Cardiovascular Effects of Medical Marijuana: A Systematic Review

Pasha, Ahmed K.; Clements, Charlene Y.; Reynolds, Charity A.; Lopez, Maegan K.; Lugo, Ciara A.; Gonzalez, Yulisa; Shirazi, Farshad; Abidov, Aiden

doi:10.1016/j.amjmed.2020.09.015

Cited by 11 publications

(6 citation statements)

References 79 publications

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“…[9] The mechanism of regular cannabis use, as a risk factor for myocardial infarction and ischaemic stroke, may be due to the sympathomimetic effect of the 9-tetrahydrocannabinol component (THC). [10] THC affects CB1 receptors within the cardiovascular system, leading to haemodynamic changes: increase in blood pressure, vasodilation, alteration of coronary blood flow and tachycardia. These changes may predispose to ischaemia.…”

Section: Discussionmentioning

confidence: 99%

“…These changes may predispose to ischaemia. [10,11] Similarly, increased vascular tone leads to reduced cerebral blood flow, which may be associated with increased risk of stroke. [11] Research is ongoing into both the potential pro-thrombotic effect of cannabis and the inflammatory potential of cannabis to contribute to the development of atheroma (both mediated via CB1 and CB2 receptors).…”

Section: Discussionmentioning

confidence: 99%

“…[5] At present, there is no 'standard' of medical cannabis, the term is used to describe any product with derivatives of cannabis. [10] With the use of cannabis worldwide increasing, it is vital for further research to be focused on this association and its potential effects going forward.…”

Section: Discussionmentioning

confidence: 99%

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Ischaemic strokes and myocardial infarctions in a young male cannabis user

Culling,

Hakim,

Pearce

et al. 2024

SSMJ

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Ischaemic cerebral infarctions are seen in young people but, under the age of 30, multiple bilateral infarcts are uncommon; genetic pre-disposition and co-morbidities often underlie them. There is growing awareness of the potential impact of modifiable risk factors, such as cannabis, for those experiencing stroke and other cardiovascular events. A case of a 29-year-old man is described who presented with sudden onset occipital headache and right eye vision loss. Computerised axial tomographic scanning (CT) of the brain demonstrated multifocal bilateral areas of low attenuation. A brain magnetic resonance imaging (MRI), confirmed bilateral acute cerebral infarctions. In view of a significant elevation in troponin levels at a previous admission, cardiac viability magnetic resonance imaging (cvMRI) was carried out and demonstrated acute infarction affecting the left ventricular apex and multiple smaller infarcts elsewhere within the myocardium. On this occasion he did not complain of chest pain. The electrocardiogram (ECG) showed ischaemic changes. The patient denied a family history of ischaemic heart disease, diabetes mellitus, hypertension and hypercholesterolaemia, but admitted to daily use of cannabis and cigarette smoking. We considered the regular use of cannabis as a possible aetiology in the development of multi-territory cerebral and myocardial infarcts, previous myopericarditis and left ventricular dysfunction

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ischaemic strokes and myocardial infarctions in a young male cannabis user

Culling,

Hakim,

Pearce

et al. 2024

SSMJ

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“…dizziness, dry mouth and nausea; Briscoe & Casarett, 2018) and long‐term physical effects (e.g. cardiovascular rhythm abnormalities; Pasha et al, 2021). Short‐term cognitive deficits were also reported following MC treatment, including impaired executive function and short‐term memory (Saulino et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Negative experiences of patients using medicinal cannabis: A systematic review of qualitative studies

Gliksberg

Kushnir

Sznitman

et al. 2023

Journal of Clinical Nursing

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Aims and ObjectivesIn this study, we systematically reviewed qualitative studies concerning patients' experience with medicinal cannabis (MC) use, to gain insight into the negative effects of MC.BackgroundOver the past decades, the use of MC for therapeutic purposes has increased. However, there is conflicting and insufficient data on possible negative physiological and psychological effects of MC treatment.DesignA systematic review was conducted and the PRISMA guidelines were adopted. Literature searches were conducted using PubMed, PsycINFO and EMBASE. Critical Appraisal Skills Programme (CASP) qualitative checklist used to assess risk of bias in the included studies.MethodsWe included studies focusing on conventional medical treatment using cannabis‐based products, approved by a physician for a particular health issue.ResultsOf the 1230 articles identified in the initial search, eight articles were included in the review. Following the compilation of themes in the eligible studies, six themes were identified: (1) MC approval; (2) administrative barriers; (3) social perception; (4) MC misuse/widespread effect; (5) adverse effects; and (6) dependence or addiction. These were grouped into two meta‐themes: (1) administrative and social aspects of MC use; and (2) experiences of the effects of medicinal cannabis.ConclusionsOur findings call for specific attention to unique consequences associated with MC use. Further research is needed in order to assess the degree to which negative experiences associated with MC use may affect various aspects of patients' medical condition.Relevance to clinical practiceDescribing the complex experience of MC treatment and its spectrum of consequences for patients may enable physicians, therapists and researchers to provide more attentive and accurate MC treatment to their patients.Patient or public contributionIn this review, patients' narratives were explored, yet the research methods did not directly involve patients or the public.

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“…Cannabis has been linked to serious CV events, including myocardial infarction, stroke, cardiomyopathies, atherosclerosis and cardiac arrhythmias [15][16][17][18][19][20][21]. Although the exact mechanisms by which cannabis use may induce CVD events are unknown, it appears to be through activation of the endogenous cannabinoid system, consisting of endocannabinoids, their receptors and complex downstream signaling pathways [18,[22][23][24][25]. When cannabinoids enter systemic circulation they activate G-protein-coupled cannabinoid receptors-CB1 and CB2 [17]-which trigger several downstream effects, such as tachycardia, vasoconstriction, platelet aggregation, vascular inflammation and cardiac myocyte changes, among others [26,27].…”

Section: Introductionmentioning

confidence: 99%

Cannabis use disorder and adverse cardiovascular outcomes: A population‐based retrospective cohort analysis of adults from Alberta, Canada

Bahji,

Hathaway,

Adams

et al. 2023

Addiction

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AimTo measure the association between cannabis use disorder (CUD) and adverse cardiovascular disease (CVD) outcomes.Design and SettingWe conducted a matched, population‐based retrospective cohort study involving five linked administrative health databases from Alberta, Canada.ParticipantsWe identified participants with CUD diagnosis codes and matched them to participants without CUD codes by gender, year of birth and time of presentation to the health system. We included 29 764 pairs (n = 59 528 individuals in total).MeasurementsCVD events were defined by at least one incident diagnostic code within the study period (1 January 2012–31 December 2019). Covariates included comorbidity, socio‐economic status, prescription medication use and health service use. Using mortality‐censored Poisson regression models, we computed survival analyses for time to incident CVD stratified by CUD status. In addition, we calculated crude and stratified risk ratios (RRs) across various covariates using the Mantel–Haenszel technique.FindingsThe overall prevalence of documented CUD was 0.8%. Approximately 2.4% and 1.5% of participants in the CUD and unexposed groups experienced an incident adverse CVD event (RR = 1.57; 95% confidence interval = 1.40–1.77). CUD was significantly associated with reduced time to incident CVD event. Individuals who appeared to have greater RRs for incident CVD were those without mental health comorbidity, who had not used health‐care services in the previous 6 months, who were not on prescription medications and who did not have comorbid conditions.ConclusionsCanadian adults with cannabis use disorder appear to have an approximately 60% higher risk of experiencing incident adverse cardiovascular disease events than those without cannabis use disorder.

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Cardiovascular Effects of Medical Marijuana: A Systematic Review

Cited by 11 publications

References 79 publications

Ischaemic strokes and myocardial infarctions in a young male cannabis user

Ischaemic strokes and myocardial infarctions in a young male cannabis user

Negative experiences of patients using medicinal cannabis: A systematic review of qualitative studies

Cannabis use disorder and adverse cardiovascular outcomes: A population‐based retrospective cohort analysis of adults from Alberta, Canada

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