Predicting Adverse Cardiovascular Effects of Methamphetamine
Methamphetamine promotes the release of dopamine and norepinephrine, leading to an increase in heart rate and blood pressure. Cardiovascular complications of methamphetamine use include arrhythmia, stroke, and acute coronary syndrome. The factors that predict cardiovascular response to methamphetamine are not known. Under laboratory conditions, investigators administered intravenous methamphetamine to 67 methamphetamine-dependent individuals and monitored heart rate and blood pressure response.
- Compared with baseline, heart rate increased by 18 beats per minute (p< 0.001), and systolic blood pressure increased by 18 mm Hg (p< 0.001) following methamphetamine administration.The peak effect was seen 10 minutes after administration.
- Factors associated with cardiovascular response included
- baseline heart rate and blood pressure (men only).
- female gender.
- alcohol use in the past 30 days.
- pre-study intravenous (compared to smoked) methamphetamine use.
- cannabis use in the past 30 days, which led to decreased peak change in heart rate.
- Factors that were not associated with cardiovascular response included
- lifetime and past 30-day use of methamphetamine.
- lifetime and past 30-day use of nicotine.
The cardiovascular effects of methamphetamine are substantial and put patients at risk for serious complications. This study helps to elucidate the factors that may be associated with more profound responses. Clinicians should warn patients of the cardiovascular complications of methamphetamine use and consider these factors when evaluating patients with recent methamphetamine ingestion.David A. Fiellin, MD
Fleury G, De La Garza R 2nd, Mahoney JJ 3rd, et al. Predictors of cardiovascular response to methamphetamine administration in methamphetamine-dependent individuals. Am J Addict. 2008;17(2):103–110.