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Multiple substance use and blood pressure in women experiencing homelessness

BACKGROUND: Substance use increases risk of cardiovascular events, particularly among women with additional risk factors like housing instability. While multiple substance use is common among unstably housed individuals, relationships between multiple substance use and cardiovascular risk factors li...

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Autores principales: Suen, Leslie W., Vittinghoff, Eric, Wu, Alan H.B., Ravi, Akshay, Coffin, Phillip O., Hsue, Priscilla, Lynch, Kara L., Kazi, Dhruv S., Riley, Elise D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975611/
https://www.ncbi.nlm.nih.gov/pubmed/36875801
http://dx.doi.org/10.1016/j.abrep.2023.100483
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author Suen, Leslie W.
Vittinghoff, Eric
Wu, Alan H.B.
Ravi, Akshay
Coffin, Phillip O.
Hsue, Priscilla
Lynch, Kara L.
Kazi, Dhruv S.
Riley, Elise D.
author_facet Suen, Leslie W.
Vittinghoff, Eric
Wu, Alan H.B.
Ravi, Akshay
Coffin, Phillip O.
Hsue, Priscilla
Lynch, Kara L.
Kazi, Dhruv S.
Riley, Elise D.
author_sort Suen, Leslie W.
collection PubMed
description BACKGROUND: Substance use increases risk of cardiovascular events, particularly among women with additional risk factors like housing instability. While multiple substance use is common among unstably housed individuals, relationships between multiple substance use and cardiovascular risk factors like blood pressure are not well characterized. METHODS: We conducted a cohort study between 2016 and 2019 to examine associations between multiple substance use and blood pressure in women experiencing homelessness and unstable housing. Participants completed six monthly visits including vital sign assessment, interview, and blood draw to assess toxicology-confirmed substance use (e.g., cocaine, alcohol, opioids) and cardiovascular health. We used linear mixed models to evaluate the outcomes of systolic and diastolic blood pressure (SBP; DBP). RESULTS: Mean age was 51.6 years; 74 % were women of color. Prevalence of any substance use was 85 %; 63 % of participants used at least two substances at baseline. Adjusting for race, body mass index and cholesterol, cocaine was the only substance significantly associated with SBP (4.71 mmHg higher; 95 % CI 1.68, 7.74) and DBP (2.83 mmHg higher; 95 % CI 0.72, 4.94). Further analysis found no differences in SBP or DBP between those with concurrent use of other stimulants, depressants, or both with cocaine, compared to those who used cocaine only. CONCLUSIONS: Cocaine was the only substance associated with higher SBP and DBP, even after accounting for simultaneous use of other substances. Along with interventions to address cocaine use, stimulant use screening during cardiovascular risk assessment and intensive blood pressure management may improve cardiovascular outcomes among women experiencing housing instability.
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spelling pubmed-99756112023-03-02 Multiple substance use and blood pressure in women experiencing homelessness Suen, Leslie W. Vittinghoff, Eric Wu, Alan H.B. Ravi, Akshay Coffin, Phillip O. Hsue, Priscilla Lynch, Kara L. Kazi, Dhruv S. Riley, Elise D. Addict Behav Rep Research paper BACKGROUND: Substance use increases risk of cardiovascular events, particularly among women with additional risk factors like housing instability. While multiple substance use is common among unstably housed individuals, relationships between multiple substance use and cardiovascular risk factors like blood pressure are not well characterized. METHODS: We conducted a cohort study between 2016 and 2019 to examine associations between multiple substance use and blood pressure in women experiencing homelessness and unstable housing. Participants completed six monthly visits including vital sign assessment, interview, and blood draw to assess toxicology-confirmed substance use (e.g., cocaine, alcohol, opioids) and cardiovascular health. We used linear mixed models to evaluate the outcomes of systolic and diastolic blood pressure (SBP; DBP). RESULTS: Mean age was 51.6 years; 74 % were women of color. Prevalence of any substance use was 85 %; 63 % of participants used at least two substances at baseline. Adjusting for race, body mass index and cholesterol, cocaine was the only substance significantly associated with SBP (4.71 mmHg higher; 95 % CI 1.68, 7.74) and DBP (2.83 mmHg higher; 95 % CI 0.72, 4.94). Further analysis found no differences in SBP or DBP between those with concurrent use of other stimulants, depressants, or both with cocaine, compared to those who used cocaine only. CONCLUSIONS: Cocaine was the only substance associated with higher SBP and DBP, even after accounting for simultaneous use of other substances. Along with interventions to address cocaine use, stimulant use screening during cardiovascular risk assessment and intensive blood pressure management may improve cardiovascular outcomes among women experiencing housing instability. Elsevier 2023-02-13 /pmc/articles/PMC9975611/ /pubmed/36875801 http://dx.doi.org/10.1016/j.abrep.2023.100483 Text en © 2023 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research paper
Suen, Leslie W.
Vittinghoff, Eric
Wu, Alan H.B.
Ravi, Akshay
Coffin, Phillip O.
Hsue, Priscilla
Lynch, Kara L.
Kazi, Dhruv S.
Riley, Elise D.
Multiple substance use and blood pressure in women experiencing homelessness
title Multiple substance use and blood pressure in women experiencing homelessness
title_full Multiple substance use and blood pressure in women experiencing homelessness
title_fullStr Multiple substance use and blood pressure in women experiencing homelessness
title_full_unstemmed Multiple substance use and blood pressure in women experiencing homelessness
title_short Multiple substance use and blood pressure in women experiencing homelessness
title_sort multiple substance use and blood pressure in women experiencing homelessness
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975611/
https://www.ncbi.nlm.nih.gov/pubmed/36875801
http://dx.doi.org/10.1016/j.abrep.2023.100483
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