A study just published in the journal Addiction reports that Canadian adults with cannabis use disorder (also known as “marijuana use disorder”) appear to have about a 60% greater risk of having their first major cardiovascular event like a stroke or heart attack when compared to those without the disorder.
The researchers also examined the risk for occurrences such as cardiac dysrhythmias (abnormal heartbeat) and peripheral vascular disease (narrowed blood vessels in the limbs).
According to the U.S. Centers for Disease Control and Prevention, an estimated 30% of people who use marijuana have cannabis use disorder and are unable to stop using it despite the fact that it is negatively affecting their lives.
Additionally, the National Institute on Drug Abuse states that marijuana use is on the rise among adults 19 to 30, having reached the highest levels on record since monitoring began in 1988. As of 2021, 43% of young adults reported using the drug in the past year. In comparison, only 29% reported past-year usage in 2011.
The American Heart Association says that cardiovascular disease affects nearly half of all American adults and is a leading cause of death, making it essential to understand and control its risk factors.
Why might cannabis use increase cardiovascular disease risk?
Dr. Blen Tesfu, a general practitioner and medical advisor for the UK-based healthcare platform Welzo, said, “It’s important to note that the association between cannabis use and cardiovascular disease is complex and can vary depending on factors like frequency and duration of use, the method of consumption, and individual susceptibility.”
According to the CDC, “Most of the scientific studies linking marijuana to heart attacks and strokes are based on reports from people who smoked marijuana (as opposed to other methods of using it). Smoked marijuana delivers tetrahydrocannabinol (THC) and other cannabinoids to the body. Marijuana smoke also delivers many of the same substances researchers have found in tobacco smoke—these substances are harmful to the lungs and cardiovascular system.”
Tesfu noted that there are several reasons why cannabis use might be associated with an increased risk for cardiovascular disease.
He explained that cannabis use can first of all lead to a short-term increase in heart rate. “In susceptible individuals, this can trigger or exacerbate underlying heart conditions, especially in cases of pre-existing heart disease.”
He further noted that cannabis can cause variations in blood pressure. Tesfu said that some research suggests that these blood pressure fluctuations can be transient while, in other cases, it can lead to orthostatic hypotension (a sudden drop in blood pressure upon standing) which can create a risk of falling or fainting.
Additionally, cannabis use can cause blood vessels to temporarily narrow, potentially reducing blood flow to the heart. According to Tesfu, this can increase the risk of heart attack, especially if you already have cardiovascular disease.
Tesfu added that cannabis use has also been linked with changes in lipid profiles, including an increase in the levels of triglycerides and a decrease in the so-called “good” high-density lipoprotein (HDL) cholesterol. “These changes can contribute to atherosclerosis and the development of CVD [cardiovascular disease],” he stated.
Dr. Atif Zafar, who is the Chief of the Stroke Program at St. Michael’s Hospital of the University of Toronto and founder of Human-Healthcare.com, further explained that cannabis contains THC, the compound that is responsible for the “high” that people feel. This compound can interact with a receptor called “CB1,” he said. “The inappropriate activation of CB1 due to frequent marijuana use can cause inflammation within the blood vessels.”
Zafar went on to relate a case study he published in 2016 where a patient of his was using cannabis up to 20 times a day and subsequently had a stroke. “[W]e found on brain imaging that his blood vessels were tight and over time they slowly opened up,” he said. “He ended up having brain damage as a result.”
How can people tell if they have cannabis use disorder?
Tesfu said that cannabis use disorder (CUD) is diagnosed based on criteria found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is a guidebook clinicians use to diagnose mental disorders.
“To determine if someone has CUD, healthcare professionals assess whether an individual meets at least two of the following criteria within a 12-month period,” he said.
Taking cannabis in larger amounts or over a more extended period of time than what was intended
Failing to cut down or control use even though there is a desire to do so
Spending a significant amount of time getting, using, or recovering from cannabis
Having strong cravings for the drug
Failing to meet obligations at home, school, or work
Continuing to use cannabis despite the fact that it is causing problems
Giving up important social or work activities because of cannabis use
Using the drug even when it is physically dangerous
Using cannabis even when it is causing or exacerbating a physical or psychological problem
Needing more cannabis over time to experience the same high
Experiencing withdrawal symptoms when reducing or quitting usage of the drug
How can people get help with cannabis use disorder?
Tesfu said that treatment for cannabis use disorder generally involves a combination of behavioral therapy; counseling; and, in some cases, medication.
He said the first step in getting help is to make a visit to a healthcare provider. “They can assess the severity of your cannabis use and help determine the most appropriate treatment approach,” he advised.
Tesfu noted that behavioral therapy — such as cognitive-behavioral therapy and motivational enhancement therapy — have proven to be the most effective in treating cannabis use disorder. “These therapies help individuals identify and change behaviors and thought patterns related to cannabis use,” he added.
Tesfu also suggested joining support groups and attending group therapy, as these can provide peer support and a sense of community during your recovery.
Additionally, depending on the severity of the disorder, either outpatient or inpatient treatment programs may be advised, according to Tesfu. “Inpatient programs provide more intensive support and structure for individuals with severe CUD.”
“It’s important to remember that seeking help is a positive step towards recovery,” Tesfu concluded. “The first and crucial step is recognizing that there is an issue and being willing to address it. A healthcare provider can guide you toward the most appropriate treatment plan based on your individual needs and circumstances.”
Research indicates that people with cannabis use disorder have a 60% greater risk for having a first-time cardiovascular event such as stroke or heart attack.
However, a big limitation of the study is that it did not look at types of marijuana use such as edibles vs vaping or smoking.
There are several ways that cannabis might increase your risk, such as narrowing blood vessels or decreasing your “good” cholesterol.
If you find yourself having symptoms of addiction to cannabis, such as wanting to quit but being unable to, you may have cannabis use disorder.
Your healthcare provider can point you to resources for quitting cannabis and possibly reducing your risk for cardiovascular problems.
H/T: www.healthline.com
