Marijuana Use in Patients With Cardiovascular Disease

DeFilippis, Ersilia M.; Bajaj, Navkaranbir S.; Singh, Amitoj; Malloy, Rhynn; Givertz, Michael M.; Blankstein, Ron; Bhatt, Deepak L.; Vaduganathan, Muthiah

doi:10.1016/j.jacc.2019.11.025

Cited by 109 publications

(98 citation statements)

References 74 publications

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“…Interestingly, intracellular CB1R does not translocate but it can increase intracellular calcium through the release of internal lysosomal calcium stores [19]. CB1R located in the mitochondria can decrease mitochondrial respiration and cAMP formation, affecting cellular energy metabolism [20]. The dynamic nature of CB1R signaling results in different outcomes of CB1R activation, leading to either cell death or cell survival depending on the environment.…”

Section: Molecular Mechanisms Of G-protein Coupled Cannabinoid Receptorsmentioning

confidence: 99%

The Impact of Marijuana on the Cardiovascular System: A Review of the Most Common Cardiovascular Events Associated with Marijuana Use

Latif

Garg

2020

JCM

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With the expanded legalization of marijuana, its medical and recreational use have sharply increased over the past decade. A wide array of new forms of cannabis is available on the market today, and the potencies are ten times those of forms previously tested, meaning that the true impact of marijuana on the cardiovascular system remains unclear. Cannabis mainly exerts its effects via the sympathetic and parasympathetic nervous systems, with different doses affecting different cannabinoids receptors. Studies have shown that marijuana plays a role in thrombosis, inflammation, and atherosclerosis. Case reports have linked marijuana use to myocardial infarction, cardiac arrythmias, cardiomyopathies, stroke, and arteritis. Most patients are young, healthy men with no cardiovascular risk factors; however, the patient population is expected to change to include older individuals in the future. The widespread public perception of safety accompanying marijuana use has contributed to its increased use among the elderly, who are the most at risk population for acute cardiovascular events. In this review, we aim to provide a basic understanding of the physiological effects of marijuana on the cardiovascular system and to review the current literature regarding cardiovascular diseases linked to marijuana use in adults.

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Section: Molecular Mechanisms Of G-protein Coupled Cannabinoid Receptorsmentioning

confidence: 99%

The Impact of Marijuana on the Cardiovascular System: A Review of the Most Common Cardiovascular Events Associated with Marijuana Use

Latif

Garg

2020

JCM

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“…Therefore, it is incumbent on the healthcare provider to inquire as to this use. For example, screening for use of cannabinoid-containing products is now advocated for select cardiovascular patient populations [43]. Finally, plant-derived products may contain myriad other compounds (e.g., cannabinoids, flavonoids, and terpenes) that may increase the risk of unintended drug-drug interactions.…”

Section: Medical Marijuana Unregulated Cbd Oil and Recreational Marmentioning

confidence: 99%

Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions

Kocis

Vrana

2020

Med Cannabis Cannabinoids

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Although prescribing information (PI) is often the initial source of information when identifying potential drug-drug interactions, it may only provide a limited number of exemplars or only reference a class of medications without providing any specific medication examples. In the case of medical cannabis and medicinal cannabinoids, this is further complicated by the fact that the increased therapeutic use of marijuana extracts and cannabidiol oil will not have regulatory agency approved PI. The objective of this study was to provide a detailed and comprehensive drug-drug interaction list that is aligned with cannabinoid manufacturer PI. The cannabinoid drug-drug interaction information is listed in this article and online supplementary material as a PRECIPI-TANT (cannabinoid) medication that either INHIBITS/INDUC-ES the metabolism or competes for the same SUBSTRATE target (metabolic enzyme) of an OBJECT (OTHER) medication. In addition to a comprehensive list of drug-drug interactions , we also provide a list of 57 prescription medications displaying a narrow therapeutic index that are potentially impacted by concomitant cannabinoid use (whether through prescription use of cannabinoid medications or therapeutic/recreational use of cannabis and its extracts).

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“…Intracellular CB1R increases intracellular calcium by releasing calcium from internal lysosomal calcium stores [17]. In the mitochondria, CB1R activation can cause the cAMP formation and reduction in mitochondrial respiration, affecting cellular energy metabolisms [18]. Because of the extensive nature of CB1R signaling, there are many outcomes of CB1R activation.…”

Section: Mechanism Of Action Of Cannabis On the Cannabinoid Receptorsmentioning

confidence: 99%