Ersilia DeFilippis, MD Second-year cardiology fellow Columbia University Irving Medical Center and NewYork-Presbyterian 

Cardiologists Should Screen Patients for Marijuana Use Interview with:

Ersilia DeFilippis, MD Second-year cardiology fellow Columbia University Irving Medical Center and NewYork-Presbyterian 

Dr. DeFilippis

Ersilia DeFilippis, MD
Second-year cardiology fellow
Columbia University Irving Medical Center and
NewYork-Presbyterian What is the background for this study?

Response: Marijuana use has been increasing significantly and is the most commonly illicit drug used in the United States. In recent years, more states have been legalizing its use for both recreational and medicinal purposes. We have all seen news reports regarding the rise of vaping-related health hazards. Yet, data are limited regarding the cardiovascular effects of marijuana which is what drove us to explore this topic. Are there specific cardiac risks from marijuana use?

Response: Observational studies suggest that marijuana may be associated with increased risk of coronary artery disease, stroke, arrhythmias, cardiomyopathy, and peripheral artery disease. Potential mechanisms include through oxidative stress, platelet activation, and stimulation of catecholamines. What are the main findings?

  • Marijuana use has been associated with a variety of cardiovascular conditions.
  • Based on a dedicated analysis we performed of NHANES, we estimated that 2 million adults who reported marijuana use had cardiovascular disease in the United States in 2015 to 2016.
  • Marijuana smoke has a similar toxin profile to inhaled tobacco smoke.
  • The metabolism of many commonly used cardiovascular medications used for abnormal heart rhythms, chest pain, and cholesterol can be altered by marijuana use. What should readers take away from your report?

Response: It is important for cardiologists to screen for marijuana use in their patients. This will not only assist with assessment of cardiovascular risk but can also prompt conversations about potential drug-drug interactions. Nevertheless, we need more data in order to inform guidelines and appropriately counsel cardiologists and their patients. What recommendations do you have for future research as a result of this work?

Response: In the current era, there remain significant barriers to cannabis research. Perhaps most important is the fact that marijuana is a Schedule I status drug by the DEA which makes it illegal to conduct rigorous controlled trials of marijuana products in the United States. Yet, we absolutely need to find ways for sound research in this space in order to better understand the adverse health outcomes associated with the use of marijuana in its variety of formulations. 

I have no disclosures related to the topic of this research.


Marijuana Use in Patients With Cardiovascular DiseaseJACC Review Topic of the Week

Ersilia M. DeFilippisMuthiah Vaduganathan, et al.

Journal of the American College of Cardiology


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Last Updated on January 21, 2020 by Marie Benz MD FAAD