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      Methamphetamine and the risk of pulmonary arterial hypertension

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          Abstract

          Purpose of review

          Methamphetamine is a highly addictive drug originally developed for the treatment of neuropsychiatric disorders. At present, the epidemic rise of illicit methamphetamine use has increased the number of patients living with medical complications. Our group has recently identified a definite association between methamphetamine use and pulmonary arterial hypertension (PAH), a life-threatening disease characterized by occlusive vasculopathy and progressive right heart failure. This review will discuss the evidence that links methamphetamine with PAH and how to approach the diagnosis and management of methamphetamine-associated pulmonary arterial hypertension (Meth-APAH) patients in clinic.

          Recent findings

          Compared with idiopathic (I) PAH, Meth-APAH patients present with worse functional status, right ventricular dysfunction, and exercise tolerance. Despite therapy, the 5-year survival of Meth-APAH patients is significantly lower compared with IPAH. Genetic studies suggest that loss of function variants in genes involved in drug detoxification can increase susceptibility for methamphetamine-related vascular injury and trigger occlusive vasculopathy.

          Summary

          PAH patients undergoing diagnostic evaluation should be screened for a history of current or past methamphetamine use. Pharmacovigilance should be implemented to monitor patients being treated with methamphetamine for neuropsychiatric disorders (e.g., attention-deficit hyperactivity disorder). More studies will be needed to identify which susceptibility factors increase risk of PAH in methamphetamine users.

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          Author and article information

          Journal
          9503765
          20595
          Curr Opin Pulm Med
          Curr Opin Pulm Med
          Current opinion in pulmonary medicine
          1070-5287
          1531-6971
          31 October 2019
          September 2018
          27 November 2019
          : 24
          : 5
          : 416-424
          Affiliations
          [a ]Department of Medicine, Stanford University School of Medicine
          [b ]Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine
          [c ]Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford, California
          Author notes
          Correspondence to Roham T. Zamanian, 300 Pasteur Dr, Room H3143, Stanford, CA 94305, USA. Tel: +1 650 725 5495; fax: +650 725 5489; Zamanian@ 123456stanford.edu
          Article
          PMC6880795 PMC6880795 6880795 nihpa1057202
          10.1097/MCP.0000000000000513
          6880795
          30036313
          ef009f7a-4feb-4602-83cc-e427997c9547
          Categories
          Article

          pulmonary arterial hypertension,methamphetamine,risk

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