Researchers warn that cannabis use is not without risk.
People who used marijuana daily were about a third more likely to develop coronary heart disease (CAD) than people who didn’t, according to a study to be presented at the American College of Cardiology’s annual scientific session. never consumed. In collaboration with the World Congress of Cardiology.
As cannabis becomes legal in an increasing number of US states, this study is one of the largest and most comprehensive to date to examine the potential long-term cardiovascular implications of drug use. Coronary artery disease is the most common form of heart disease and occurs when the arteries that supply blood to the heart narrow due to a buildup of cholesterol. Coronary artery disease usually causes chest pain, shortness of breath and fatigue, and can lead to a heart attack.
Previous studies have reported somewhat mixed results on the relationship between cannabis and heart disease, with some suggesting that smoking marijuana may increase the risk of heart attack, stroke, and other cardiac events, particularly for young people.
“We found that cannabis use is related to coronary artery disease, and there appears to be a dose-response relationship in that more frequent cannabis use is associated with a higher risk of coronary artery disease,” Ishan Paranjpe said. , MD, resident physician at Stanford University and the study’s lead author. “In terms of the public health message, it shows that there are probably some harms of cannabis use that weren’t recognized before, and people should take heed of that.”
Using data from the National Institutes of Health’s All of Us research program, which includes detailed information on the health and habits of 175,000 people, the researchers first analyzed the relationship between the frequency of consumption of cannabis (assessed using surveys at the time of study entry) and rates of coronary artery disease (assessed based on medical records spanning several years). They then used Mendelian randomization, a genetics-based approach to identify a causal relationship between cannabis use disorders and coronary heart disease risk using data from an independent genetic consortium. Cannabis use disorder is a recognized psychiatric disorder involving frequent marijuana use and addiction.
After adjusting for age, sex and major cardiovascular risk factors, the results indicated that daily cannabis users were 34% more likely to have coronary artery disease than those who never used marijuana. In contrast, monthly cannabis use was not associated with a significantly increased risk of coronary artery disease. Mendelian randomization analysis suggested that this was due to a causal relationship, concluding that people with cannabis use disorders were more likely to develop coronary artery disease. Moreover, in the genetic analysis, this causal relationship was independent of the potential confounding effects of tobacco and alcohol consumption.
Based on these findings, the researchers said it is important for people to know that cannabis use is not without risk and to be sure to tell their doctor if they are using cannabis so that clinicians can take the appropriate measures to monitor their heart health.
Previous studies have suggested that tetrahydrocannabinol (THC), the molecule responsible for the psychoactive effects of cannabis, acts on receptors found in the central nervous system as well as in the heart and blood vessels. This interaction between THC and blood vessels may provide a pathway for cannabis to promote inflammation and plaque buildup, ultimately leading to coronary heart disease. The same effects would not necessarily be expected with the use of
“From a scientific perspective, these findings are exciting as they suggest that there may be new drug targets and mechanisms that we can explore to take control of this pathway in the future,” Paranjpe said. .
The datasets used in this study did not distinguish between different forms of cannabis use, for example, whether the drug was smoked or consumed in edibles or other forms. Since THC enters the body through a different route and reaches the brain more quickly when cannabis is smoked than consumed, the researchers said it might be worth looking at the health implications of these different forms. cannabis use in future studies.
Although the use and possession of cannabis remains illegal under federal law, more than half of US states have legalized or decriminalized the recreational use of marijuana, and three-quarters allow its use for medical purposes. A 2019 study estimated that about 18% of American adults used marijuana that year.
Paranjpe will present the study, “Association of Cannabis Use Disorder With Risk of Coronary Artery Disease: A Mendelian Randomization Study,” on Sunday, March 5, 2023, at 9:30 a.m. CT / 3:30 p.m.