Tuesday , November 14, 2017 - 1:00 PM
By AMERICAN HEART ASSOCIATION NEWS
ANAHEIM, California – The steady rise in methamphetamine use across the country seems to be creating its own epidemic – a new kind of heart failure case, according to new research.
The study, released Tuesday at the American Heart Association’s Scientific Sessions conference, shows heart failure associated with methamphetamine use quadrupled in a decade among U.S. veterans treated by the San Diego Veterans Administration Medical Center.
But what researchers said was even more worrisome is the heart failure was more severe and happening in younger-than-typical patients. The study suggested the condition is a “new phenotype” it called Meth-HF.
“It’s greatly concerning to the cardiac community,” said study author Isac Thomas, M.D., a cardiology fellow at the University of California, San Diego School of Medicine. “The primary step for providers taking care of these patients is to have greater recognition. It’s happening right in front of our eyes, a large number of young people coming in with heart failure. … Recognition of that fact can lead to earlier detection.”
Methamphetamine, also known as crank, ice, crystal meth, speed and glass, is a highly addictive stimulant that usually comes in crystal or powder forms. It can be smoked, “snorted,” swallowed or injected.
According to federal drug surveys in 2012, over 12 million people – nearly 5 percent of the population – have tried meth at least once. Statistics in 2015 from the Substance Abuse and Mental Health Services Administration show about 900,000 people were current meth users.
“You don’t always ask about drug or methamphetamine use,” said lead author Marin Nishimura, M.D., an internal medicine resident at the University of California, San Diego. “But we are seeing that it’s important to think about that, especially with a patient who is younger and presents with a new diagnosis of heart failure.”
Nishimura and fellow researchers examined data from 9,588 patients diagnosed with heart failure at the San Diego VA between 2005 and 2015. They determined 480 had meth-related heart failure. Comparing those patients to heart failure patients without methamphetamine use, they found:
-- The prevalence of meth use rose from 1.7 percent among VA heart failure patients in 2005 to 8 percent in 2015.
-- Meth-HF patients were an average age of 61, more than a decade younger than other heart failure patients, whose average age was 72.
-- The combination of heart failure and methamphetamine use resulted in more emergency department visits -- 1.9 visits a year versus 0.9 -- and more hospital admissions.
Christopher B. Granger, M.D., director of Duke’s Cardiac Intensive Care Unit in Durham, North Carolina, said the study should spread awareness that methamphetamine use is spreading and has deadly and “substantial health consequences.”
But there’s still hope.
“It’s also potentially a reversible cause of heart failure,” said Granger, who was not part of the study. “That’s really important – that if we can identify this early in the process and help these patients to stop abusing methamphetamine, they may actually have recovery of heart function. So, I think there’s lots of reasons it’s important for both the public and health care providers to be aware of this particular problem.”
In May, a study published in the American College of Cardiology’s journal Heart Failure showed quitting methamphetamine can reverse some damage the drug causes to the heart and can improve heart function when combined with medical treatment. It suggested quitting meth should be a first-line approach in treating those cases of heart failure.
Nishimura agrees and said this new and different type of heart failure patient needs a “multidisciplinary approach.” That could include help from a mental health specialist, such as a psychologist, and a substance abuse specialist, as well as medical therapies.
“So, if we treat the heart failure but also the patient as a whole,” she said, “we will have a better chance at the patient’s recovery.”
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-- Scientific Sessions 2017 news stories
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