Effects of Marijuana on the Heart Remain Uncertain

The gradual legalization of marijuana for recreational use has baby boomers rejoicing. Many have “smoked pot” since the 60s and argue there’s no logical reason for its status as an illegal drug.  

But in reality, do we know how safe marijuana is? Recent research suggests we do not. A 2017 study concluded that regular marijuana use may triple the risk of death from hypertension. However, a 2018 review of 45 years of marijuana studies found that evidence is too weak to draw conclusions.

Pot Smoking and Blood Pressure. Researchers observed 1,213 people age 20 and older, who indicated whether they had ever used marijuana or cigarettes in the 2005 National Health and Nutrition Examination Survey (NHANES). In this group, 34 percent had never used marijuana or cigarettes, 21 percent used only marijuana, 20 percent used both marijuana and cigarettes, 16 percent were former smokers but continued to use marijuana, 5 percent were former smokers and 4 percent smoked only cigarettes. The average duration of marijuana use was 11.5 years; for cigarettes, 10.1 years.

Higher Risk of Death. When the researchers compared these data with 2011 mortality data from the National Center for Health Statistics, they discovered that marijuana users had a 3.42 percent higher risk of death from hypertension than non-users, even when those diagnosed with hypertension were excluded from the calculation. The risk increased with each year of marijuana use, they reported in the Aug. 8, 2017, European Journal of Preventive Cardiology. However, no connection was seen between marijuana use and death from heart disease or stroke.

Oddly, the association between current and former cigarette smokers and death from hypertension was much lower. In addition, no significant association between cigarette smoking and heart disease or stroke was seen. The authors attributed these unlikely findings to the small sample size.

Insufficient Evidence. Another group of researchers pulled all studies of marijuana published in English between January 1975 and September 2017 (which excluded the study above). They found only 24. Only one, however, was considered well designed. This 3,882-patient case-crossover study looked at marijuana as a potential trigger of heart attack and concluded an increased risk in the first hour after smoking marijuana.

As the authors explained online in the Jan. 23, 2018, Annals of Internal Medicine, the remaining studies had too few participants, or were too poorly constructed, to draw conclusions.

Thirteen studies of the effects of marijuana on diabetes or high cholesterol levels came up with insufficient evidence.  Six studies that concluded marijuana offers some benefits were small studies that measured marijuana exposure only once or included patients with little exposure to marijuana.

“Many articles in the lay press have suggested to the public that marijuana use has cardiovascular benefits, reduces blood pressure, stabilizes blood sugar levels, or improves cholesterol profiles. Our review found insufficient evidence to support these claims,” said the authors.

What is evident is that large, well-designed studies are needed to better understand the potential connections between marijuana use and cardiovascular risk. Until that time, it’s “smoker beware.”

What This Means For You. “We are not disputing the possible medicinal benefits of standardized cannabis formulations; however, recreational use of marijuana should be approached with caution,” say the authors of the European Journal of Preventive Cardiology study.

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