Cumulative Marijuana Use and Carotid Intima-Media Thickness at Middle Age: The CARDIA Study

Jakob, Julian; Wyl, Roman von; Stalder, Odile; Pletcher, Mark J.; Vittinghoff, Eric; Tal, Kali; Rana, Jamal S.; Sidney, Stephen; Reis, Jared P.; Auer, Reto

doi:10.1016/j.amjmed.2020.11.026

Cited by 8 publications

(6 citation statements)

References 39 publications

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“…Other studies found that long and short-term marijuana exposure was not associated with carotid intima-media thickness as measured by high-definition ultrasonography or coronary artery plaque sizes determined by noncontrast cardiac computed tomography scans. 36,37 Our report builds on these findings by replicating these results in a more contemporary cohort. Due to concerns regarding the rising potency of marijuana, some have suggested that the recent reports of marijuana-related cardiovascular effects might be driven by these stronger formulations of the compound.…”

Section: Discussionsupporting

confidence: 57%

Comparison of Atherosclerotic Cardiovascular Risk Factors and Cardiometabolic Profiles Between Current and Never Users of Marijuana

Alhassan,

Akunor,

Howard

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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Background: The relationship between marijuana use and cardiovascular health remains uncertain, with several observational studies suggesting a potential association with increased adverse atherosclerotic cardiovascular disease (ASCVD) outcomes. This study examined the relationship between marijuana use, ASCVD risk factors, and cardiometabolic risk profiles. Methods: US adults (18–59 years) without cardiovascular disease were identified from the National Health And Nutrition Examination Survey (2005–2018) based on self-reported marijuana use. Current users (used within the past month) and never users were compared with assess the burden and control of traditional ASCVD risk factors and biomarkers, using inverse probability of treatment weighting to adjust for sociodemographic and lifestyle factors, including tobacco use. Results: Of the 13 965 participants identified (mean age, 37.5; 51.2% female; 13% non-Hispanic Black), 26.6% were current users. Current users were predominantly male, low-income, and more likely to be concurrent tobacco users. Inverse probability of treatment weighting analysis showed no significant differences in the burden and control of hypertension (19.3% versus 18.8%, P =0.76; 79.8% versus 77.8%, P =0.75), dyslipidemia (24.0% versus 19.9%, P =0.13; 82% versus 75%, P =0.95), diabetes (4.8% versus 6.4%, P =0.19; 52.9% versus 50.6%, P =0.84), obesity (35.8% versus 41.3%, P =0.13), and physical activity levels (71.9% versus 69.3%, P =0.37) between current and never users. Likewise, mean 10-year ASCVD risk scores (2.8% versus 3.0%, P =0.49), 30-year Framingham risk scores (22.7% versus 24.2%, P =0.25), and cardiometabolic profiles including high-sensitivity C-reactive protein (3.5 mg/L versus 3.7 mg/L, P =0.65), neutrophil-lymphocyte ratio (2.1 versus 2.1, P =0.89), low-density lipoprotein (114.3 mg/dL versus 112.2 mg/dL, P =0.53), total cholesterol (191.2 mg/dL versus 181.7 mg/dL, P =0.58), and hemoglobin A1C (5.4% versus 5.5%, P =0.25) were similar between current and never users. Conclusions: This cross-sectional study found no association between self-reported marijuana use and increased burden of traditional ASCVD risk factors, estimated long-term ASCVD risk, or cardiometabolic profiles. Further studies are needed to explore potential pathways between adverse cardiovascular disease outcomes and marijuana use.

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Section: Discussionsupporting

confidence: 57%

Comparison of Atherosclerotic Cardiovascular Risk Factors and Cardiometabolic Profiles Between Current and Never Users of Marijuana

Alhassan,

Akunor,

Howard

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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“…Given the risk of prolonged cardiovascular effects, conservative recommendations suggest avoiding cannabinoids for 72 hours prior to surgery 93 94. While cannabinoid use does not appear to be a risk factor for coronary artery disease95–99 it may trigger acute coronary syndromes in those with underlying atherosclerotic heart disease 90 100–102…”

Section: Methodsmentioning

confidence: 99%

“…92 Given the risk of prolonged cardiovascular effects, conservative recommendations suggest avoiding cannabinoids for 72 hours prior to surgery. 93 94 While cannabinoid use does not appear to be a risk factor for coronary artery disease [95][96][97][98][99] it may trigger acute coronary syndromes in those with underlying atherosclerotic heart disease. 90 100-102 Smoking cannabis has been associated with a dose-dependent impairment of large airway function resulting in airflow obstruction and hyperinflation, but it has seldom been associated with frank emphysema.…”

Section: Original Researchmentioning

confidence: 99%

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids

Shah

Schwenk

Sondekoppam

et al. 2023

Reg Anesth Pain Med

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BackgroundThe past two decades have seen an increase in cannabis use due to both regulatory changes and an interest in potential therapeutic effects of the substance, yet many aspects of the substance and their health implications remain controversial or unclear.MethodsIn November 2020, the American Society of Regional Anesthesia and Pain Medicine charged the Cannabis Working Group to develop guidelines for the perioperative use of cannabis. The Perioperative Use of Cannabis and Cannabinoids Guidelines Committee was charged with drafting responses to the nine key questions using a modified Delphi method with the overall goal of producing a document focused on the safe management of surgical patients using cannabinoids. A consensus recommendation required ≥75% agreement.ResultsNine questions were selected, with 100% consensus achieved on third-round voting. Topics addressed included perioperative screening, postponement of elective surgery, concomitant use of opioid and cannabis perioperatively, implications for parturients, adjustment in anesthetic and analgesics intraoperatively, postoperative monitoring, cannabis use disorder, and postoperative concerns. Surgical patients using cannabinoids are at potential increased risk for negative perioperative outcomes.ConclusionsSpecific clinical recommendations for perioperative management of cannabis and cannabinoids were successfully created.

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“…Much of the current literature is observational from longitudinal cohort studies. For example, data from the CARDIA study has reported that cannabis smokers had no increased rates of CVD or CVD risk markers, had no difference in arterial calcium levels, had lower levels of visceral adipose tissue, lower fasting glucose and insulin, and lower waist circumference and body mass index (Auer et al., 2018 ; Bancks et al., 2018 ; Jakob et al., 2021 ; Penner et al., 2013 ; Reis et al., 2017 ). Conversely, data from the same study indicated an increased risk of prediabetes (but not diabetes) with current cannabis use or high lifetime exposures (Bancks et al., 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Prior acute exercise restores postprandial fat oxidation in active cannabis users

Schubert,

Terauds,

Plant

et al. 2024

Physiological Reports

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Data suggest cannabis users have similar or lower levels of blood lipids compared to nonusers. However, the extent to which cannabis users experience postprandial lipemia is not known. Eleven cannabis users and 11 nonusers completed either rest or 1 h of exercise at their ventilatory threshold the evening before a meal tolerance test (MTT). Substrate oxidation, blood pressure, and capillary blood were obtained before and every 30–60 min post‐meal for 3 h. Linear mixed models were utilized to examine differences in variables between groups, conditions, across time, and their interactions. Exercise led to increased fat oxidation post‐MTT (p < 0.05), with cannabis users exhibiting higher AUC compared to the control trial (p < 0.05). Exercise also caused significantly lower levels of triglycerides (p < 0.05). Metabolic flexibility was improved in cannabis users in the exercise trial only (p < 0.05). No effect of group, trial, or interactions were detected for other variables of interest (all p > 0.05). This study indicated that prior exercise improves lipid metabolism in cannabis users and nonusers after a high‐fat meal test. Cannabis users appear sensitive to the effects of exercise. Future studies should incorporate additional meals and variables related to cardiovascular health and metabolism.

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Cumulative Marijuana Use and Carotid Intima-Media Thickness at Middle Age: The CARDIA Study

Cited by 8 publications

References 39 publications

Comparison of Atherosclerotic Cardiovascular Risk Factors and Cardiometabolic Profiles Between Current and Never Users of Marijuana

Comparison of Atherosclerotic Cardiovascular Risk Factors and Cardiometabolic Profiles Between Current and Never Users of Marijuana

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids

Prior acute exercise restores postprandial fat oxidation in active cannabis users

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