The American Heart Association (AHA) this week released as statement on cannabis use as it pertains to cardiovascular risk.
Within their findings, they write: 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.
Inflammation to blood vessels caused by toxins within the smoke could affect blood pressure as well as heart muscle contractility (discussed below).
Many studies have linked marijuana use to heart attacks, heart failure and stroke.
In 2017, Dr. Aditi Kalla and colleagues from Einstein Medical Center in Philadelphia analyzed 20 million health records of patients who were hospitalized in 2009 and 2010 and found those who used marijuana (1.5% of the patients studied) were at high risk of coronary artery disease, sudden cardiac death, heart failure and stroke.
What’s even more striking is the patients were younger, aged 18-55. Risk factors including obesity, high blood pressure, alcohol use and smoking were already taken into account.
One theory for the link between heart disease/stroke and marijuana use is that cannabis may affect the cardiac muscle cell’s ability to contract, affecting the pumping mechanism of the heart, thereby leading to heart failure. Another theory is marijuana, like cigarette smoking, may be increasing risk of clots. Below is a report on a study linking marijuana use to Transient Ventricular Regional Ballooning (TVRB). This can also lead to heart failure. Another theory suggests cannabis causes a release of stress hormones, such as cortisol.
In 2016 study out of St. Luke’s University Hospital Network found marijuana to cause stress cardiomyopathy. This is a temporary condition that causes a “ballooning” of a region of the ventricle known as Transient Ventricular Regional Ballooning (TVRB). We know that many drugs can cause cardiomyopathy (affect the heart muscle) such as cocaine and stimulants causing dilated cardiomyopathy, but this is new in that a sedating type of drug such as cannabis/marijuana, can cause similar effects on the heart.
The condition of TVRB can mimic many different heart conditions because it presents with chest pain, shortness of breath and dizziness. So many individuals admitted for these symptoms are evaluated for a heart attack, angina, pneumonia, and a variety of other diagnoses.
In this study, the researchers looked at data from 33,000 hospital admissions who had TVRB and saw a link between 210 of these admissions and marijuana use. They are unsure how marijuana affects the heart, but theorize that it could be an increase in cortisol and stress hormones. Although none of the marijuana users in this study died, the TVRB can cause cardiac arrest, heart attack.
The AHA statement suggests more research and warnings may need to be provided to the public as recreational use continues to expand throughout the country.