Association of Recreational Marijuana Use with Aneurysmal Subarachnoid Hemorrhage

Rumalla, Kavelin; Reddy, Adithi Y.; Mittal, Manoj

doi:10.1016/j.jstrokecerebrovasdis.2015.10.019

Cited by 57 publications

(62 citation statements)

References 28 publications

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“…ICD‐9‐CM code has been used in previous studies for the diagnosis of CVS . Cannabis use was identified using the ICD‐9‐CM codes 304.30 (Cannabis dependence, unspecified), 304.31 (Cannabis dependence, continuous), 304.32 (Cannabis dependence, episodic), 305.20 (nondependent Cannabis use, unspecified), 305.21 (nondependent Cannabis use, continuous) and 305.22 (nondependent Cannabis abuse, episodic) . The SID is sponsored by the Agency for Healthcare Research and Quality as a part of Healthcare Cost and Utilisation Project .…”

Section: Methodsmentioning

confidence: 99%

Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Bhandari

Jha

Medina

et al. 2019

Internal Medicine Journal

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Background Currently, 33 states in the United States along with the District of Columbia have legalised cannabis in some forms. There is a paucity of data on the impact of legalisation of cannabis use on hospitalisations due to cyclic vomiting syndrome (CVS). Aim To study the trends in CVS‐related hospitalisations and cannabis use in CVS in relation to legalisation of recreational cannabis use in Colorado. Methods All hospital admissions in Colorado between 2010 and 2014 with the diagnosis of CVS were identified using the Colorado State Inpatient Database. Five‐year trends in CVS‐related hospitalisations along with the cannabis use were analysed. Multivariate logistic regression analysis was performed to determine predictors of cannabis use in CVS. Results There was a significant increase in CVS‐related hospitalisations by 46% from 806 in 2010 to 1180 in 2014 when CVS was included as all‐listed diagnoses (P < 0.001). The overall prevalence of cannabis use in CVS (13% with CVS as primary diagnosis and 17% with CVS as all‐listed diagnoses) was much higher than non‐CVS‐related hospitalisations (1.7%) (P < 0.001 for both comparisons). Cannabis use increased dramatically in both CVS and non‐CVS‐related hospitalisations following legalisation of cannabis for recreational use in 2012. Conclusion Our study shows a significant increase in CVS‐related hospitalisations concomitant with an increase in cannabis use with its liberalisation in Colorado. Future studies on the relationship between cannabis use and hyperemesis are warranted, especially with its ongoing legalisation in the United States.

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Section: Methodsmentioning

confidence: 99%

Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Bhandari

Jha

Medina

et al. 2019

Internal Medicine Journal

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“…Recently, a growing body of research has linked cannabis use to stroke, particularly to those occurring before 45 years of age. 6,7 It seems cannabis-associated strokes usually occur in chronic or current cannabis users who also smoke tobacco, 8 either in combination with or immediately after cannabis use. The cerebrovascular effects of cannabis highlighted as possible mechanisms for subsequent strokes include hypotension, altered cerebral vasomotor function, vasospasm, cerebral vasoconstriction, and swings in blood pressure.…”

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confidence: 99%

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Falkstedt

Wolff

Allebeck

et al. 2017

Stroke

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Background and Purpose-Current knowledge on cannabis use in relation to stroke is based almost exclusively on clinical reports. By using a population-based cohort, we aimed to find out whether there was an association between cannabis use and early-onset stroke, when accounting for the use of tobacco and alcohol. Methods-The cohort comprises 49 321 Swedish men, born between 1949 and 1951, who were conscripted into compulsory military service between the ages of 18 and 20. All men answered 2 detailed questionnaires at conscription and were subject to examinations of physical aptitude, psychological functioning, and medical status. Information on stroke events up to ≈60 years of age was obtained from national databases; this includes strokes experienced before 45 years of age. Results-No associations between cannabis use in young adulthood and strokes experienced ≤45 years of age or beyond were found in multivariable models: cannabis use >50 times, hazard ratios=0.93 (95% confidence interval [CI], 0.34-2.57) and 0.95 (95% CI, 0.59-1.53). Although an almost doubled risk of ischemic stroke was observed in those with cannabis use >50 times, this risk was attenuated when adjusted for tobacco usage: hazards ratio=1.47 (95% CI, 0.83-2.56). Smoking ≥20 cigarettes per day was clearly associated both with strokes before 45 years of age, hazards ratio=5.04 (95% CI, 2.80-9.06), and with strokes throughout the follow-up, hazards ratio=2.15 (95% CI, 1.61-2.88). Conclusions-We found no evident association between cannabis use in young adulthood and stroke, including strokes before 45 years of age. Tobacco smoking, however, showed a clear, dose-response shaped association with stroke.

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“…Four studies examined the association between marijuana use and various outcomes, including peripheral arterial disease (41), irregular heartbeat (42), multifocal intracranial stenosis (43), and aneurysmal subarachnoid hemorrhage (44). All 4 studies were rated as high ROB, primarily because their marijuana exposure assessments and adjustments for baseline risk factors were inadequate.…”

Section: Resultsmentioning

confidence: 99%

Associations Between Marijuana Use and Cardiovascular Risk Factors and Outcomes

et al. 2018

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Background: Marijuana use is increasing in the United States, and its effect on cardiovascular health is unknown. Purpose: To review harms and benefits of marijuana use in relation to cardiovascular risk factors and clinical outcomes. Data Sources: PubMed, MEDLINE, EMBASE, PsycINFO, and the Cochrane Library between 1 January 1975 and 30 September 2017. Study Selection: Observational studies that were published in English, enrolled adults using any form of marijuana, and reported on vascular risk factors (hyperglycemia, diabetes, dyslipidemia, and obesity) or on outcomes (stroke, myocardial infarction, cardiovascular mortality, and all-cause mortality in cardiovascular cohorts). Data Extraction: Study characteristics and quality were assessed by 4 reviewers independently; strength of evidence for each outcome was graded by consensus. Data Synthesis: 13 and 11 studies examined associations between marijuana use and cardiovascular risk factors and clinical outcomes, respectively. Although 6 studies suggested a meta bolic benefit from marijuana use, they were based on cross-sectional designs and were not supported by prospective studies. Evidence examining the effect of marijuana on diabetes, dyslipidemia, acute myocardial infarction, stroke, or cardiovascular and all-cause mortality was insufficient. Although the current literature includes several long-term prospective studies, they are limited by recall bias, inadequate exposure assessment, minimal marijuana exposure, and a predominance of low-risk cohorts. Limitation: Poor- or moderate-quality data, inadequate assessment of marijuana exposure and minimal exposure in the populations studied, and variation in study design. Conclusion: Evidence examining the effect of marijuana on cardiovascular risk factors and outcomes, including stroke and myocardial infarction, is insufficient. Primary Funding Source: National Heart, Lung, and Blood Institute. (PROSPERO: CRD42016051297)

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Association of Recreational Marijuana Use with Aneurysmal Subarachnoid Hemorrhage

Cited by 57 publications

References 28 publications

Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Associations Between Marijuana Use and Cardiovascular Risk Factors and Outcomes

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