Cannabis is among the most used recreational and medicinal drugs in the United States.The effects of chronic use on hypertension remain poorly understood. Our study retrospectively evaluated data collected by the National Health and Nutrition Examination Survey from 2017 to 2018. Cannabis use was measured with five metrics: (1) sustained use at any point in the past, (2) sustained use within the past year, (3) frequency of use, (4) age of first cannabis use, and (5) current use. Hypertension status was determined by individuals reporting having been diagnosed in the past. Multivariable logistic regressions were performed, controlling for age, race, and gender. A total of 4565 respondents were identified, of which 867 (19.0%) reported sustained cannabis use in the past. Participants who reported past sustained cannabis use did not have sta-

Introduction Depression and anxiety are common leading causes of disability and are associated with systemic effects including cardiovascular comorbidities. Low-income populations may experience higher frequencies of depressive or anxiety-related symptoms, and be at greater risk for developing hypertension. Aim We performed a cross-sectional study of low-income participants who completed hypertension and disability questionnaires as part of the 2017–2018 cycle of the National Health and Nutrition Examination Survey (NHANES) to identify associations between depressive/anxiety-related symptoms and hypertension status. Methods Multivariable logistic regressions were performed to identify whether (1) frequency of depressive symptoms, (2) frequency of anxiety-related symptoms, (3) self-reported depression medication use, or (4) self-reported anxiety medication use predicted previous hypertension diagnosis. Results A total of 74,285,160 individuals were represented in our cohort. Participants that reported taking depression (OR 2.72; 95% CI 1.41–5.24; P = 0.009) and anxiety (OR 2.50; 95% CI 1.42–4.41; P = 0.006) medications had greater odds of hypertension. Individuals with depressive feelings daily, monthly, and few times per year were more likely to have hypertension. Respondents with daily (OR 2.28; 95% CI 1.22–4.24; P = 0.021) and weekly (OR 1.88; 95% CI 1.05–3.38; P = 0.040) anxiety symptoms were more likely to have hypertension. Conclusions Low-income adults in the United States with symptoms of anxiety or depression have higher likelihood of hypertension than those with no symptoms. Respondents who indicated taking medication for anxiety disorders or depression were more likely to have been diagnosed with hypertension.

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Engagement in sun protection behaviors is broadly recommended to prevent the development of Ultraviolet radiation (UVR)-related conditions such as skin cancer. 1 These behaviors may come in the form of sun avoidance, the use of protective clothing, and application of sunscreen. Weighing the risks and benefits of sun exposure is a particularly important consideration in sunburn-susceptible Caucasian populations as overlap in the International Commission on Illumination action spectra of erythema with that of pre-vitamin D synthesis generates concern for sunscreen use compromising vitamin D synthesis. 2,3 There are mixed reports on the impact of sun protection behaviors and their influence on vitamin D status. 4,5 Vitamin D deficiency is associated with an increased risk of bone fractures, autoimmune disease, and cancer; however, supplementation may manage vitamin D deficiency while promoting sunThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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