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

• Published in: Journal of the American College of Cardiology Vol. 75; no. 3; p. 320
• Main Authors: DeFilippis, Ersilia M, Bajaj, Navkaranbir S, Singh, Amitoj, Malloy, Rhynn, Givertz, Michael M, Blankstein, Ron, Bhatt, Deepak L, Vaduganathan, Muthiah
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 28.01.2020
• Subjects: Acute coronary syndromes; Adipose tissue; Cannabidiol; Cannabinoid receptors; Cannabis; Cardiology; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - therapy; Chemicals; Chemotherapy; Coronary vessels; Drug use; Electronic cigarettes; FDA approval; Health hazards; Health risk assessment; Health risks; Heart attacks; Humans; Inhalation; Marijuana; Marijuana Use - epidemiology; Marijuana Use - therapy; Marijuana Use - trends; Myocytes; Nutrition Surveys - methods; Pharmacodynamics; Pharmacology; Platelets; Receptors; Respiration; Schedules; Smoking; Tobacco; United States - epidemiology; United States; United States > US; coronary artery disease; cannabis; marijuana; vascular disease; arrhythmia
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2019.11.025

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.