Cardiovascular disease (CVD) is a global epidemic representing the leading drugs derived from marijuana, could have therapeutic impact in CVD. as well as cannabis being classified as a Schedule 1 substance.7 Other. This article has been cited by other articles in PMC. the non-medicinal use of cannabis can significantly affect physical and mental health and lead to . (41) showed that smoking cannabis has acute effects on cardiovascular function and on. Cannabinoids as therapeutic agents in cardiovascular disease: a tale of with beneficial effects on the cardiovascular system, such as a protective role in . case of other drugs with actions on blood pressure, the acute effects of cannabinoids.
Affect Cardiovascular How Other Health Cannabinoids
A review article in the New England Journal of Medicine summarized what is known about the effects of marijuana on all aspects of health. There is some epidemiological evidence that marijuana use in young men, in particular, is associated with an increased risk of heart attack within an hour of use, said Dr. Reid, whereas the risk in young women is not increased to the same degree. Pipe and Reid expect increased interest in research around marijuana use.
When you smoke marijuana, your heart rate and blood pressure increase. At the same time, smoking in general, whether tobacco, marijuana or a mixture of the two, reduces the capacity of the blood to deliver oxygen throughout the body — an effect of the products of combustion such as carbon monoxide.
This combination adds up to increased risk for a cardiac event like a heart attack, particularly while a person is smoking and immediately afterward. This suggests another reason why it is not a good idea to use marijuana, he noted. He also noted that marijuana use could be problematic for people with an irregular heartbeat, or arrhythmia, because it activates the sympathetic nervous system. For one thing, marijuana is rarely used in isolation. Generally, tobacco, alcohol or both are involved.
And while the amount smoked is less with marijuana, experience has shown that smoking marijuana can make it harder to quit smoking tobacco. In reality, most people use the two together, thus, as Dr. Another problem relates to dose control. The problem becomes more acute when marijuana is eaten, said Dr. People who eat marijuana may not feel the effect as quickly as those who smoke it, leading them to use more.
One concern frequently raised is the link between marijuana and depression. Authors could not find any obvious causative factor other than use of cannabis Synthetic cannabinoids SCs are cannabis preparations that were synthesized during the process of identifying cannabinoid receptors. JWH has stronger affinity for CB1 and CB2 receptors and produces extreme cannabinomimetic effects compared to marijuana. SCs are marketed under various other names including K2, skunk, joker, mojo, aroma, dream and black mamba etc.
The rising popularity of these products has been accompanied by a significant increase in the number of emergency admissions due to SCs. There is considerable risk of toxicity from either acute or chronic use with evidence of an increase in the number of chronic or even daily users of this class of drugs and a parallel increase in cases of withdrawal complications Although widely considered harmless, several recent reports have been published on cases of serious cardiovascular events attributed to the use of SCs.
The most prevalent cardiac side effect of SC consumption is tachycardia Chest pain has also been reported to occur after consumption of SCs Other reported cardiovascular events are peri-mesencephalic sub-arachnoid hemorrhage and middle cerebral artery occlusion Cases of ST-elevation MI, although rare, have been reported following the use of K2 in patients as young as 14 years old as well as in adults On the other hand, Orsini et al.
They hypothesized that consumption of K2 caused transient myocardial ischemia resulting in ventricular stunning leading to acute CHF Development of acute ischemic strokes due to consumption of SCs has also been reported in young adults without any history of predisposing factors This highlights importance of appropriate and complete history taking when patients in this age group present to the emergency department especially with cardiovascular events.
Important legal considerations relevant to the use of SCs are the lack of sufficiently reliable tests for their detection in urine, unlike those available for marijuana and the classification of these drugs as analogues of controlled substances rather than controlled substances Efforts to curb its use via the implementation of appropriate public health strategies are imperative.
Cannabis users may require surgery due to injuries or accidents occurring after recent use. Cannabis has been shown to cause significant respiratory symptoms and changes in spirometry even with relatively short duration of inhalation Cannabis use has been associated with significant airway inflammation and alteration in histopathology in bronchial mucosa and these effects appears to be additive when cannabis is smoked in conjunction with tobacco In one study, it was concluded that smoking of cannabis is associated with significant airway inflammation which was similar to what encountered in tobacco smokers Because of all these physiological and histopathological changes, patients undergoing surgery should be inquired about illicit drug use including cannabis 91 , The interactions between cannabis and anaesthetic agents and the effects of these interactions are poorly understood.
In a prospective, randomized, single blinded study, regular cannabis users showed variable response to induction of anaesthesia with propofol when compared to non-users, although higher doses of propofol were needed to achieve loss of consciousness, adequate jaw relaxation and depression of airway reflexes for insertion of laryngeal mask THC has also been reported to prolong the sedative effects of general anaesthesia in experimental models 94 , 95 , and has been implicated in perioperative complications such as bronchospasm due to airway irritation, tachycardia, and uvular oedema Cannabis leaves burn at higher temperature than similar quantity of tobacco causing increased direct airway irritation.
Excessive respiratory burden of carbon monoxide and tar can occur with cannabis smoking when compared to smoking Cannabis use is also possibly reported to be associated with diffuse alveolar haemorrhage in post-operative period in a patient which was thought to be due to 97 negative pressure pulmonary edema and possible inhibition of thrombin-driven clot formation It is important to extract history of cannabis use as a routine part of preoperative work up.
The choice of the appropriate anaesthetic agent is important in cases of cannabis users. If sedative hypnotic drugs are used in cannabis users, excessive depression of the central nervous system may occur; therefore, barbiturates, opioids, and benzodiazepines, and phenothiazines are preferably avoided. Further, recent use of cannabis can cause decrease blood pressure due to vasodilatation along with tachycardia leading to increased oxygen myocardial demand 99 , therefore drugs which are likely to increase HR, such as ketamine, atropine, and epinephrine should also be avoided It should also keep in mind that the intraoperative and immediate postoperative need of opiates for analgesia in patients with history of recent or chronic cannabis consumption may be significantly increased 92 , While the majority of published data suggest a harmful effect of cannabis and cannabinoids on the cardiovascular system, a few suggest possible beneficial effects.
The use of cannabis or marijuana has been linked to increase risk of cardiac events immediately after use, although little information is available about the long-term impact of marijuana among patients with established coronary disease.
An analysis carried out on around 4, MI patients from a U. Indirect beneficial effects have been demonstrated in studies showing that cannabis or marijuana use attenuates or modulates common cardiovascular disease risk factors.
Preliminary data from a small double blinded placebo controlled study carried out in the U. Additionally, a number of epidemiologic studies have shown lower prevalence of obesity and diabetes mellitus among marijuana users compared with those who never used marijuana, suggesting a relationship between cannabinoids and metabolic processes. A study done on adult Americans from the National Health and Nutrition Examination Survey showed that marijuana use was associated with lower levels of fasting insulin and HOMA-IR, and smaller waist circumference Furthermore, some studies hypothesized that lower rates of obesity among habitual marijuana users are directly related to the exposure to the THC present in cannabis, and proposed its potential use for the management of obesity and its complications A recently published study on mice that tested three regimens of THC administration suggests that a pre-treatment with an ultra-low dose of THC provides a significant protection against an ischemic insult to the heart as evidenced by lower troponin levels, and reduced infarct size The fact that cannabis use has become increasingly popular among youngsters is a major cause for concern.
It is important to consider a negative impact of cannabis abuse on education as well as the risk of abuse of other illicit drugs among the youth on the development of psychosis. Currently, there is a lack of consensus on what position to adopt regarding legalization of cannabis.
While one view regards recreational cannabis uses as harmless, the opposing viewpoint is that it raises some serious public health concerns and that its use should continue to be discouraged by governing bodies and prohibited by law Table 2. The literature suggests the occurrence of harmful effects including fatal cardiovascular events that could be related to cannabis use.
Further research and studies are needed to determine the impact of acute and especially the chronic regular use of cannabis on various organ systems, particularly the cardiovascular system. With the recent decriminalization and legalisation of cannabis use in some parts of the world and the increase in the number of conditions that cannabis can be prescribed for, there is a good possibility that physicians will encounter more cases of cardiovascular and cerebrovascular complications of cannabis use in the near future.
It is necessary to increase awareness among physicians and the general public alike regarding the increased risk of cardiovascular complications associated with cannabis use.
In addition, implementing effective strategies for the prudent dispersal of the drug is necessary to avoid unnecessary increases in cannabis-related complications and therefore preclude the resultant burden on public and private health services. The current evidences highlight the urgent need for a change in the mindset among cannabis users, particularly the young regarding the adverse effects of cannabis use and the risk of acute coronary events, stroke, and possibly death.
Authors would like to acknowledge Dr. Amar Shere MD for creating the online versions of all figures. The authors have no conflicts of interest to declare. National Center for Biotechnology Information , U.
Journal List J Thorac Dis v. Hemant Goyal , 1 Hamza H. Awad , 2 and Jalal K. Author information Article notes Copyright and License information Disclaimer. I Conception and design: All authors; V Data analysis and interpretation: All authors; VI Manuscript writing: All authors; VII Final approval of manuscript: Received Apr 9; Accepted Jun Copyright Journal of Thoracic Disease.
This article has been cited by other articles in PMC. Abstract The growing popularity of medical and recreational consumption of cannabis, especially among the youth, raises immediate concerns regarding its safety and long-terms effects.
Cannabis, marijuana, cardiovascular, myocardial infarction MI , atrial fibrillation, stroke, synthetic marijuana. Introduction Currently, cannabis is the most widely produced and consumed illicit drug in the world with global numbers of users approaching Cannabis and acute coronary syndrome In the past, risk of ischemia associated with marijuana use was considered to be low Table 1 Proposed pathophysiology of cannabis-induced acute myocardial infarction Depending on cardiac catheterization findings.
Angiogram finding Possible mechanisms Normal angiogram Reversible coronary vasospasm Increased carboxyhemoglobin blood levels Increase in sympathetic activity Coronary artery dissection Hemodynamic effects Coronary thrombosis Down-stream plaque rupture, direct pro-thrombotic effect Sluggish coronary flow Pro-thrombotic effect Coronary artery stenosis Angiopathy, plaque rupture.
Open in a separate window. Proposed mechanisms for cannabis induced cardiovascular effects. Peripheral vascular effects of cannabis The effects of cannabis on peripheral vasculature have not been clinically well studied yet. Effects on cerebrovascular system Currently, the evidence regarding the relationship between stroke and cannabis use is not firmly established, although a temporal link has been reported in several cases of ischemic stroke with no other apparent causes Proposed mechanisms of cannabis induced cerebrovascular effects.
Other reported adverse cardiac effects of cannabis use Takotsubo cardiomyopathy Rarely, development of stress cardiomyopathy has been temporally related to consumption of cannabis Myopericarditis A case of recurrent myopericarditis was reported in a year-old male which occurred after heavy consumption of adulterated cannabis both times. Synthetic marijuana and its cardiovascular complications Synthetic cannabinoids SCs are cannabis preparations that were synthesized during the process of identifying cannabinoid receptors.
Pre- and perioperative implications of cannabis use Cannabis users may require surgery due to injuries or accidents occurring after recent use. Potential beneficial effects of cannabis in cardiovascular system While the majority of published data suggest a harmful effect of cannabis and cannabinoids on the cardiovascular system, a few suggest possible beneficial effects.
Conclusions The fact that cannabis use has become increasingly popular among youngsters is a major cause for concern. Table 2 The effects of cannabis on the cardiovascular system. Acknowledgements Authors would like to acknowledge Dr. Footnotes Conflicts of Interest: World Drug Report Racial differences and the role of neighborhood in the sequencing of marijuana and tobacco initiation among urban youth.
Subst Abus ; National Conference of State Legislatures. Accessed October 10, Risks associated with the non-medicinal use of cannabis.
Dtsch Arztebl Int ; Hall W, Degenhardt L. Adverse health effects of non-medical cannabis use. The histopathology of drugs of abuse. J Am Heart Assoc ; 3: Gaoni Y, Mechoulam R. J Am Chem Soc ; International Union of Pharmacology. Classification of cannabinoid receptors. Pharmacol Rev ; Endocannabinoid signaling at the periphery: Trends Pharmacol Sci ; Montecucco F, Di Marzo V. At the heart of the matter: Cannabinoid pharmacology in the cardiovascular system: Biol Rev Camb Philos Soc ; Steffens S, Pacher P.
Targeting cannabinoid receptor CB 2 in cardiovascular disorders: Br J Pharmacol ; Marijuana Use and Cardiovascular Disease. Cardiol Rev ; Atrial fibrillation and marijuana smoking. Int J Clin Pract ; Cardiovascular consequences of marijuana use. J Clin Pharmacol ; Cardiovascular system effects of marijuana. Frequency and irregularity of heart rate in drivers suspected of driving under the influence of cannabis.
Eur J Intern Med ; Marijuana smoking is associated with atrial fibrillation. Am J Cardiol ; Ventricular tachycardia due to marijuana use in a heart transplant patient. Rev Esp Cardiol ; Is recent cannabis use associated with acute coronary syndromes? An illustrative case series.
Acta Cardiol ; Ventricular fibrillation triggered by marijuana use in a patient with ischemic cardiomyopathy: Cases J ; 1: Acute cannabis intoxication mimicking brugada-like ST segment abnormalities.
Int J Cardiol ; Pratap B, Korniyenko A. Toxic effects of marijuana on the cardiovascular system. Cardiovasc Toxicol ; Brugada electrocardiogram pattern induced by cannabis; is cannabis safe? Am J Emerg Med ; Ballard ME, de Wit H. Combined effects of acute, very-low-dose ethanol and delta 9 -tetrahydrocannabinol in healthy human volunteers.
Pharmacol Biochem Behav ; Cannabis coadministration potentiates the effects of "ecstasy" on heart rate and temperature in humans. Clin Pharmacol Ther ; Cannabis-associated myocardial infarction in a young man with normal coronary arteries. J Emerg Med ; Exercise-induced acute coronary syndrome in a year-old man with massive cannabis consumption. Ann Cardiol Angeiol Paris ; Acute myocardial infarction in a young man; fatal blow of the marijuana: Korean Circ J ; Anadolu Kardiyol Derg ; Subst Abuse ; 9: Triggering myocardial infarction by marijuana.
An exploratory prospective study of marijuana use and mortality following acute myocardial infarction. Am Heart J ; Marijuana use and long-term mortality among survivors of acute myocardial infarction. ST-segment elevation myocardial infarction in a year-old man with normal coronaries--it is not always cocaine!
Am J Emerg Med ; Myocardial infarction following the combined recreational use of Viagra and cannabis. Clin Cardiol ; Aronow WS, Cassidy J. Effect of marihuana and placebo-marihuana smoking on angina pectoris. N Engl J Med ; The procoagulatory effects of deltatetrahydrocannabinol in human platelets.
Anesth Analg ; Forensic Sci Med Pathol ; 2: Novel time-dependent vascular actions of Delta9-tetrahydrocannabinol mediated by peroxisome proliferator-activated receptor gamma. Biochem Biophys Res Commun ; Further characterization of the time-dependent vascular effects of delta9-tetrahydrocannabinol. J Pharmacol Exp Ther ; Time-dependent vascular actions of cannabidiol in the rat aorta.
Eur J Pharmacol ; Increased blood pressure after abrupt cessation of daily cannabis use. J Addict Med ; 5: Alshaarawy O, Elbaz HA. Cannabis use and blood pressure levels: J Hypertens ; Triphasic blood pressure responses to cannabinoids: Acute and long-term effects of cannabis use: Curr Pharm Des ; J Addict Med ; 4: J Eur Acad Dermatol Venereol ; Images in vascular medicine.
Spontaneous renal artery dissection in a cannabis user. Vasc Med ; Central retinal vein occlusion in a young patient following cannabis smoke inhalation. Eur J Ophthalmol ; Critical limb ischemia in a young man: Case Rep Vasc Med ; An uncommon cause of visceral arterial embolism in patients presenting with acute abdominal pain: Acta Gastroenterol Belg ; Postgrad Med J ; Recreational marijuana use and acute ischemic stroke: A population-based analysis of hospitalized patients in the United States.
J Neurol Sci ; Cannabis use, ischemic stroke, and multifocal intracranial vasoconstriction: Desbois AC, Cacoub P. Ann Vasc Surg ;
Marijuana and heart health: What you need to know
However, the cardiovascular and other health effects of cannabis aren't The magnitude of marijuana's psychoactive effect depends on the. Read all about the research on the effects of cannabis on your heart and How Other Cannabinoids Affect Cardiovascular Health. CBD vs. What we do know about the drug's effects on the cardiovascular system is Another article, from in the American Heart Journal, found that habitual Depression is a known risk factor for heart disease, in part because it.