Outcomes of beta-blocker therapy in methamphetamine users with cardiovascular conditions

Abstract

Methamphetamine use is associated with a range of cardiovascular conditions, including hypertension and heart failure. Beta-blocker use is commonly avoided when treating patients intoxicated with methamphetamines due to a fear of inducing unopposed alpha stimulation and worsening hypertension. We performed a retrospective review of medical records in a county hospital in California with a high prevalence of methamphetamine users. We included adults who tested positive for methamphetamines on urine toxicology, subjects who received beta-blockers within 48 h of their arrival were assigned to the case group, and those who received a non-beta-blocker antihypertensive or no antihypertensive were assigned to the control group. We compared the length of stay (LOS), readmission rate within 30 days, and systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the groups at admission and 24 h. There was no significant difference between LOS and 30-day readmission rates between subjects who received beta-blockers and subjects who did not. Subjects who received carvedilol were compared to subjects in the control group who received another antihypertensive. SBP was significantly higher in the carvedilol group at admission, but there was no significant difference between groups after 24 h, and there was no significant difference in LOS. Treatment with beta-blockers in the case group did not increase LOS or readmission rates compared to the control group, and treatment with carvedilol effectively reduced SBP in patients with hypertension and methamphetamine-induced cardiomyopathy. Our results indicate that beta-blockers, particularly carvedilol, are an effective treatment modality in methamphetamine users.