Marijuana Use May Damage Heart and Brain Health

• As more people across the U.S. use marijuana for medical and recreational purposes, two new studies suggest that consuming marijuana on a regular basis may have negative effects on heart and brain health. Masu.
• In one study, daily marijuana use increased the risk of developing heart failure by about a third compared to people who reported never using marijuana, even after taking other factors into account.
• A second study found that older adults with type 2 diabetes, high blood pressure, or high cholesterol who used marijuana had significantly more severe symptoms during hospitalization than those who reported not using marijuana. The risk of acute cardiac and brain events was significantly increased.

Two preliminary studies to be presented at the American Heart Association show that regular marijuana use increases the risk of heart failure, stroke, and heart attack, even after accounting for other cardiovascular risk factors such as type 2 diabetes, high blood pressure, and obesity. The risk may increase. Scientific Sessions 2023. Held in Philadelphia from November 11-13, the conference is the premier forum for the global exchange of the latest scientific advances, research, and evidence-based clinical practice updates in cardiovascular science. is.

The use of marijuana, known medically as cannabis, is growing in popularity across the country as more states legalize it for recreational and medical purposes. However, it is still not fully understood how marijuana affects heart and brain health. Two new studies by separate research groups reveal a link between regular marijuana use and risk of heart failure, heart attack, and stroke.

Daily marijuana use is associated with the development of heart failure: “All of Us” research program (Poster Abstract MDP250)

More than 150,000 adults in the United States participated in the All of Us Research program. National Institutes of Health-Sponsored Programs. Researchers analyzed the association between daily marijuana use and heart failure, focusing on the relationships between lifestyle, biology, and environment in diverse populations.

“Previous research has shown a link between marijuana use and health. cardiovascular disease coronary artery disease, heart failure, and atrial fibrillation, which is known to cause heart failure,” said Yakub Bene Alhassan, MD, MPH, resident physician at MedStar Health in Baltimore and lead author of the study. . “Marijuana use is not without health concerns, and our study provides further data linking marijuana use to cardiovascular disease.”

Bene-Alhasan and colleagues followed 156,999 people who did not have heart failure when they enrolled in the study program. Study participants completed a survey about their frequency of marijuana use and were followed for nearly four years (45 months). This analysis was adjusted to account for individual demographic and economic factors, alcohol use, smoking, and other cardiovascular risk factors associated with heart failure, including type 2 diabetes, hypertension, high cholesterol, and obesity. .

The analysis revealed the following:

• During the study period, 2,958 people (almost 2%) developed heart failure.
• People who reported daily marijuana use 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, and smoking history.
• In a secondary analysis, the risk of heart failure decreased from 34% to 27% when coronary artery disease was added to the study, suggesting that coronary artery disease is a pathway by which daily cannabis use can lead to heart failure. I am.

“Our results should encourage more researchers to study marijuana use to better understand its health effects, particularly on cardiovascular risk,” said Bene-Alhassan. Ta. “We want to provide the public with quality information about marijuana use, inform policy making at the state level, educate patients, and guide health care professionals.”

Research details:

• The definition of marijuana use was the use of marijuana when it was not prescribed for a medical condition or, if prescribed for a medical purpose, use beyond that purpose.
• The median age of participants was 54 years. 60.9% of participants were female at birth. 70.7% identified as white adults. 21.8% were black or African American adults. 4.2% were adults of Asian descent. 2.2% identified as more than one race/ethnicity. 1.1% were from other races/ethnicities.
• Study enrollment began in June 2016. Participants were followed for up to approximately 4 years (45 months) from the time of enrollment until June 2022.

A limitation of the study is that it relied on data that did not specify whether marijuana was inhaled or eaten. Researchers say the way marijuana is ingested may influence cardiovascular outcomes.

Co-authors, their disclosures, and funding sources are listed in the abstract.

Increased risk of major adverse cardiac and cerebrovascular events in older non-smokers who use cannabis (Poster Abstract MDP249)

In the second study, various researchers evaluated data from the 2019 National Inpatient Sample, the nation’s largest database on hospitalizations, to determine whether patients who used marijuana were more likely to experience heart attacks, strokes, cardiac arrest, arrhythmias, etc. We investigated whether the length of hospital stay was complicated by cardiovascular events. . Researchers extracted records for adults aged 65 and older who had cardiovascular risk factors and who did not report tobacco (cigarettes or other tobacco products) use. This patient record group was then divided into two groups: marijuana users and non-marijuana users. Marijuana users’ hospital records record cannabis use disorder, which can vary from hospital to hospital.

“Since 2015, cannabis use in the United States has nearly doubled and is increasing among older adults, so it’s important to understand the potential increased cardiovascular risks from cannabis use.” , said study lead author Abhilash Mondal, M.D., a resident physician at Nazareth. hospital in Philadelphia. “What is unique about our study is that patients who were using tobacco were excluded, as cannabis and tobacco are sometimes used together. Therefore, the relationship between cannabis use and cardiovascular disease outcomes was excluded. We were able to investigate this in detail.”

The study found 28,535 cannabis users with pre-existing cardiovascular risk factors (high blood pressure, type 2 diabetes, or high cholesterol).

• 20% were more likely to have a major heart or brain event during their hospitalization compared to the group who did not use cannabis.
• 13.9% of cannabis users with cardiovascular risk factors experienced serious cardiac and brain adverse events during hospitalization compared to non-cannabis users.
• In addition, cannabis users had a higher incidence of heart attacks (7.6% vs. 6%, respectively) and were more likely to be transferred to another facility (28.9% vs. 19%) compared to non-cannabis users.
• Hypertension (defined as 130/80 mm Hg or higher) and high cholesterol were predictors of serious heart and brain adverse events in marijuana users.

“We need to pay attention to serious cardiac and stroke events in older adults with cannabis use disorders. At this time, further research is needed to understand the long-term effects of cannabis use.” Mondal said. “Health care professionals should include the question, ‘Do you use cannabis?'” when taking a patient’s medical history. When he asks patients if they smoke, people assume they do. The main public message is to be more aware of the increased risks and to open lines of communication so that cannabis use is recognized and considered. ”

A limitation of the analysis is that the data are from a large database, so patient health records may contain coding errors. Additionally, electronic medical record codes for cannabis use disorder may vary between hospitals, which could skew the results of our analysis.

Research details:

• Health records from the 2019 National Inpatient Sample were examined for 28,835 adults with cannabis use disorder, high blood pressure, type 2 diabetes, or high cholesterol. The comparison group included 10.68 million adults with the same risk factors and who did not use marijuana.
• The researchers examined hospital records and analyzed the incidence of in-hospital cardiovascular disease events in adults in both groups.
• In the cannabis use disorder group, 69.5% of participants were male and 30.5% were female. In contrast, 54.2% of the female non-users were male compared to 45.8% of the non-cannabis user group.
• Race health records according to cannabis use and non-use were as follows: Among white adults, the rates were 70.2% and 76.4%. 20.1% vs. 10.8% among black adults; among Hispanic adults, 5.6% vs. 7.4%; 0.70% vs. 2.7% for Asian or Pacific Islander adults. 1% vs. 0.40% among American Indian adults.

“The latest research on cannabis use shows that smoking and inhaling cannabis produces the same amount of carboxyhemoglobin (carbon monoxide, a toxic gas) and tar (partially burned combustible material) in the blood as inhaling a cigarette. Both have been shown to be associated with “myocardial disease, chest pain, heart rhythm disturbances, heart attacks, and other serious symptoms” in 2020 volunteers. said Robert L. Page II, PharmD, MSc, PhD, FAHA, chair of the writing group. American Heart Association Scientific Statement: Medical Cannabis, Recreational Cannabis, and Cardiovascular Health. “Combined with the results of these two research studies, the cardiovascular risks of cannabis use are becoming clearer and should be carefully considered and monitored by medical professionals and the public.”

Page is a professor in the Skaggs School of Pharmacy, Department of Clinical Pharmacy and Physical Therapy, at the University of Colorado Anschutz Campus in Aurora, Colorado.

Co-authors, their disclosures, and funding sources are listed in the abstract.