Methamphetamine use has led to increased heart failure hospitalizations and costs in California

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DALLAS, July 14, 2021 – Heart failure hospitalizations and the costs of methamphetamine use have risen sharply in a decade in California, according to a new study published today in Circulation: cardiovascular quality and results, a journal of the American Heart Association.

“The results of our study should draw urgent attention to this insidious but rapidly growing form of severe heart failure – methamphetamine-related heart failure, which kills young people, depletes healthcare resources and threatens to break down. spread like wildfire to California, the West and the rest of the nation, ”said lead author Susan X. Zhao, MD, cardiologist at Santa Clara Valley Medical Center in San Jose, Calif. California is experiencing a resurgence in methamphetamine use, and the problem has been significantly compounded in recent years by the increase of purer and more potent methamphetamine in our communities. “

Heart failure is a chronic disease in which the heart becomes too weak to pump blood properly. Signs of heart failure include fatigue, shortness of breath, and heart palpitations. According to the American Heart Association’s Heart Disease and Stroke Statistics Update – 2021, approximately 6 million American adults aged 20 and older have heart failure based on 2015 data. 2018. The condition is most prevalent in people aged 60 and over.

Methamphetamine, also known as methamphetamine, is an addictive stimulant that can affect the cardiovascular system by triggering blood vessel spasms and life-threatening spikes in blood pressure. It can also increase plaque in the arteries and rewire the heart’s electrical system. Prolonged use of methamphetamine has been associated with a severe form of dilated cardiomyopathy, a condition in which weakened heart muscle enlarges and cannot pump enough blood. According to the 2017 US National Survey on Drug Use and Health, 1.6 million people reported using methamphetamine and the average age of new methamphetamine users was 23.

This study is a retrospective review of California hospital data including more than one million patients discharged between 2008 and 2018 with a diagnosis of heart failure. During this 11-year period, the researchers noted:

  • 42,565 (4%) of the patients had been diagnosed with heart failure related to methamphetamine – also known as MethHF – compared to 990,511 (96%) diagnosed with heart failure unrelated to methamphetamine use.
  • Hospitalizations for heart failure related to methamphetamine increased by 585%, while hospitalizations for heart failure unrelated to methamphetamine use decreased by 6%.
  • 94% of patients with methamphetamine-related heart failure were under 65, and more than half were between 35 and 54.
  • 79% of patients with methamphetamine-related heart failure were males and almost half of patients with methamphetamine-related heart failure were Caucasian adults.
  • Patients with methamphetamine-related heart failure were also more likely to use alcohol and use tobacco and other street drugs. They were also more likely to be homeless than other heart failure patients.
  • People with methamphetamine-related heart failure had fewer pre-existing cardiovascular problems such as atrial fibrillation or type 2 diabetes, but more high blood pressure (33%) than patients with heart failure who didn’t. were not using methamphetamine (30%).

The researchers found that the financial toll of methamphetamine-related heart failure is also significant: hospital stays were several days longer than those of other heart failure patients, and they suffered more. interventions, resulting in significantly higher health costs. The costs of hospitalization for methamphetamine-related heart failure in California increased 840%, from $ 41.5 million in 2008 to $ 390.2 million in 2018, compared with an 82% increase in costs for all heart failure hospitalizations, which rose from $ 3.5 billion to $ 6.3 billion.

“Treating patients with methamphetamine-related heart failure consumes resources and strains the health care system,” Zhao said. “Many patients present late in the disease with limited options available to them. Proactive and preventive public health awareness and education is needed to stem the influx of methamphetamine-related heart failure to its health. source.”

Zhao said that while methamphetamine-related heart failure can be considered a “disease of working-class white men,” the demographics are changing and diversifying, among people of different racial and ethnic groups and women as well. Methamphetamine-related heart failure also spreads from urban areas to rural communities.

“The methamphetamine epidemic is often overshadowed by the upsurge in opioid-related deaths and illnesses,” she said. “The long-term health consequences associated with methamphetamine use must be recognized by the public as well as by clinical communities. This study was intended to be more of a public health alarm: the urgency of the methamphetamine use disorder cannot be overstated. “

An accompanying editorial by Uri Elkayam, MD, and Pavan Reddy, MD, commented that inattention to methamphetamine-related heart failure may be due in part to a lower risk of immediate death from overdose of methamphetamine versus opioids. However, they note that methamphetamines are “just as dangerous and costly to society but more insidious in nature, its effects can cause decades of mental and physical debilitation before ending in untimely death.”

According to the editorial, “The increasing prevalence of MethHF should sound the alarm, but also signal an opportunity. Until recently, MethHF was only highlighted in the form of isolated case reports, but is now regularly seen in areas of high use. While this study makes progress in highlighting the potential societal impact of this prolonged disease, prospective data from larger cohorts may help clarify questions left unanswered by this study. Importantly, we don’t know which risk factors predispose to the development of MethHF, which prognostic factors may predict cardiac recovery, or which medical therapies may be of benefit to patients. Further understanding can simultaneously benefit the patient and reduce spiraling healthcare costs. “

Zhao and his colleagues plan to work with public health agencies to develop a statewide awareness campaign in California and examine national data to determine if it reflects what is happening at the state level. State, she added.

This study is limited in that it is a retrospective review of hospital discharge data based on a standardized coding system which may be sensitive to bias and confounding factors, including the fact that certain groups of patients patients may be asked about drug use patterns more than other groups.

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The co-authors are Andres Deluna, MD, MPH; Kate Kelsey, MPH; Clifford Wang, MD, MPH; Aravind Swaminathan, MD; Allison Staniec, Ph.D .; and Michael H. Crawford, MD Author disclosures are detailed in the manuscript.

The study did not receive any external funding.

Additional Resources:

The available multimedia is in the right column of the output link – https: //writing.heart.org /new/has methamphetamine use increased hospitalization costs for heart failure in california? preview =7c862571ef69d1147e6619549a151071

After July 14, view the manuscript and editorial online.

Meth and heart disease: a deadly crisis we don’t fully understand, report says

Methamphetamine use makes heart failure patients younger and harder to treat

Stopping Methamphetamine Helps Reverse Drug-Induced Heart Failure

Illegal drugs and heart disease

Follow the AHA / ASA news on Twitter @HeartNews

Keep up to date with AHAs Circulation: cardiovascular quality and results @CircOutcomes journal

Statements and conclusions of studies published in the scientific journals of the American Heart Association are solely those of the study authors and do not necessarily reflect the policy or position of the Association. The Association makes no representations or warranties as to their accuracy or reliability. The Association receives funding mainly from individuals; foundations and corporations (including pharmaceutical companies, device makers, and other corporations) also donate and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing scientific content. The revenues of pharmaceutical and biotechnology companies, device manufacturers and health insurance providers and the Association’s aggregate financial information can be found here.

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