Is meth use destroying vets' hearts?
Heart failure cases linked to meth use among vets nearly quadrupled during the past decade at the San Diego VA Medical Center, rising from 1.7 percent in 2005 to 8 percent in 2015, investigators found.
Veterans using meth also tended to develop heart failure at a much younger age, around 61, on average, compared with 72 for typical heart failure patients, said lead researcher Dr. Marin Nishimura. She is an internal medicine resident with the University of California, San Diego.
"When we see a younger individual who comes to the hospital with heart failure, we should be thinking about meth use," Nishimura said.
Heart failure is a chronic and progressive condition in which the heart gradually loses the ability to pump enough blood to meet the body's needs, according to the American Heart Association (AHA).
Nishimura and her team decided to investigate the toll meth takes on veterans' hearts after noticing more patients with methamphetamine-related heart failure coming in for treatment at the VA Medical Center.
The researchers reviewed records for nearly 9,600 vets diagnosed with heart failure at the San Diego center between 2005 and 2015. Among those, 480 were found to have a history of meth abuse, based on the results from urine tests during treatment.
"We can't say all of these patients had methamphetamine-induced heart failure, but these are cases where people were using methamphetamine and developed heart failure," Nishimura said.
Although the study does not prove that meth use caused heart failure in these patients, it does offer some evidence supporting meth-related heart damage.
Among heart failure patients, meth users were less likely to have blocked arteries or an irregular heartbeat condition known as atrial fibrillation than non-meth users, the researchers found.
Meth, cocaine and other stimulants "are really direct cardiac toxins," doing immediate harm to the heart, said Dr. Mary Walsh, president of the American College of Cardiology. She is also the medical director of heart failure and cardiac transplantation at St. Vincent Heart Center of Indiana.
"Meth clearly alone without any other factors can lead to heart disease and heart failure, and for people at risk of heart failure it can worsen symptoms," Walsh said. "All of us in every hospital in the United States have seen that."
Nishimura added that meth also might contribute to heart failure by causing surges of adrenaline and its related hormones, or by doing damage to small blood vessels.
Meth users were twice as likely as regular heart failure patients to visit the emergency department, and they were six times more likely to seek psychiatric care. They also tended to exhibit more substance abuse and psychiatric problems like post-traumatic stress disorder, the findings showed.
Doctors treating a younger patient with heart failure should consider doing a urine screen to see if they're using meth, Nishimura suggested.
However, doctors have to act promptly—Nishimura noted that meth filters out of the body within about a day of last use.
"Oftentimes, we focus on other traditional risk factors when treating heart failure," she said. "Maybe drug use should also be explored."
Nishimura pointed out that this study focused only on San Diego vets, and needs to be replicated elsewhere to see whether the problem is widespread.
The findings were to be presented Tuesday at the AHA's annual meeting in Anaheim, Calif. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
For more on drug abuse and heart disease, visit the American Heart Association.
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