Methamphetamine use associated with cardiovascular disease in hospitalized patients

1. Among hospitalized patients, methamphetamine use was associated with an increased risk of cardiovascular disease.

2. Among individuals using methamphetamines, those with chronic kidney disease, hypertension, and diabetes had an increased risk of cardiovascular disease.

Evidence Rating Level: 2 (Good)

Methamphetamine use is growing to be a global health crisis and presents a significant disease burden. Studies have suggested that methamphetamine use is associated with cardiovascular disease (CVD) and worse outcomes, although there is limited evidence exploring the incidence and predictors of CVD among individuals using amphetamines. In this retrospective cohort study, data from 202,490,246 Californian patients between 2005 and 2011 was obtained to assess hospital admissions, methamphetamine use, and incidence of pulmonary hypertension, stroke, heart failure, myocardial infarction, and overall CVD burden. The results of this study suggest that the incidence of CVD was 32% higher among individuals who used methamphetamines compared to those who did not (HR 1.32, 95%CI 1.26-1.38). Specifically, methamphetamine use was associated with elevated risk of heart failure, myocardial infarction, pulmonary hypertension, and stroke. Factors contributing to an increased risk of developing CVD among methamphetamine users included chronic kidney disease (HR 2.38, 95%CI 1.74-3.25), a pre-existing diagnosis of hypertension (HR 2.26, 95%CI 2.03-2.51), diabetes (HR 1.75, 95%CI 1.55-1.97), and smoking (HR 1.28, 95%CI 1.17-1.40). Interestingly, the simultaneous use of cocaine and alcohol were not associated with an increased risk of CVD overall, among methamphetamine users. In conclusion, methamphetamine use presents a significant healthcare burden globally due to the risks associated with cardiovascular disease. This study had several strengths including the longitudinal nature with follow-up of selected participants over many years. As well, a large and diverse population was selected, which improves the power and overall validity of the study. Further research investigating the mechanisms of action behind the association of cardiovascular disease with methamphetamine use, as well as the effects of different types of amphetamines along with the effects of its duration of use and dosage, could be very valuable.

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