Ictus y consumo de cannabis en pacientes sin factores de riesgo cardiovascular: revisión sistemática de casos clínicos

Gómez‐Ochoa, Sergio Alejandro

doi:10.1016/j.nrl.2017.09.016

Neurología

2021

DOI: 10.1016/j.nrl.2017.09.016

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Ictus y consumo de cannabis en pacientes sin factores de riesgo cardiovascular: revisión sistemática de casos clínicos

Sergio Alejandro Gómez‐Ochoa

Abstract: There is a wide variety of reports of stroke associated with cannabis use in patients with no other risk factors. Noteworthy findings were presentation at young age and a strong temporal association, which place cannabis use as a potential risk factor for this population in line with the epidemiological and pathophysiological studies in this area.

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Cited by 4 publications

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A Review of Cardiovascular Effects of Marijuana Use

Rezkalla,

Kloner

2024

Journal of Cardiopulmonary Rehabilitation and Prevention

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Objective: Cannabinoids exert their effects on body tissues via cannabinoid 1 (CB1) and cannabinoid 2 (CB2) receptors. Receptors are present in brain, myocardium, vascular endothelium, platelets, and adipose tissues. Under normal physiologic conditions, endocannabinoid effects are minimal. The use of exogenous cannabis leads to endothelial dysfunction and increases vascular thrombosis via CB1 receptor stimulation. On the other hand, CB2 receptors may have a beneficial anti-inflammatory response. Review Methods: We reviewed reports of the effects of cannabis on the cardiovascular system utilizing PUBMED from the last 20 years with emphasis on the most recent reports. Summary: Despite a plethora of reviews and some retrospective studies, there is a need for more definitive data regarding the effect of cannabis use on cardiovascular events (CVE). Marijuana does not appear to accelerate atherosclerosis. There is a suggestion that it may induce myocardial infarction in a small percentage of users, especially in male users, particularly during recent use. It has a possibility of increasing cerebrovascular events when combined with other risk factors such as tobacco use. There is an association between cannabis use and increased evidence of peripheral vascular disease. To have a definitive answer to the question of whether cannabis contributes to CVE, there is an urgent need for prospective controlled studies with patients presenting to academically oriented medical facilities with CVE following cannabis use for either medicinal or recreational use.

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A Review of Cardiovascular Effects of Marijuana Use

Rezkalla,

Kloner

2024

Journal of Cardiopulmonary Rehabilitation and Prevention

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2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association

Bushnell,

Kernan,

Sharrief

et al. 2024

Stroke

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AIM: The “2024 Guideline for the Primary Prevention of Stroke” replaces the 2014 “Guidelines for the Primary Prevention of Stroke.” This updated guideline is intended to be a resource for clinicians to use to guide various prevention strategies for individuals with no history of stroke. METHODS: A comprehensive search for literature published since the 2014 guideline; derived from research involving human participants published in English; and indexed in MEDLINE, PubMed, Cochrane Library, and other selected and relevant databases was conducted between May and November 2023. Other documents on related subject matter previously published by the American Heart Association were also reviewed. STRUCTURE: Ischemic and hemorrhagic strokes lead to significant disability but, most important, are preventable. The 2024 primary prevention of stroke guideline provides recommendations based on current evidence for strategies to prevent stroke throughout the life span. These recommendations align with the American Heart Association’s Life’s Essential 8 for optimizing cardiovascular and brain health, in addition to preventing incident stroke. We also have added sex-specific recommendations for screening and prevention of stroke, which are new compared with the 2014 guideline. Many recommendations for similar risk factor prevention were updated, new topics were reviewed, and recommendations were created when supported by sufficient-quality published data.

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Marijuana Use and the Risk of Early Ischemic Stroke

Dutta

Ryan

Thompson

et al. 2021

Stroke

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Background and Purpose: Few studies have examined the dose-response and temporal relationships between marijuana use and ischemic stroke while controlling for important confounders, including the amount of tobacco smoking. The purpose of our study was to address these knowledge gaps. Methods: A population-based case-control study with 1090 cases and 1152 controls was used to investigate the relationship of marijuana use and early-onset ischemic stroke. Cases were first-ever ischemic stroke between the ages of 15 and 49 identified from 59 hospitals in the Baltimore-Washington region. Controls obtained by random digit dialing from the same geographic region were frequency-matched to cases by age, sex, region of residence and, except for the initial study phase, race. After excluding subjects with cocaine and other vasoactive substance use, the final study sample consisted of 751 cases and 813 controls. All participants underwent standardized interviews to characterize stroke risk factors and marijuana use. Unconditional logistic regression analysis was used to assess the relationships between marijuana use and risk of ischemic stroke, adjusting for age, sex, race, study phase, the amount of current tobacco smoking, current alcohol use, hypertension, and diabetes. Results: After adjusting for other risk factors, including the amount of current tobacco smoking, marijuana use was not associated with ischemic stroke, regardless of the timing of use in relationship to the stroke, including ever use, use within 30 days, and use within 24 hours. There was a nonsignificant trend towards increased stroke risk among those who smoked marijuana at least once a week (odds ratio, 1.9 [95% CI, 0.8–4.9]). Conclusions: These analyses do not demonstrate an association between marijuana use and an increased risk of early-onset ischemic stroke, although statistical power was limited for assessing the association among very heavy users.

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Ictus y consumo de cannabis en pacientes sin factores de riesgo cardiovascular: revisión sistemática de casos clínicos

Cited by 4 publications

References 30 publications

A Review of Cardiovascular Effects of Marijuana Use

A Review of Cardiovascular Effects of Marijuana Use

2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association

Marijuana Use and the Risk of Early Ischemic Stroke

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