The Impact of Marijuana on the Cardiovascular System: A Review of the Most Common Cardiovascular Events Associated with Marijuana Use

Abstract

With the expanded legalization of marijuana, its medical and recreational use have sharply increased over the past decade. A wide array of new forms of cannabis is available on the market today, and the potencies are ten times those of forms previously tested, meaning that the true impact of marijuana on the cardiovascular system remains unclear. Cannabis mainly exerts its effects via the sympathetic and parasympathetic nervous systems, with different doses affecting different cannabinoids receptors. Studies have shown that marijuana plays a role in thrombosis, inflammation, and atherosclerosis. Case reports have linked marijuana use to myocardial infarction, cardiac arrythmias, cardiomyopathies, stroke, and arteritis. Most patients are young, healthy men with no cardiovascular risk factors; however, the patient population is expected to change to include older individuals in the future. The widespread public perception of safety accompanying marijuana use has contributed to its increased use among the elderly, who are the most at risk population for acute cardiovascular events. In this review, we aim to provide a basic understanding of the physiological effects of marijuana on the cardiovascular system and to review the current literature regarding cardiovascular diseases linked to marijuana use in adults.

Cannabis und synthetische Cannabinoide – eine nicht nur radiologische Übersicht

“…In einer USA-weiten Studie war das Risiko eines akuten ischämischen Schlaganfalls ("acute ischemic stroke", AIS) infolge Cannabis-Abusus in einer großen Kohorte von Patienten mit AIS (Alter 15-54) signifikant erhöht, insbesondere in der Altersgruppe zwischen 25 und 34 Lebensjahren (Faktor 2,26) [42]. Vielfach tritt ein AIS auch bei jüngeren Konsumenten auf, die keine Nikotin-Raucher sind und keine weiteren kardialen oder vaskulären Erkrankungen oder Risikofaktoren aufweisen [25,53]. Vergleichbar dem Myokardinfarkt ist die Pathophysiologie des AIS bei Cannabis-Konsumenten noch nicht vollständig geklärt, es wird auch hier auf die Vasokonstriktion, die verstärkte Thromboseneigung und eine Dysregulation der mitochondrialen Funktion verwiesen [19,54].…”

“…Die genannten Hirnregionen weisen eine hohe Konzentration von CB1-Rezeptoren auf und haben eine Schlüsselfunktion bei kognitiven und mentalen Leistungen, also denjenigen zerebralen Leistungen, die typischerweise im Rahmen von Cannabis-Abusus eingeschränkt sind. [24,25,44].…”

Role of Cannabis in the Incidence of Myocardial Infarction: A Review

“…Since these receptors are present in the body extensively, its activation affects multiple systems [ 7 ]. The molecular mechanism of the receptors involves signal transduction through modulation of adenylyl cyclase (AC), nuclear factor kappa light chain enhancer of activated B cells (NF-kb), and mitogen-activated protein kinases (MAPK) [ 7 , 14 ]. CB1R stimulation causes activation of the adenylyl cyclase inhibitor subunit of G-proteins (Gi/o).…”

“…Since the decriminalization of usage, possession, and selling of marijuana, there are various synthetic substances produced and sold commercially with tetrahydrocannabinol (THC) as the main ingredient. Various brand names of synthetic marijuana available on the internet are Armageddon, Aztec Gold, K2, Black Mamba, Cloud-9, Demon, Mad Hatter, and Spice [7]. Azofeifa et al conducted a study that presented an increase of marijuana consumption by 455% among adults ages 55 to 64 and a 333% increase in those greater than 65 years of age [8].…”

“…It was believed earlier that vaping was safer than smoking because of no carbon monoxide component from heating. It also produced increased blood THC level and psychoactive effect, but recent reports say it causes more damage to the lungs [7,9]. The active chemical present in cannabis is tetrahydrocannabinol (THC).…”