doubled in the United States, from 8% to 16%. All geographic regions saw increases, and the highest jump occurred in the Midwest at nearly 5% per year.

Read more at American Heart Association