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Medical Marijuana, Recreational Cannabis, and Cardiovascular Health
TAKE-HOME MESSAGE
- The authors of this American Heart Association scientific statement review the use of medicinal and recreational cannabis both for medicinal and recreational purposes, which has expanded over the last 2 decades. Cannabis has little benefit for the cardiovascular system but many of the adverse effects include cardiovascular disease. The authors review the safety and efficacy of cannabis for a variety of indications as well as for recreation while also considering the policy and public health perspective.
- Further research is urgently needed to provide high-quality evidence regarding the risks and benefits of cannabis to inform both members of the public and policy.
abstract
This abstract is available on the publisher's site.
Access this abstract nowCannabis, or marijuana, has potential therapeutic and medicinal properties related to multiple compounds, particularly Δ-9-tetrahydrocannabinol and cannabidiol. Over the past 25 years, attitudes toward cannabis have evolved rapidly, with expanding legalization of medical and recreational use at the state level in the United States and recreational use nationally in Canada and Uruguay. As a result, the consumption of cannabis products is increasing considerably, particularly among youth. Our understanding of the safety and efficacy of cannabis has been limited by decades of worldwide illegality and continues to be limited in the United States by the ongoing classification of cannabis as a Schedule 1 controlled substance. These shifts in cannabis use require clinicians to understand conflicting laws, health implications, and therapeutic possibilities. Cannabis may have therapeutic benefits, but few are cardiovascular in nature. Conversely, many of the concerning health implications of cannabis include cardiovascular diseases, although they may be mediated by mechanisms of delivery. This statement critically reviews the use of medicinal and recreational cannabis from a clinical but also a policy and public health perspective by evaluating its safety and efficacy profile, particularly in relationship to cardiovascular health.
Additional Info
Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific Statement From the American Heart Association
Circulation 2020 Aug 05;[EPub Ahead of Print], RL Page, LA Allen, RA Kloner, CR Carriker, C Martel, AA Morris, MR Piano, JS Rana, JF Saucedo,From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Cannabis is being legalized for both medical and recreational use in more and more states. As this occurs, it becomes important for healthcare providers to understand the pros and cons of cannabis. The current article from the American Heart Association critically reviews the use of medicinal and recreational marijuana from a clinical, policy, and public health standpoint. While medical marijuana may play a therapeutic role in certain disease states (management of pain, anorexia, nausea and vomiting, multiple sclerosis spasticity, certain forms of epilepsy, anxiety, depression, others), data to date do not support its use as a therapy for cardiovascular disease. In fact, cannabis has been associated with adverse cardiovascular events, including myocardial infarction (especially in younger patients), arrhythmias, strokes, heart failure, and cardiovascular mortality. While it has been postulated that some components of marijuana may be cardioprotective (cannabidiol, or CBD), the THC (delta-9-tetrahydrocannabinol) component stimulates the sympathetic nervous system and is associated with endothelial dysfunction and oxidative stress. It is inevitable that more and more states will legalize marijuana. Similar to the situation of the legal use of alcohol, we must know the pros and cons of marijuana on the organ systems. We know that alcohol in moderation may have some benefits on cardiovascular mortality; but, in excess, it causes cardiomyopathy, hypertension, and arrhythmias. There is an urgent need for well-designed prospective studies to examine the effect of both the acute and long-term effects of marijuana on the cardiovascular system, especially since current forms of marijuana have higher doses of THC than in the past.