Insufficient Evidence To Determine Cardiovascular Risks of Marijuana

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Marijuana plant (Cannabis sativa) Interview with:
Divya Ravi, MD, MPH

The Wright Center for Graduate Medical Education
Scranton, PA What is the background for this study? What are the main findings?

Response: There is evidence to suggest that Marijuana can bring about changes at the tissue level and has the ability to potentiate vascular disease, in ways similar to tobacco.  With change in legalization and increase usage trends, we conducted this review to examine the known effects of marijuana on cardiovascular outcomes and risk factors, given that cardiovascular disease remains the greatest cause of morbidity and mortality worldwide.

Our review found insufficient evidence to draw meaningful conclusions that marijuana use is associated with cardiovascular risk factors and outcomes. The few studies that suggested a possible benefit from marijuana use, were cross-sectional, and were contradicted by more robust longitudinal studies that reported potential harmful effects. What should readers take away from your report?

Response:  At this juncture we have little data on potential harms or benefits associated with use to inform the counseling of marijuana users. It may be wise to proceed with caution until we have sufficient evidence to comment on the health effects of chronic marijuana use.

There is a need to perform robust longitudinal studies that adequately characterizes marijuana exposure (given the different forms in which it is being used) especially among an aging population. What recommendations do you have for future research as a result of this work?

Response: There is a need for robust longitudinal studies that adequately characterize marijuana exposure (given the different forms in which it is being used) especially among an aging population. There are several challenges to conducting research in this area. First, studying the health effects through experimental studies is unethical and we can only rely upon longitudinal observational studies to further this understanding. Second, given the various forms of use (vaping, dabbing, edibles) assessing exposure status is challenging 

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Ravi D, Ghasemiesfe M, Korenstein D, Cascino T, Keyhani S. Associations Between Marijuana Use and Cardiovascular Risk Factors and OutcomesA Systematic Review. Ann Intern Med. [Epub ahead of print 23 January 2018] doi: 10.7326/M17-1548

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Last Updated on January 24, 2018 by Marie Benz MD FAAD