Anger Proneness Increases Risk of Heart Failure

Abstract

Introduction: Crystal Methamphetamine (meth), commonly known as ice, is the drug of choice in Hawaii and, increasingly, the U.S. A common drug of abuse for over 2 decades, meth is associated with memory loss, aggression, psychosis, hypertension and dental problems. Case reports and small series suggest that meth is also associated with heart failure (HF), particularly among Native Hawaiian and Pacific Peoples (NHPP). Hypothesis: NHPP have a higher prevalence of HF associated with meth as compared to Caucasians. Methods: All NHPP, Caucasian, Japanese and Filipino patients discharged from 2003 through 2007 with a primary diagnosis of HF were identified through our hospital’s data warehouse. A trained study nurse performed a detailed medical record review to obtain study data, including ejection fraction (EF) and possible causes of HF. For patients with EF!41%, 2 cardiologists reviewed all charts to determine a probable cause of HF. A third cardiologist reviewed the case if the first two disagreed. If any two cardiologists did not agree, the patient was excluded (n544). Results: A total of 1,362 patients were identified with 865 (64%) having an EF!41%. The table summarizes our findings. NHPP was the largest population (38%) and, with Filipinos, were significantly younger than Caucasians. Ischemia was determined to be the most common cause of HF. However meth use was associated with HF significantly more frequently among NHPP (16%) and Filipinos (13%) than Caucasians (3%). Conclusion: NHPP and Filipinos are more likely to have HF that is associated with crystal methamphetamine than are Caucasians, and are significantly younger. The rate of HF may increase as the use of meth increases.