Methamphetamine use as an independent risk factor for intracerebral hemorrhage in hypertensive patients: A...

Methamphetamine has been increasingly implicated in cerebrovascular injury, but its independent contribution to intracerebral hemorrhage (ICH) among patients with hypertension is not well established. This study examined whether methamphetamine use is associated with a higher likelihood of ICH in hypertensive adults and explored whether methamphetamine exposure may affect hemorrhage severity and neurological and functional outcomes at discharge.

We conducted a retrospective case-control study involving hypertensive adults admitted to a tertiary hospital. The study included 101 patients with spontaneous ICH and 117 hypertensive controls without ICH. Methamphetamine use served as the primary exposure variable. Data on demographics, duration of hypertension, adherence to antihypertensive therapy, and other substance use were collected. Logistic regression was used to estimate odds ratios (ORs) for ICH. Among patients with ICH, hemorrhage severity (ICH score and hematoma volume) and neurological and functional outcomes at admission and discharge were assessed using the NIH Stroke Scale (NIHSS), Glasgow Coma Scale (GCS), and modified Rankin Scale (mRS).

In unadjusted analysis, methamphetamine use showed no significant association with ICH (OR 1.58; P = 0.16). After adjustment for age, sex, duration of hypertension, and medication adherence, methamphetamine use was associated with higher odds of ICH (adjusted OR 3.13; 95% CI 1.30-7.52; P = 0.011). Among patients with ICH, methamphetamine use was not associated with hemorrhage severity, including hematoma volume and ICH score, nor with measures of neurological severity or functional outcomes at admission or discharge.

Methamphetamine use was associated with a higher likelihood of ICH among hypertensive adults, while short-term neurological and functional outcomes did not differ between users and non-users.