Association between lifetime cannabis use and arterial stiffness in a middle-aged general population

Vallée, Alexandre

doi:10.1097/hjh.0000000000003389

Cited by 3 publications

(3 citation statements)

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“…Recent research has indicated a potential increase in cardiovascular (CV) risks associated with cannabis consumption. [1][2][3][4][5] However, these studies have been constrained by their focus on specific population segments, which may affect the perceived association of cannabis with CV health. 6,7 Additionally, there has been a scarcity of research exploring how cannabis use might affect females and males differently.…”

Section: Introductionmentioning

confidence: 99%

“…Considering the growing movement toward legalizing cannabis across various regions, it has become increasingly critical to comprehend the health consequences of its habitual use. Recent research has indicated a potential increase in cardiovascular (CV) risks associated with cannabis consumption . However, these studies have been constrained by their focus on specific population segments, which may affect the perceived association of cannabis with CV health .…”

Section: Introductionmentioning

confidence: 99%

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Heavy Lifetime Cannabis Use and Mortality by Sex

Vallée

2024

JAMA Netw Open

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ImportanceThe association between mortality and cannabis use remains unclear.ObjectiveTo examine sex-stratified associations of cumulative lifetime cannabis use with all-cause, cardiovascular disease (CVD), and cancer mortality in the UK Biobank population.Design, Setting, and ParticipantsThis cohort study used data from volunteers in the UK Biobank population. Participant monitoring for mortality in the UK Biobank study commenced from the point of their inclusion between 2006 and 2010 and continued until December 19, 2020. Data regarding the causes of death were sourced from the National Health Service Information Centre. Data were analyzed from inception of study inclusion to December 2020.ExposureCannabis use status was assessed by questionnaire and categorized as heavy, moderate, low, and never.Main Outcomes and MeasuresThe main outcomes were all-cause, CVD, and cancer mortality. Sex-stratified associations of cumulative lifetime cannabis use with mortality were estimated using Cox proportional hazards regression with adjustment for demographic and clinical variables.ResultsAmong 121 895 participants (54.51% females with mean [SD] age of 55.15 [7.64] years; 45.49% males with mean [SD] age of 56.46 [7.79] years) during an overall median of 11.80 years (IQR, 10.53-13.22 years) of follow-up, 2375 total deaths occurred, including 1411 deaths from CVD and 440 from cancer. In males, after full adjustment, the hazard ratios (HRs) were 1.28 (95% CI, 0.90-1.81) for all-cause mortality, 0.98 (95% CI, 0.43-2.25) for CVD mortality, and 1.09 (95% CI, 0.71-1.67) for cancer mortality among heavy cannabis users compared with never users. In females, after full adjustment, the HRs were 1.49 (95% CI, 0.92-2.40) for all-cause mortality, 2.67 (95% CI, 1.19-4.32) for CVD mortality, and 1.61 (95% CI, 0.91-2.83) for cancer mortality among heavy cannabis users compared with never users. In female current tobacco users, after full adjustment, heavy cannabis use was associated with all-cause mortality (HR, 2.25; 95% CI, 1.12-4.53), CVD mortality (HR, 2.56; 95% CI, 1.43-15.36), and cancer mortality (HR, 3.52; 95% CI, 1.50-8.33) and among never tobacco users was associated with CVD mortality (HR, 2.98; 95% CI, 1.67-6.61). In male current tobacco users, heavy cannabis use was associated with cancer mortality (HR, 2.44; 95% CI, 1.14-5.23).Conclusions and RelevanceIn this study, a positive association between CVD mortality and heavy lifetime cannabis use was observed among females. Longitudinal studies are needed in general populations to investigate the potential effects of cannabis on mortality.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heavy Lifetime Cannabis Use and Mortality by Sex

Vallée

2024

JAMA Netw Open

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“…In female vessels endothelium-dependent vasodilatory functions may be augmented by estrogens, inducing vascular protective effects before menopause and applied in the frame of estrogen replacement therapy after menopause [20,29,30]. Sex differences can exist in the cannabinoid sensitivity of blood vessels: lifetime cannabis use induced increased vascular stiffness in males [31].…”

Section: Introductionmentioning

confidence: 99%

Role of CB1 Cannabinoid Receptors in Vascular Responses and Vascular Remodeling of the Aorta in Female Mice

Bányai,

Vass,

Kiss

et al. 2023

IJMS

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Both the endocannabinoid system (ECS) and estrogens have significant roles in cardiovascular control processes. Cannabinoid type 1 receptors (CB1Rs) mediate acute vasodilator and hypotensive effects, although their role in cardiovascular pathological conditions is still controversial. Estrogens exert cardiovascular protection in females. We aimed to study the impact of ECS on vascular functions. Experiments were performed on CB1R knockout (CB1R KO) and wild-type (WT) female mice. Plasma estrogen metabolite levels were determined. Abdominal aortas were isolated for myography and histology. Vascular effects of phenylephrine (Phe), angiotensin II, acetylcholine (Ach) and estradiol (E2) were obtained and repeated with inhibitors of nitric oxide synthase (NOS, Nω-nitro-L-arginine) and of cyclooxygenase (COX, indomethacin). Histological stainings (hematoxylin-eosin, resorcin-fuchsin) and immunostainings for endothelial NOS (eNOS), COX-2, estrogen receptors (ER-α, ER-β) were performed. Conjugated E2 levels were higher in CB1R KO compared to WT mice. Vasorelaxation responses to Ach and E2 were increased in CB1R KO mice, attenuated by NOS-inhibition. COX-inhibition decreased Phe-contractions, while it increased Ach-relaxation in the WT group but not in the CB1R KO. Effects of indomethacin on E2-relaxation in CB1R KO became opposite to that observed in WT. Histology revealed lower intima/media thickness and COX-2 density, higher eNOS and lower ER-β density in CB1R KO than in WT mice. CB1R KO female mice are characterized by increased vasorelaxation associated with increased utilization of endothelial NO and a decreased impact of constrictor prostanoids. Our results indicate that the absence or inhibition of CB1Rs may have beneficial vascular effects.

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Acute Effects of Cannabis Inhalation on Arterial Stiffness, Vascular Endothelial Function, and Cardiac Function

Cheung,

Coates,

Baker

et al. 2024

JAHA

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Background The cardiovascular impact of cannabis use is incompletely understood. Although evidence links chronic use to an increased risk of disease and adverse cardiovascular events, few studies have investigated the acute effects of cannabis inhalation on subclinical dysfunction. Furthermore, it remains unknown how method of inhalation and cannabinoid profile modify risk. While controlling for inhalation method and the effects of either Δ‐9‐tetrahydrocannabinol (THC) or cannabidiol (CBD), we examined the acute cardiovascular effects of cannabis use on arterial stiffness, vascular endothelial responsiveness, and cardiac function, as markers of cardiovascular impairment. Methods and Results Twenty‐two young, healthy, cannabis users were assessed for arterial stiffness via pulse wave velocity, vascular endothelial function via brachial artery flow mediated dilation, and cardiac function via echocardiography, before and after (1) smoking THC‐predominant cannabis (S‐THC), (2) vaporizing THC‐predominant THC (V‐THC), and (3) vaporizing cannabidiol‐predominant cannabis (V‐CBD). S‐THC and V‐THC increased heart rate (S‐THC: ∆17±15 bpm, V‐THC: ∆16±16 bpm;both P <0.0001) and mean arterial pressure (S‐THC: ∆7±6 mm Hg, V‐THC: ∆5±5 mm Hg;both P <0.0001) whereas V‐CBD did not (∆1±4 bpm, ∆3±4 mm Hg;both P >0.05). After inhalation, pulse wave velocity increased (S‐THC: ∆0.29±0.75 m/s, V‐THC: ∆0.42±0.74 m/s, V‐CBD: ∆0.10±0.44 m/s; P =0.002) and diastolic function was reduced ([early/late ratio] S‐THC: ∆‐0.2±0.53, V‐THC: ∆‐0.33±58, V‐CBD: ∆0.01±66; P =0.03). Differences in heart rate were related to changes in pulse wave velocity (r 2 =0.2; P =0.0002) and diastolic function (r 2 =0.26; P <0.0001). Inhalation method did not alter these cannabinoid‐dependent responses. Conclusions THC predominant, but not cannabidiol predominant, cannabis elicits increases in heart rate and blood pressure irrespective of inhalation method, which may increase arterial stiffness and reduce diastolic function. These findings implicate THC as a relevant factor for cannabis‐related subclinical cardiovascular dysfunction. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04693884.

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Association between lifetime cannabis use and arterial stiffness in a middle-aged general population

Cited by 3 publications

References 69 publications

Heavy Lifetime Cannabis Use and Mortality by Sex

Heavy Lifetime Cannabis Use and Mortality by Sex

Role of CB1 Cannabinoid Receptors in Vascular Responses and Vascular Remodeling of the Aorta in Female Mice

Acute Effects of Cannabis Inhalation on Arterial Stiffness, Vascular Endothelial Function, and Cardiac Function

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