Racial disparities in methamphetamine-associated intracerebral hemorrhage

Neurology. 2015 Mar 10;84(10):995-1001. doi: 10.1212/WNL.0000000000001339. Epub 2015 Feb 6.


Objective: To assess racial disparities in the prevalence of methamphetamine-associated intracerebral hemorrhage (Meth-ICH) among Native Hawaiians and other Pacific Islanders (NHOPI).

Methods: Prospectively collected data from an ongoing, multiethnic, single-center cohort study were analyzed. The inclusion criteria for the cohort study required that patients be adult (age 18 years or older) residents of Hawaii with nontraumatic spontaneous intracerebral hemorrhage (ICH). Patients of race other than white, Asian, or NHOPI were excluded. Determination of Meth-ICH was made prospectively by positive urine toxicology result and lack of other clinically suspected ICH etiology. Prevalence of Meth-ICH among NHOPI was compared with that of white and Asian patients.

Results: A total of 193 patients (white 16%, Asian 61%, NHOPI 23%) were analyzed. NHOPI were younger than white (54 ± 15 vs 68 ± 15 years, respectively, p = 0.0001) and Asian (vs 65 ± 16 years, p = 0.0001) patients. Overall, 25 (13%) Meth-ICHs (mean age: 49 ± 6 years, range: 33-56 years) were identified. NHOPI had higher prevalence of Meth-ICH compared with white (24% vs 0%, respectively, p = 0.003) and Asian (vs 12%, p = 0.046) patients. The observed age differences between the racial groups persisted even after excluding the Meth-ICH group (p < 0.01 for all comparison).

Conclusions: NHOPI have higher prevalence of Meth-ICH compared with white and Asian patients. However, the age disparity is not entirely driven by methamphetamine abuse.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asian Americans
  • Central Nervous System Stimulants / adverse effects*
  • Cerebral Hemorrhage / chemically induced
  • Cerebral Hemorrhage / ethnology*
  • Hawaii / ethnology
  • Health Status Disparities*
  • Humans
  • Methamphetamine / adverse effects*
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander / ethnology*
  • Prevalence
  • Whites


  • Central Nervous System Stimulants
  • Methamphetamine