Chronic Khat Usage as a Cause of Chronic Hypertensive Encephalopathy and Vascular Dementia: A Case Report

Khat is a native plant of Eastern Africa that is widely utilized for its stimulant-like effects. It is known to have effects similar to those of amphetamine and has a comparable side effect profile, including tachycardia, hypertension, and insomnia. In this case report, we present a 45-year-old Somali gentleman with a history of more than eight years of chronic Khat use, presenting with progressive cognitive decline. MRI findings were significant for white matter changes and microhemorrhages in the setting of chronic and poorly controlled hypertension, likely secondary to chronic Khat use. Understanding, identifying, and educating about the effects of long-term Khat use are important considerations in the treatment and management of hypertension and should be included in the differential diagnosis of vascular dementia and progressive cognitive decline in the Somali population in the United States.