Clinical Correlates and Outcomes of Methamphetamine‐Associated Cardiovascular Diseases in Hospitalized Patients in California

Journal of the American Heart Association · 2022 · 28 citations

• Medicine
• Internal medicine
• Psychiatry

Background Methamphetamine misuse affects 27 million people worldwide and is associated with cardiovascular disease (CVD); however, risk factors for CVD among users have not been well studied. Methods and Results We studied hospitalized patients in California, captured by the Healthcare Cost and Utilization Project database, between 2005 and 2011. We studied the association between methamphetamine use and CVD (pulmonary hypertension, heart failure, stroke, and myocardial infarction). Among 20 249 026 persons in the Healthcare Cost and Utilization Project, 66 199 used methamphetamines (median follow-up 4.58 years). Those who used were more likely younger (33 years versus 45 years), male (63.3% versus 44.4%), smoked, misused alcohol, and had depression and anxiety compared with nonusers. Methamphetamine use was associated with the development of heart failure (hazard ratio [HR], 1.53 [95% CI, 1.45-1.62]) and pulmonary hypertension (HR, 1.42 [95% CI, 1.26-1.60]). Among users, male sex (HR, 1.73 [95% CI, 1.37-2.18]) was associated with myocardial infarction. Chronic kidney disease (HR, 2.38 [95% CI, 1.74-3.25]) and hypertension (HR, 2.26 [95% CI, 2.03-2.51]) were strong risk factors for CVD among users. When compared with nonuse, methamphetamine use was associated with a 32% significant increase in CVD, alcohol abuse with a 28% increase, and cocaine use with a 47% increase in CVD. Conclusions Methamphetamine use has a similar magnitude of risk of CVD compared with alcohol and cocaine. Prevention and treatment could be focused on those with chronic kidney disease, hypertension, and mental health disorders.

Migration of Garifuna

Oxford University Press eBooks · 2021 · 18 citations

• Sociology
• Geography
• Ethnology

Abstract This chapter examines the causes and consequences of migrations as well as population expansions and reductions of the Garifuna (also known as the Black Caribs), and the Carib and Arawak Native Americans from South America to the Leeward Islands of the Caribbean. In the 1600s, African slaves were brought by the British to the Lesser Antilles and admixed with Indigenous Native Americans to establish the Garifuna populations. British colonial takeover of St. Vincent (called Yurumein by the Garifuna) from the French resulted in conflict over land ownership with the Black Caribs, a war, and the forcible relocation of the Garifuna from St. Vincent to Baliceaux Island, Bay Islands, and eventually to the coast of Central America-- Honduras. From two founding communities established near Trujillo, Honduras, the Garifuna populations expanded through fission to form 54 villages distributed along the coast of Central America from Belize to Nicaragua. The evolutionary consequences of these migrations included an exceptional fertility in the founding populations, high genetic variability in some communities due to admixture between Native American and African populations, and resistance to malaria due to genes brought by the parental populations. The Garifuna provide an evolutionary success story driven by their unique history of migrations and genetic ancestry.

Socioeconomic Burden of Rising Methamphetamine-Associated Heart Failure Hospitalizations in California From 2008 to 2018

Circulation Cardiovascular Quality and Outcomes · 2021 · 38 citations

• Medicine
• Emergency medicine
• Pediatrics

BACKGROUND: Methamphetamine-associated cardiomyopathy/heart failure (MethHF) is an increasingly recognized disease entity in the context of a rising methamphetamine (meth) epidemic that most severely impacts the western United States. Using heart failure (HF) hospitalization data from the Office of Statewide Health Planning and Development, this study aimed to assess trend and disease burden of MethHF in California. METHODS: -based secondary diagnoses. Statistical significance of trends in age-adjusted rates of hospitalization per 100 000 adults were evaluated using nonparametric analysis. RESULTS: <0.001), with lower Charlson Comorbidity Index, yet they had longer length of stay, more hospitalizations per patient, and more procedures performed during their stays. CONCLUSIONS: MethHF hospitalizations increased sharply during the study period and contributed significantly to the HF hospitalization burden in California. This emerging HF phenotype, which engenders considerable financial and societal costs, calls for an urgent and concerted public health response to contain its spread.