Marijuana Use in Patients With Cardiovascular Disease: JACC Review Topic of the Week.

Ersilia M DeFilippis, Navkaranbir S Bajaj, Amitoj Singh, Rhynn Malloy, Michael M Givertz, Ron Blankstein, Deepak L Bhatt, Muthiah Vaduganathan

Journal: Journal of the American College of Cardiology 2020;75(3):320-332

PMID: 31976871

Free Full Text on Elsevier Science View on PubMed

Abstract

Marijuana use is increasing as more states are legalizing cannabis for both medicinal and recreational purposes. National survey data estimate that >2 million Americans with established cardiovascular diseases currently use or have used marijuana in its variety of forms, including inhalation and vaping. Cannabinoid receptors are distributed in multiple tissue beds and cells, including platelets, adipose tissue, and myocytes. Observational data suggest associations between marijuana and a broad range of adverse cardiovascular risks. Marijuana is becoming increasingly potent, and smoking marijuana carries many of the same cardiovascular health hazards as smoking tobacco. Synthetic cannabinoids have been linked to more sustained and deleterious pharmacodynamic effects. Marijuana is classified as a Schedule I substance, thus limiting its rigorous study for cardiovascular health effects. This review summarizes cardiovascular considerations related to marijuana use, pharmacological interactions, and future steps to provide clearer guidance regarding its cardiovascular safety. Screening for marijuana use is encouraged, especially in young patients presenting with cardiovascular disease.

Address: Columbia University Irving Medical Center, New York, New York. Electronic address: https://twitter.com/ersied727.; University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: https://twitter.com/bajaj_nav.; Sarver Heart Center, University of Arizona, Tucson, Arizona.; Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts.; Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/RonBlankstein.; Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/DLBHATTMD.; Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts. Electronic address: [email protected].

DOI: 10.1016/j.jacc.2019.11.025

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MeSH Terms: Cardiovascular Diseases, Humans, Marijuana Use, Nutrition Surveys, United States