What is the Relationship Between Cannabis and Cardiovascular Health?

Marc Moulin October 29, 2020 0 comments

Some studies say cannabis is good for the heart. Others say it may not be. But, all agree that smoking of cannabis is a problem.

Cannabis is the most widely consumed drug throughout the world. As more countries and individual states legalize, experts expect those consumption numbers to grow. Global rates of cardiovascular disease are also on the rise. These colliding trends have health professionals scrambling to better understand the relationship between cannabis and cardiovascular health. Moreover, several observational and retrospective studies suggest that cannabis consumption can negatively impact the heart. However, in addition to the need for more robust research, individual behaviors related to the method of cannabis consumption and dose need to be considered.

Increased Hospitalization, Stroke for Cannabis Consumers?

Furthermore, in a study published in Medicina (2019), the researchers investigated the relationship between cannabis consumption and cardiovascular-related hospitalizations.[1]Desai, R., Fong, H. K., Shah, K., Kaur, V. P., Savani, S., Gangani, K., … & Goyal, H. (2019). Rising trends in hospitalizations for cardiovascular events among young cannabis users (18–39 … Continue reading

Basically, the study looked at over fifty-two million hospitalization records between 2007 and 2014 from the National Inpatient Sample and identified that a substantial number of the patients were young current or former cannabis consumers. When compared to non-consumers, the records revealed an interesting pattern. The frequency of admission to hospital for acute myocardial infarction (0.23% vs. 0.14%) and heart arrhythmia (4.02% vs. 2.84%) was significantly higher in cannabis consumers compared to non-consumers. Importantly, the included patients did not have a history of other substance use, ruling out some other confounding factors such as tobacco smoke. Other retrospective studies support these findings.

Moreover, a study published in Stroke (2019),  evaluated the risk of stroke in cannabis consumers. [2]Parekh, T., Pemmasani, S., & Desai, R. (2020). Marijuana Use Among Young Adults (18–44 Years of Age) and Risk of Stroke: A Behavioral Risk Factor Surveillance System Survey … Continue reading The researchers summarized data from the Behavioral Risk Factor Surveillance System (2016 – 2017) and unsurprising found that almost fourteen percent of participants reported consuming cannabis in the previous month.

The researchers adjusted for tobacco use and discovered large increases in the risk of stroke for regular cannabis consumers. For those who consumed cannabis more than ten days per month, the analysis showed that they had 2.45 greater odds of having a stroke. These results have caught the attention of the American Heart Association (AHA) and they are warning the public.

AHA Warning About Cannabis and Cardiovascular Health

In a scientific statement published in Circulation (2020), the AHA warned that cannabis consumption may increase the risk of cardiovascular events. [3]Page, R. L., Allen, L. A., Kloner, R. A., Carriker, C. R., Martel, C., Morris, A. A., … & Saucedo, J. F. Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific … Continue reading

The AHA caution that THC triggers the body’s ‘fight or flight’ response, leading to a higher heart rate, a greater need for oxygen, high blood pressure, and flawed functioning in the arterial walls. It is important to note that these effects are dose-dependent and are more intense at higher doses. It is unknown whether cardiovascular events routinely occur when an individual ingests modest amounts of THC. Furthermore, the statement highlights that certain methods of consumption, particularly cannabis smoking, comes with additional risks. Unfortunately, cannabis smoking is the most popular method of consumption among cannabis consumers.

Is Smoking Cannabis Bad for my Health?

Moreover, according to the 2019 Canadian Cannabis Survey, eighty-four percent of cannabis consumers smoke their cannabis. Regardless of THC concentration, smoking cannabis can come with long-term risks. “Many consumers and health care professionals don’t realize that cannabis smoke contains components similar to tobacco smoke,” said Robert L. Page, the chair of the writing group for the statement. Basically, cannabis smoking can result in a five-times increase in carbon monoxide and a three-times increase in tar, similar to the detrimental effects of smoking tobacco.

Cannabis itself may not be bad for our cardiovascular health. However, how we consume it certainly can be. Only through more robust research can researchers uncover the relationship between cannabis and cardiovascular health, but legal barriers are making that difficult.

AHA Calls for DEA to Declassify Cannabis

The AHA suggests that the DEA should accordingly remove cannabis from the Schedule I of the U.S. Controlled Substances Act. This would allow the drug to be widely studied by scientists and provide better information to healthcare professionals. “We urgently need carefully designed, prospective short- and long-term studies regarding cannabis use and cardiovascular safety as it becomes increasingly available and more widely used,” Page said.

“The public needs fact-based, valid scientific information about cannabis’s effect on the heart and blood vessels. Research funding at federal and state levels must be increased to match the expansion of cannabis use – to clarify the potential therapeutic properties and to help us better understand the cardiovascular and public health implications of frequent cannabis use.”

Does Cannabis Provide Cardiovascular Benefit? 

Basically, most of the attention in science has focused on the dangers of cannabis on the cardiovascular system. But, some research alternatively suggests the possibility of benefits. For example, take a review published in the Journal of Thoracic Disease (2017). Here, the authors discuss the benefits to cardiovascular risk factors including a reduced risk of obesity, and diabetes, among cannabis consumers compared to non-consumers. [4]Goyal, H., Awad, H. H., & Ghali, J. K. (2017). Role of cannabis in cardiovascular disorders. Journal of Thoracic Disease9(7), 2079.

Another study found that low-dose THC provided significant protection against ischemic insult to the heart. [5]Waldman, M., Hochhauser, E., Fishbein, M., Aravot, D., Shainberg, A., & Sarne, Y. (2013). An ultra-low dose of tetrahydrocannabinol provides cardioprotection. Biochemical Pharmacology, 85(11), … Continue reading Further, this animal study is particularly interesting because the route of administration did not involve combustion like with smoking. Additional research in humans may show that with safer consumption methods and appropriate doses, risks to the cardiovascular system are nullified. As worldwide consumption increases, the need for research is at an all-time high.

References

1Desai, R., Fong, H. K., Shah, K., Kaur, V. P., Savani, S., Gangani, K., … & Goyal, H. (2019). Rising trends in hospitalizations for cardiovascular events among young cannabis users (18–39 years) without other substance abuse. Medicina55(8), 438.
2Parekh, T., Pemmasani, S., & Desai, R. (2020). Marijuana Use Among Young Adults (18–44 Years of Age) and Risk of Stroke: A Behavioral Risk Factor Surveillance System Survey Analysis. Stroke51(1), 308-310.
3Page, R. L., Allen, L. A., Kloner, R. A., Carriker, C. R., Martel, C., Morris, A. A., … & Saucedo, J. F. Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation, CIR-0000000000000883.
4Goyal, H., Awad, H. H., & Ghali, J. K. (2017). Role of cannabis in cardiovascular disorders. Journal of Thoracic Disease9(7), 2079.
5Waldman, M., Hochhauser, E., Fishbein, M., Aravot, D., Shainberg, A., & Sarne, Y. (2013). An ultra-low dose of tetrahydrocannabinol provides cardioprotection. Biochemical Pharmacology85(11), 1626-1633.

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