Patients with cannabis use disorder (CUD) face a heightened risk of adverse cardiovascular events, according to new data published in Addiction.[1]
“Mounting epidemiological, clinical and laboratory research suggests that regular cannabis use is associated with many adverse health outcomes,” wrote first author Anees Bahji, BSc(H), MD, an assistant professor with the department of psychiatry at the University of Calgary, and colleagues. “However, an inadequately explored area is the intersection between cannabis and cardiovascular disease (CVD).”
Bahji, et al. focused on data from nearly 60,000 adults from Alberta, Canada, who participated in a population-based health administrative databases. The group started by identifying 29,764 participants with a history of CUD using administrative health data, including medical and psychiatric records. Each participant with a confirmed history of CUD was then matched by age and gender with a participant with no history of CUD.
What is Cannabis Use Disorder?
What, exactly, is CUD? Does it simply mean anyone who uses cannabis on a regular basis? Cardiovascular Business reached out to Bahji to find out more.
“CUD is indeed a recognized medical and psychiatric condition characterized by the problematic and compulsive use of cannabis—commonly known as marijuana or weed—despite negative consequences on physical, mental or social well-being,” he explained. “To diagnose CUD, clinicians typically refer to specific criteria outlined in medical and psychiatric manuals like the Diagnostic and Statistical Manual of Mental Disorders.”
Bahji said clinicians consider more than how often a person uses cannabis when making a CUD diagnosis. Are they smoking or otherwise ingesting excessively large amounts of cannabis? Is it taking up a significant amount of time? Is it causing them to participate less and less in other activities? These are just some of the questions that can come into play.
“Using cannabis once each night before sleep, for example, would not automatically qualify as CUD,” Bahji added. “It's the overall pattern of use and its consequences, as assessed through the diagnostic criteria, that would lead to a CUD diagnosis.”
The group’s findings
Overall, the study’s primary outcome—the first occurrence of acute myocardial infarction, unstable angina, ischemic heart disease, ischemic stroke, heart failure, heart arrhythmia or peripheral vascular disease—was seen in 2.4% of CUD patients and 1.5% of no-CUD patients. This suggests that there is a significant overall association between CUD and adverse cardiovascular events. In addition, this appeared to be an even greater association when the patient presented with a history of more than one CUD-related ICD-9 or ICD-10 code in their medical history.
“This study's main contribution to the field is in helping to quantify the extent of the association of CUD with CVD risk,” the authors wrote. “The study confirms that apparently healthy people, in terms of their medical and medication history, are at increased risk of CVD if they have CUD.”
The group did note that they were not technically able to confirm a causal link between CUD and CVD. However, they have certainly identified an important trend among cannabis users.
“This evidence suggests that cannabis use may place a healthier population at increased risk of major cardiovascular events,” the authors concluded. “As a result, our study points to the importance of educating our patients about the potential risks associated with cannabis use and CUD.”
Click here to read the full study in Addiction, a journal from the Society for the Study of Addiction.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.