Rising Trends in Hospitalizations for Cardiovascular Events among Young Cannabis Users (18–39 Years) without Other Substance Abuse

Abstract

Background and objectives: Modern-day epidemiologic data on the risk and shifting landscape of occurrence of cardiovascular events in cannabis users remain inadequate and rather conflicting, especially amongst the young adult population. Furthermore, the problem of polysubstance use among youth is challenging for healthcare professionals and policy-makers. Previous studies report higher risk of concomitant use of tobacco, alcohol, cocaine, and amphetamine in young cannabis users. However, most of these studies did not eliminate the confounding effects of concomitant other substance abuse while assessing the incidence and outcome of cardiovascular events in cannabis users. Materials and methods: Using weighted discharge records from the National Inpatient Sample (NIS) from 2007–2014, we assessed the national trends in hospitalizations for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, stroke, and venous thromboembolic events (VTE) among young cannabis users (18–39 years), excluding cases with concomitant substance abuse with alcohol, tobacco, cocaine, and amphetamine. Results: Of 52.3 million hospitalizations without other substance abuse, 0.7 million (1.3%) young adults were current/former cannabis users. Among young adults without concomitant substance abuse, the frequency of admissions for AMI (0.23% vs. 0.14%), arrhythmia (4.02% vs. 2.84%), and stroke (0.33% vs. 0.26%) was higher in cannabis users as compared to non-users (p < 0.001). However, the frequency of admissions for VTE (0.53% vs. 0.84%) was lower among cannabis users as compared non-users. Between 2007 and 2014, we observed 50%, 79%, 300%, and 75% relative increases in hospitalizations for AMI, arrhythmias, stroke, and VTE, respectively, among young cannabis users as compared to non-users, showing relatively inferior or no ascent in the rates (ptrend < 0.001). Conclusions: The rising trends in hospitalizations for acute cardiovascular events among young cannabis users without concomitant other substance abuse call for future prospective well-designed studies to assess cannabis-related short-and long-term cardiovascular implications while simultaneously developing focused interventions towards raising awareness among the young population regarding the potential deleterious effects of cannabis use.

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

“…Heavy marijuana users have a greater risk of developing palpitations compared to lighter users, with daily users having a relative risk of 2.2 (95% CI, 1.6-3.3; p-value < 0.0001) compared to a relative risk of 1.4 (95% CI, 1.1-1.9; p-value < 0.006) in occasional users [73]. A retrospective review of nearly 2.5 million patients in the National Inpatient Sample database found that 2.7% of marijuana users experienced arrythmias, with atrial fibrillation being the most common subtype [74]. Korantzopoulos et al reported an average age of 24 years old for patients experiencing cannabis-induced arrythmias, with all cases experiencing atrial fibrillation shortly after smoking marijuana [75].…”

Role of Cannabis in the Incidence of Myocardial Infarction: A Review

“…Furthermore, in a nationwide retrospective cohort study done by Desai et al, consisting of 52,290,927 young patients from age 18 to 39 years, they found that the prevalence of AMI was greater (0.2% vs. 0.1%) in the marijuana users when compared with the non-users [45]. A prospective exploratory study of marijuana use and mortality following MI by Mukamal et al found out that marijuana use was associated with three times increased mortality following AMI [46].…”

Cardiovascular events post cannabis abuse during the COVID-19 pandemic

“…Thus, CB smoking increases the heart rate, the serum norepinephrine level and myocardial oxygen demand immediately, it reduces oxygen supply and leads to pro-coagulant or pro-thrombotic state, while the increased atropine inhibits the parasympathetic activity (12)(13)(14)(15)(16)(17). According to recent reports, the CB use might also cause dose-dependent elevation of the systolic blood pressure and heart rate (18,19) and induce atrial fibrillation shortly after smoking MJ (20). While smoking CB, the oxygen delivery to the heart and other vital organs is diminished and the carboxyhemoglobin levels are elevated, resulting in reduce of the time to onset of symptoms during exercise in patients with stable angina (12).…”