Association Between Recreational Cannabis Use and Cardiac Structure and Function

Khanji, Mohammed Y; Jensen, Magnus Thorsten; Kenawy, Asmaa A.; Raisi‐Estabragh, Zahra; Paiva, José Miguel; Aung, Nay; Fung, Kenneth; Lukaschuk, Elena; Zemrak, Filip; Lee, Aaron M.; Barutçu, Ahmet; Maclean, Edd; Neubauer, Stefan; Petersen, Steffen E.

doi:10.1016/j.jcmg.2019.10.012

Cited by 12 publications

(10 citation statements)

References 3 publications

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“…age, sex, diabetes mellitus, tobacco and alcohol use) (Kalla et al., 2018). Whilst the exact mechanism by which cannabis affects cardiac function is not fully understood, activation of CB1 receptors in cardiac smooth muscle can decrease contractility (Bonz et al., 2003), and there is evidence suggesting that regular cannabis use can induce structural and functional changes to cardiac chambers (Khanji et al., 2020).…”

Section: Discussionmentioning

confidence: 99%

Can cannabis kill? Characteristics of deaths following cannabis use in England (1998–2020)

et al. 2022

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Background: Cannabis is the most widely used illegal drug but is rarely considered a causal factor in death. Aims: This study aimed to understand trends in deaths in England where cannabinoids were detected at post-mortem, and to evaluate the clinical utility of post-mortem cannabinoid concentrations in coronial investigations. Methods: Deaths with cannabinoid detections reported to the National Programme on Substance Abuse Deaths (NPSAD) were extracted and analysed. Results: From 1998 to 2011, on average 7% of all cases reported to NPSAD had a cannabinoid detected ( n = 110 deaths per year), rising to 18% in 2020 ( n = 350). Death following cannabis use alone was rare (4% of cases, n = 136/3455). Traumatic injury was the prevalent underlying cause in these cases (62%, n = 84/136), with cannabis toxicity cited in a single case. Polydrug use was evident in most cases (96%, n = 3319/3455), with acute drug toxicity the prevalent underlying cause (74%, n = 2458/3319). Cardiac complications were the most cited physiological underlying cause of death (4%, n = 144/3455). The median average Δ9-tetrahydrocannabinol post-mortem blood concentrations were several magnitudes lower than previously reported median blood concentrations in living users (cannabis alone: 4.3 µg/L; cannabis in combination with other drugs: 3.5 µg/L). Conclusions: Risk of death due to cannabis toxicity is negligible. However, cannabis can prove fatal in circumstances with risk of traumatic physical injury, or in individuals with cardiac pathophysiologies. These indirect harms need careful consideration and further study to better elucidate the role cannabis plays in drug-related mortality. Furthermore, the relevance of cannabinoid quantifications in determining cause of death in coronial investigations is limited.

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Section: Discussionmentioning

confidence: 99%

Can cannabis kill? Characteristics of deaths following cannabis use in England (1998–2020)

et al. 2022

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“…We chose this threshold because, in our clinical practice, we frequently encounter patients who consume cannabis once a week, and regular, weekly cannabis use has been associated with adverse cardiac morphological changes. 26 We obtained data on the primary method of consumption (i.e., smoking, vapourization or other forms of consumption) directly from the BRFSS survey. Further details on the variables used to define exposure in our study are found in Appendix 1, available at www.cmaj.ca/ lookup/doi/10.1503/cmaj.202392/tab-related-content.…”

Section: Exposurementioning

confidence: 99%

Recent cannabis use and myocardial infarction in young adults: a cross-sectional study

Ladha

Mistry

Wijeysundera

et al. 2021

CMAJ

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Cannabis is one of the most commonly used recreational drugs. 1 Recent legalization of cannabis in Canada, 2 and decriminalization in multiple jurisdictions in the United States, 3 has contributed to its increased availability and social acceptance. Cannabis use is also increasing, particularly among young adults (aged 18 to 44 yr). 4,5 Furthermore, when comparing prevalence rates before and after legalization in Canada, use among young adults increased by a larger amount relative to other age groups. 6 Despite the widespread use of cannabis, its effects on health remain poorly understood.The American Heart Association recently issued a recommendation not to smoke or vapourize any product containing cannabis because of its potential harm on cardiovascular health, and called for more research on the epidemiology and trends in cannabis use among youth and high-risk populations. 7 The association between recent cannabis use and stroke has been assessed; 8 however, its effect on other cardiovascular outcomes remains incompletely characterized. Although heavy cannabis use has been reported to trigger acute myocardial infarction (MI), the current evidence is limited to case-control studies that are prone to bias and studies relying solely on administrative data. [9][10][11][12][13][14] It is also limited in its definition of exposure, as these studies assess patients with heavy cannabis use (cannabis abuse or cannabis use disorder). 9-14 Very few studies have assessed the prevalence of recent cannabis use (any use within past 30 days) and its association with MI. 7,9,15 Prevalence estimates of the primary method of cannabis consumption and the frequency of cannabis use are incompletely characterized, and the potential impact of these factors on the risk of MI remains undefined.We aimed to assess the prevalence of recent cannabis use and its association with history of MI in young adults (aged 18 to 44 yr) in the US, using national health survey data. Methods Study design and participantsWe performed a cross-sectional study using data collected from 2 cycles of the annual Behavioral Risk Factor Surveillance System (BRFSS), a health-related telephone survey conducted by the Centers for Disease Control and Prevention (CDC). 16 The BRFSS was designed to collect prevalence data on risk behaviours,

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“…Employing modern tests of cardiac function and imaging techniques, such as stress echocardiography [ 92 ] or magnetic resonance imaging [ 93 ], is required to fill this knowledge gap, as imaging and analysis capabilities have evolved substantially since the publication of the aforementioned seminal works. The importance of cardiac mechanics (such as left ventricular strain, torsion and twist) for understanding cardiac function is increasingly recognized [ 94 , 95 ]; yet to date only two studies have examined these variables in chronic cannabis users [ 96 , 97 ], and no studies have examined the acute effects of cannabis or THC.…”

Section: Cannabis and Systems-level Cardiorespiratory Physiologymentioning

confidence: 99%

Cannabis and Athletic Performance

et al. 2021

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Cannabis is widely used for both recreational and medicinal purposes on a global scale. There is accumulating interest in the use of cannabis and its constituents for athletic recovery, and in some instances, performance. Amidst speculation of potential beneficial applications, the effects of cannabis and its two most abundant constituents, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), remain largely un-investigated. The purpose of this review is to critically evaluate the literature describing the effects of whole cannabis, THC, and CBD, on athletic performance and recovery. While investigations of whole cannabis and THC have generally shown either null or detrimental effects on exercise performance in strength and aerobic-type activities, studies of sufficient rigor and validity to conclusively declare ergogenic or ergolytic potential in athletes are lacking. The ability of cannabis and THC to perturb cardiovascular homeostasis warrants further investigation regarding mechanisms by which performance may be affected across different exercise modalities and energetic demands. In contrast to cannabis and THC, CBD has largely been scrutinized for its potential to aid in recovery. The beneficial effects of CBD on sleep quality, pain, and mild traumatic brain injury may be of particular interest to certain athletes. However, research in each of these respective areas has yet to be thoroughly investigated in athletic populations. Elucidating the effects of whole cannabis, THC, and CBD is pertinent for both researchers and practitioners given the widespread use of these products, and their potential to interact with athletes’ performance and recovery.

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Association Between Recreational Cannabis Use and Cardiac Structure and Function

Cited by 12 publications

References 3 publications

Can cannabis kill? Characteristics of deaths following cannabis use in England (1998–2020)

Can cannabis kill? Characteristics of deaths following cannabis use in England (1998–2020)

Recent cannabis use and myocardial infarction in young adults: a cross-sectional study

Cannabis and Athletic Performance

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