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

Authors Mau M, Asao K, Efird J, Saito E, Ratner R, Hafi M, Seto T

Published 7 December 2008 Volume 2009:5 Pages 45—52


Review by Single anonymous peer review

Peer reviewer comments 3

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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

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