Risk factors associated with methamphetamine use and heart failure among Native Hawaiians and other Pacific Island peoples

Marjorie K Mau¹, Karynna Asao², Jimmy Efird³, Erin Saito, Robert Ratner⁴, Muhannad Hafi⁴, Todd Seto⁵

¹Department of Native Hawaiian Health; ³Biostatistics and Data Management Facility; ⁵Department of Medicine, John A. Burns School of Medicine, University of Hawai’i at Manoa; ²Claremont College; ⁴Medstar Research Institute

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 ≤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.

Keywords: Native Hawaiian and other Pacific Islander, ethnic minority, methamphetamine use, heart failure