Comparison of Functional and Hemodynamic Parameters Between Methamphetamine-Associated and Idiopathic Pulmonary Arterial Hypertension: Systematic Review and Meta-Analysis

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Pulmonary Arterial Hypertension (n=1991). Intervention: Methamphetamine-associated pulmonary arterial hypertension vs. Idiopathic pulmonary arterial hypertension. Primary outcome: World Health Organization Functional Class III or IV (WHO-FC III/IV) (RR 1.17, 95% CI 1.05-1.30, p=0.01).

Q: What does this research mean for the field?

Methamphetamine-associated pulmonary arterial hypertension is associated with a significantly higher risk of WHO functional class III/IV impairment and modest hemodynamic worsening compared to idiopathic pulmonary arterial hypertension. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Fani Papaioannou; Thomas Karagiannis; Afroditi Boutou; Athina Georgopoulou; Stergios Kaprinis; Georgia Pitsiou

doi:10.3390/healthcare14142089

July 13, 2026HealthcareOpen Access

Comparison of Functional and Hemodynamic Parameters Between Methamphetamine-Associated and Idiopathic Pulmonary Arterial Hypertension: Systematic Review and Meta-Analysis

View Full Paper

Ask AI

Bookmark

Share

Key result

Methamphetamine-associated PAH linked to ~17% higher risk of WHO functional class III/IV versus idiopathic PAH.

RR 1.17
95% CI 1.05-1.30
P=0.01
n=1,991

Figures

Why the study?

The study was conducted to compare functional and hemodynamic parameters between patients with methamphetamine-associated pulmonary arterial hypertension and idiopathic pulmonary arterial hypertension.

Does methamphetamine-associated PAH present with worse functional and hemodynamic parameters compared to idiopathic PAH?

Key Points

To systematically compare functional capacity and invasive hemodynamic parameters between patients diagnosed with methamphetamine-associated pulmonary arterial hypertension and idiopathic pulmonary arterial hypertension.
Searched MEDLINE, Scopus, and gray literature through September 2025 for observational studies comparing Meth-APAH and IPAH cohorts diagnosed via right heart catheterization.
Included 5 observational studies (2 prospective cohort, 2 retrospective cohort, and 1 cross-sectional) comprising N=1991 participants.
Synthesized primary outcomes (WHO-FC III/IV, 6-MWD, mPAP) and secondary hemodynamics (RAP, SVI, CI, PVR, PAWP, HR) using random-effects meta-analyses and sensitivity analyses.
Meth-APAH was associated with a significantly higher risk of presenting with WHO-FC III/IV functional impairment compared to IPAH (RR 1.17, 95% CI 1.05–1.30, p = 0.01).
Patients with Meth-APAH exhibited higher right atrial pressure (MD 1.59, 95% CI 0.07–3.11, p = 0.04) and reduced stroke volume index (MD −3.57, 95% CI −6.74–−0.40, p = 0.04).
No statistically significant differences were detected for 6-MWD (MD −4.23, 95% CI −99.51–91.04, p = 0.9), mPAP (MD −1.19, 95% CI −8.71–6.33, p = 0.65), CI (MD −0.13, 95% CI −0.51–0.26, p = 0.38), or PVR (SMD 0.08, 95% CI −0.33–0.48, p = 0.63).

Study Design

Type

Meta-Analysis (n=1,991)

Structured PICO

Does methamphetamine-associated PAH present with worse functional and hemodynamic parameters compared to idiopathic PAH?

P

Population

1,991 patients with pulmonary arterial hypertension confirmed by right heart catheterization, comparing those with methamphetamine-associated PAH to idiopathic PAH across 5 observational studies.

E

Exposure

Methamphetamine-associated pulmonary arterial hypertension (Meth-APAH) (Exposure)

C

Comparator

Idiopathic pulmonary arterial hypertension (IPAH)

O

Outcome

World Health Organization Functional Class III or IV (WHO-FC III/IV), six-minute walk distance (6-MWD), and mean pulmonary arterial pressure (mPAP)surrogate

Main Result

Relative Risk: 1.17 (95% CI 1.05–1.3)

p-value: p=0.01

Methamphetamine-associated PAH is associated with modestly worse functional class and specific hemodynamic parameters (higher right atrial pressure, lower stroke volume index) compared to idiopathic PAH, highlighting the need for tailored management.

Limitations

Small number of eligible studies
Meta-analysis relied solely on baseline cross-sectional measurements
Absence of standardized criteria for quantifying methamphetamine exposure
Residual confounding due to observational nature of included studies
Exclusive origin of studies from the United States limits generalizability
Meta-analysis relied solely on baseline measurements, effectively making the data cross-sectional
Small number of eligible studies with varied designs
Absence of clearly defined and standardized criteria for quantifying adequate methamphetamine exposure
Residual confounding and reliance on unadjusted data
Exclusive origin of the studies from the United States limits generalizability

Implication

May warrant vigilance for severe functional class in Meth-APAH; extends observational comparisons but leaves causal and outcome questions open.

Abstract

Background: We conducted a systematic review and meta-analysis to compare functional and hemodynamic parameters between patients with Meth-APAH and idiopathic PAH (IPAH). Methods: MEDLINE, Scopus, and gray literature were searched up to September 2025. Eligible studies were observational and compared functional and hemodynamic parameters between patients with Meth-APAH and IPAH. All participants had undergone diagnostic right heart catheterization (RHC) and were classified by methamphetamine use history and/or toxicological screening. Primary outcomes included World Health Organization Functional Class III or IV (WHO-FC III/IV), six-minute walk distance (6-MWD), and mean pulmonary arterial pressure (mPAP). Secondary outcomes were cardiac index (CI), right atrial pressure (RAP), pulmonary vascular resistance (PVR), stroke volume index (SVI), pulmonary artery wedge pressure (PAWP), and heart rate (HR). Random-effects models were applied for pooled estimates. Results: Five studies comprising 1991 participants were included. Patients with Meth-APAH demonstrated a significantly higher risk of being classified as WHO-FC III/IV (RR 1.17, 95%CI 1.05–1.30, p = 0.01), as well as higher RAP (MD 1.59, 95%CI 0.07–3.11, p = 0.04) and reduced SVI (MD −3.57, 95%CI −6.74–−0.4, p = 0.04), but differences were modest. No significant differences were found for 6-MWD, mPAP, CI, PVR, PAWP, or HR. Conclusions: Meth-APAH could be associated with worse functional and hemodynamic profile compared to IPAH, but available studies are few with high heterogeneity, so that clear differences in several functional and hemodynamic parameters could not be established between these disease entities. These results highlight the need for further research in this direction.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Papaioannou et al. (2026) conducted a meta-analysis in Pulmonary Arterial Hypertension (n=1,991). Methamphetamine-associated pulmonary arterial hypertension vs. Idiopathic pulmonary arterial hypertension was evaluated on World Health Organization Functional Class III or IV (WHO-FC III/IV) (RR 1.17, 95% CI 1.05-1.30, p=0.01). Methamphetamine-associated pulmonary arterial hypertension was associated with a higher risk of being WHO Functional Class III or IV compared to idiopathic PAH (RR 1.17, p=0.01).

synapsesocial.com/papers/6a5600ff10535b590d16246f https://doi.org/10.3390/healthcare14142089

View Full Paper

Ask AI

Bookmark

Share

Comparison of Functional and Hemodynamic Parameters Between Methamphetamine-Associated and Idiopathic Pulmonary Arterial Hypertension: Systematic Review and Meta-Analysis

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Comparison of Functional and Hemodynamic Parameters Between Methamphetamine-Associated and Idiopathic Pulmonary Arterial Hypertension: Systematic Review and Meta-Analysis

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading