Risk factors associated with methamphetamine use and heart failure among native Hawaiians and other Pacific Island peoples.
Author(s): Mau MK, Asao K, Efird J, Saito E, Ratner R, Hafi M, Seto T
Affiliation(s): Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Manoa, USA. mmau@hawaii.edu
Publication date & source: 2009, Vasc Health Risk Manag., 5(1):45-52. Epub 2009 Apr 8.
Publication type: Randomized Controlled Trial; Research Support, N.I.H., Extramural
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. MAIN OUTCOME MEASURE: 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.
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