Risk factors associated with methamphetamine use and heart failure among native Hawaiians and other Pacific Island peoples.
OBJECTIVE
Heart failure (HF), a long term outcome of chronic methamphetamine use (MU), occurs more frequently in racial and ethnic minority populations at high risk for cardiovascular disparities. This study examined the association of socio-demographic and clinical risk factors with MU among heart failure patients who are Native Hawaiians (NH) or other Pacific Island peoples (PIP). DESIGN/SETTING/PATIENT POPULATION: Cross-sectional study of NHs and PIPs with advanced heart failure enrolled in the Malama Pu'uwai Study, a randomized control trial to test an educational intervention to reduce re-hospitalization and/or death. A total of 82 participants were enrolled between 6/1/06 to 12/31/07 and met the following eligibility criteria: 1) self-identified NH or PIP, 2) Left ventricular systolic ejection fraction <or=45%, 3) Age of 21 years or older. Data were analyzed by odds ratios (OR), 95% confidence intervals (CI), and multiple logistic regression analysis.


METHODS
Methamphetamine use.


RESULTS
Twenty-two percent of HF participants were identified as being current or prior methamphetamine users. Younger age and non-married status (combined never married or divorced/separated) were independently associated with MU after adjustment for sex, education, and other co-morbidities associated with HF (ie, age >50 years, OR = 0.16, 95% CI, 0.03-0.84; non-married status combined as never married OR = 8.5, CI, 1.5-47; divorced/separated OR = 11, CI 1.8-75).


CONCLUSIONS
RISK FACTORS ASSOCIATED WITH MU IN NH AND PIPS WITH HEART FAILURE INCLUDE: younger age and being divorced/separated or never married. Health care providers should be aware of MU as a contributing factor in the approach and treatment of HF in NHs and PIPs.
Mau
Marjorie K
MK
Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Manoa, USA. mmau@hawaii.edu
Asao
Karynna
K
Efird
Jimmy
J
Saito
Erin
E
Ratner
Robert
R
Hafi
Muhannad
M
Seto
Todd
T
D000328:Adult; D000367:Age Factors; D019969:Amphetamine-Related Disorders / Q000150:complications* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004243:Divorce; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D054624:Health Status Disparities; D006333:Heart Failure / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D012847:Single Person; D013318:Stroke Volume; D016277:Ventricular Function, Left
D000697:Central Nervous System Stimulants; D008694:Methamphetamine