2023-11-09 23:15:10
The use of marijuana, also known as cannabis, is gaining popularity in the United States and other nations as more states legalize it for recreational and medical use. However, it is not yet fully known how marijuana affects heart and brain health. Two new studies, conducted by separate research groups, provide information on the association between regular marijuana use and the risk of heart failure, heart attack and stroke.
More than 150,000 adults in the US participated in the All of Us Research Program, sponsored by the National Institutes of Health. Researchers focused on the relationship between lifestyle, biology and environment in various populations and analyzed the association between daily marijuana use and heart failure.
“Previous research shows links between marijuana use and cardiovascular diseases such as coronary artery disease, heart failure and atrial fibrillation, which is known to cause heart failure,” explained Dr. Yakubu Bene-Alhasan, resident physician at Medstar Health in Baltimore and lead author of the study. “Marijuana use is not free of health problems and our study provides more data linking its use with cardiovascular diseases.”
Bene-Alhasan and her colleagues followed 156,999 people who did not have heart failure at the time they enrolled in the research program. Study participants completed a survey about the frequency of their marijuana use and were followed for nearly 4 years (45 months). The analysis was adjusted to account for individual demographic and economic factors, alcohol consumption, smoking, and other cardiovascular risk factors related to heart failure, such as type 2 diabetes, high blood pressure, high cholesterol, and obesity. .
The analysis determined the following:
-During the study period, 2,958 people (almost 2%) developed heart failure.
-People who reported using marijuana daily had a 34% increased risk of developing heart failure, compared to those who reported never using marijuana. This risk was the same regardless of age, sex at birth, or smoking history.
-In a secondary analysis, when coronary artery disease was added to the investigation, the risk of heart failure was reduced from 34% to 27%, suggesting that coronary artery disease is a pathway through which daily marijuana use can cause heart failure.
“Our results should encourage more researchers to study marijuana use to better understand its health consequences, especially cardiovascular risk,” Bene-Alhasan said. “We want to provide the public with high-quality information about marijuana use and help inform policy decisions at the state level, educate patients and guide health professionals.”
Electrocardiogram recreation. (Illustration: Amazings/NCYT)
In a second study, different researchers evaluated data from the 2019 National Inpatient Sample, the largest national hospitalization database in the United States, to investigate whether hospitalizations were complicated by a cardiovascular event, including a heart attack. , stroke, cardiac arrest or arrhythmia in patients who used marijuana. The researchers extracted records from adults over 65 years of age with cardiovascular risk factors who did not report tobacco use (cigarettes or other tobacco products). This set of patient records was then divided into two groups: marijuana users and non-marijuana users. Marijuana user hospital records were coded for cannabis use disorder, which may vary from hospital to hospital.
“Since 2015, cannabis use in the United States has nearly doubled and is increasing among older people; therefore, it is important to understand the possible increased cardiovascular risk from cannabis use,” said Dr. Avilash Mondal, a resident physician at Nazareth Hospital in Philadelphia and lead author of the study. “What is unique about our study is that patients who used tobacco were excluded because cannabis and tobacco are sometimes used together; therefore, we were able to specifically examine cannabis use and cardiovascular outcomes.”
The study revealed that, of the 28,535 cannabis users with existing cardiovascular risk factors (high blood pressure, type 2 diabetes or high cholesterol):
-20% were more likely to suffer a major cardiac or brain event while hospitalized, compared to the group that did not use cannabis.
-13.9% of cannabis users with cardiovascular risk factors suffered a major adverse cardiac and brain event while hospitalized compared to non-cannabis users.
-In addition, cannabis users, compared to non-users, had a higher rate of heart attacks (7.6% versus 6%, respectively) and were more likely to be transferred to other facilities (28.9% versus the 19%).
-High blood pressure (defined as greater than 130/80 mmHg) and high cholesterol were predictors of major adverse cardiac and brain events in marijuana users.
“We must be aware of major cardiac and stroke events in older adults with cannabis use disorder. At this point, we need more studies to understand the long-term effects of cannabis use,” Mondal said. “Healthcare professionals should include the question: ‘Do you use cannabis?’ when taking note of a patient’s history. When asked if they smoke, patients only think about cigarettes. The main message to the public is to be more aware of the increased risks and open the lines of communication so that cannabis use is recognized and considered.”
A limitation of the analysis is that the data come from a large database, which may have coding errors in patients’ medical records. Additionally, the electronic medical record code for cannabis use disorder may vary from hospital to hospital, thus biasing the results of the analysis. (Source: American Heart Association)
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