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...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Addictive Behaviors Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352853223000056 |
| _version_ | 1797804630738993152 |
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| author | Leslie W. Suen Eric Vittinghoff Alan H.B. Wu Akshay Ravi Phillip O. Coffin Priscilla Hsue Kara L. Lynch Dhruv S. Kazi Elise D. Riley |
| author_facet | Leslie W. Suen Eric Vittinghoff Alan H.B. Wu Akshay Ravi Phillip O. Coffin Priscilla Hsue Kara L. Lynch Dhruv S. Kazi Elise D. Riley |
| author_sort | Leslie W. Suen |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-13T05:40:03Z |
| format | Article |
| id | doaj.art-ea9769907f134071bfc53cf62fd675de |
| institution | Directory Open Access Journal |
| issn | 2352-8532 |
| language | English |
| last_indexed | 2024-03-13T05:40:03Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Addictive Behaviors Reports |
| spelling | doaj.art-ea9769907f134071bfc53cf62fd675de2023-06-14T04:33:33ZengElsevierAddictive Behaviors Reports2352-85322023-06-0117100483Multiple substance use and blood pressure in women experiencing homelessnessLeslie W. Suen0Eric Vittinghoff1Alan H.B. Wu2Akshay Ravi3Phillip O. Coffin4Priscilla Hsue5Kara L. Lynch6Dhruv S. Kazi7Elise D. Riley8National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States; Corresponding author at: National Clinicians Scholar Program Fellow, University of California, San Francisco, 490 Illinois St, 7th Floor, San Francisco, CA 94158, United States.Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Medicine, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Medicine, Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United States; San Francisco Department of Public Health, San Francisco, CA, United StatesDivision of Cardiology, Chan Zuckerberg San Francisco General Hospital, San Francisco, CA, United StatesDepartment of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United StatesRichard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United StatesDepartment of Medicine, Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United StatesBackground: 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.http://www.sciencedirect.com/science/article/pii/S2352853223000056Blood pressureCocaineHypertensionSubstance-related disordersWomen |
| spellingShingle | Leslie W. Suen Eric Vittinghoff Alan H.B. Wu Akshay Ravi Phillip O. Coffin Priscilla Hsue Kara L. Lynch Dhruv S. Kazi Elise D. Riley Multiple substance use and blood pressure in women experiencing homelessness Addictive Behaviors Reports Blood pressure Cocaine Hypertension Substance-related disorders Women |
| 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 | Blood pressure Cocaine Hypertension Substance-related disorders Women |
| url | http://www.sciencedirect.com/science/article/pii/S2352853223000056 |
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