Mau Marjorie K, Asao Karynna, Efird Jimmy, Saito Erin, Ratner Robert, Hafi Muhannad, Seto Todd
Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Manoa, USA.
Vasc Health Risk Manag. 2009;5(1):45-52. Epub 2009 Apr 8.
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.
Methamphetamine use.
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).
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.
心力衰竭（HF）是慢性甲基苯丙胺使用（MU）的一个长期后果，在心血管疾病差异风险较高的种族和少数民族人群中更为常见。本研究调查了社会人口统计学和临床风险因素与夏威夷原住民（NH）或其他太平洋岛民（PIP）心力衰竭患者中甲基苯丙胺使用之间的关联。设计/地点/患者人群：对参加“关爱之心研究”的患有晚期心力衰竭的NH和PIP进行横断面研究，该研究是一项随机对照试验，旨在测试一项教育干预措施以减少再住院和/或死亡。2006年6月1日至2007年12月31日期间共招募了82名参与者，他们符合以下纳入标准：1）自我认定为NH或PIP；2）左心室收缩射血分数≤45%；3）年龄21岁及以上。数据通过比值比（OR）、95%置信区间（CI）和多因素逻辑回归分析进行分析。
甲基苯丙胺使用情况。
22%的心力衰竭参与者被确定为当前或既往甲基苯丙胺使用者。在对性别、教育程度以及与心力衰竭相关的其他合并症（即年龄>50岁）进行调整后，年龄较小和未婚状态（包括从未结婚或离婚/分居）与甲基苯丙胺使用独立相关（年龄>50岁，OR = 0.16，95%CI，0.03 - 0.84；未婚状态合并从未结婚OR = 8.5，CI，1.5 - 47；离婚/分居OR = 11，CI 1.8 - 75）。
NH和PIP心力衰竭患者中与甲基苯丙胺使用相关的风险因素包括：年龄较小以及离婚/分居或从未结婚。医疗保健提供者在诊治NH和PIP心力衰竭患者时应意识到甲基苯丙胺使用是一个促成因素。
