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Recent studies presented by the American Heart Association and the American College of Cardiology have highlighted the potential cardiovascular risks associated with regular marijuana use. These findings are crucial as marijuana becomes increasingly accessible and popular across the United States.
“Observational data are strongly pointing to the fact that … cannabis use at any point in time, be it recreational or medicinal, may lead to the development of cardiovascular disease,” said Robert Page II, chair of the writing group for the 2020 American Heart Association Scientific Statement: Medical Marijuana, Recreational Cannabis, and Cardiovascular Health, in a statement. Dr. Page has had no involvement in the new studies.
The AHA recommendations advise people refrain from smoking or vaping any substance, including cannabis products, because of the potential harm to the heart, lungs and blood vessels.
What Did the Studies Find?
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Increased Risk of Heart Failure and Heart Attack:
- A study involving over 150,000 U.S. adults, part of the All of Us Research Program, found that daily marijuana use raised the risk of developing heart failure by about one-third. This was after considering other factors such as demographics, alcohol use, smoking, and cardiovascular risk factors like Type 2 diabetes, high blood pressure, and obesity. During the study period, nearly 2% of the participants developed heart failure, and those reporting daily marijuana use had a 34% increased risk compared to non-users
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Link with Coronary Artery Disease (CAD):
- Another study presented at the American College of Cardiology's Annual Scientific Session found that daily marijuana users were 34% more likely to develop CAD compared to those who never used the drug. This study used data from the All of Us Research Program and employed Mendelian randomization to establish a causal relationship between cannabis use disorder and CAD risk. Notably, this risk was independent of tobacco and alcohol use.
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Impact on Elderly Patients with Cardiovascular Risk Factors:
- A separate study focused on older individuals with Type 2 diabetes, high blood pressure, and high cholesterol. It was observed that those who used marijuana significantly increased their risk for a major acute heart or brain event, such as heart attack or stroke, while hospitalized, compared to non-users.
Understanding What the Risks Are:
- Tetrahydrocannabinol (THC) and Cardiovascular Health:
- THC, the psychoactive component in cannabis, interacts with receptors in the central nervous system, heart, and blood vessels. This interaction may promote inflammation and plaque buildup, leading to conditions like CAD. However, cannabidiol (CBD), another component of cannabis, does not have the same effect and is often used in products without THC.
Marijuana use is on the rise among older adults. A 2020 study found the numbers of American seniors over age 65 who now smoke marijuana or use edibles increased two-fold between 2015 and 2018. A 2023 study found past month binge drinking and marijuana use among the over-65 crowd rose by 450% between 2015 and 2019.
What are the Chronic Conditions?
Older adults often develop a number of chronic conditions by age 65 which appear to make the impact of marijuana worse, according to one of the studies that examined hospital records for adults over 65 with cannabis use disorder who did not smoke tobacco.
Implications and Future Research:
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Awareness and Communication with Healthcare Providers:
- These studies emphasize the importance of awareness about the potential risks of cannabis use, particularly for heart health. It's vital for individuals who use cannabis to inform their healthcare providers, enabling clinicians to monitor their heart health more effectively.
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Potential for New Therapeutic Interventions:
- The research opens avenues for better understanding the molecular pathways involved in marijuana use and heart disease. This knowledge could lead to new drug targets and mechanisms for preventing or treating heart disease.
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Need for Further Studies:
- The current studies do not differentiate between the various forms of cannabis consumption, such as smoking or ingestion through edibles. Future research could explore the different health implications of these methods, especially since THC enters the body and brain differently depending on the mode of consumption.
“A growing body of evidence suggests that cannabis is not entirely without harm and may actually cause cardiovascular disease,” said lead study author Dr. Ishan Paranjpe, a resident physician at Stanford University.
While the legalization and medical use of marijuana are on the rise, these studies provide critical insights into the potential cardiovascular risks associated with its use. They highlight the need for increased awareness and further research to fully understand the health implications of marijuana, especially concerning heart health.
Sources
- https://www.abstractsonline.com/pp8/?_ga=2.252499981.569559676.1693429947-1069604919.1693247687#!/10871/session/647
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000883
- https://pubmed.ncbi.nlm.nih.gov/35934163/
- https://www.cnn.com/2023/11/06/health/marijuana-heart-stroke-risk-wellness/index.html
Author
Dr. Mark L. Meyer
Dr. Meyer graduated from Haverford College with a Bachelor of Science, High Honors, in cellular and molecular biology, Phi Beta Kappa, Magna Cum Laude. He attended the Yale University School of Medicine, where he also completed a categorical residency in Internal Medicine, served for one year as an Emergency Department attending physician, and held the title of Clinical Instructor in the Department of Surgery. During this time, Dr. Meyer obtained a J.D. from the Yale Law School, concentrating on medical ethics, scientific research law, and FDA law. He then completed a fellowship in Cardiovascular Diseases at the Hospital of the University of Pennsylvania, where he obtained Level 3 Nuclear Cardiology training.
