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Not So Harmless? Pot Linked to Heart Problems

By RoboCodeine7610, Apr 25, 2014 | Updated: Apr 25, 2014 | | |
  1. RoboCodeine7610

    Pot may not have a chilling-out, calming effect on everyone — evidence is emerging that for some people,smoking marijuana could increase the risk of heart problems, doctors say.

    In a new study, researchers used data from a database called the French Addictovigilance Network, gathered from 2006 to 2010. Of the nearly 2,000 reported complications related to marijuana, the researchers found that 2 percent, or 35 cases, involved heart problems. These cases included 20 people who suffered a heart attack, and nine who died.

    Researchers found most patients were men, with an average age of about 34. Regular marijuana users with a family history of heart disease had an increased risk of heart disease, according to the study, published today (April 23) in the Journal of the American Heart Association.

    Many of the patients also had other risk factors for heart disease, such as smoking tobacco and drinking alcohol, the researchers noted. Nevertheless, nearly half of the patients were regular users of only marijuana.

    Researchers also found a small increase in heart problems over time. In 2006, only 1.1 percent of the reported complications were heart related, but that rate increased to 3.6 percent in 2010.

    "The general public thinks marijuana is harmless, but information revealing the potential health dangers of marijuana use needs to be disseminated to the public, policymakers and health care providers," said study researcher Émilie Jouanjus, a medical faculty member at the Centre Hospitalier Universitaire de Toulouse in France.

    Considering 1.2 million people in France use marijuana regularly, the number of reported complications may seem small. The researchers said, however, that the surveillance system may miss many drug-related complications.

    This type of study cannot demonstrate a cause-and-effect relationship between marijuana and heart problems, but the findings underscore the need for more research on this topic, experts said.

    "The study is very small and has many limitations, but it is a warning sign," said Dr. Suzanne Steinbaum, a cardiologist and the director of Women's Heart Health of Lenox Hill Hospital in New York.

    "The perception is that marijuana is a magical drug, that it's totally safe, and we can use it in medical treatment. What we don't know about are the negative effects, the potential harms," said Steinbaum, who is also an op-ed contributor to Live Science.

    Several previous reports have linked marijuana use with serious heart problems. In one study involving nearly 4,000 patients, researchers found that people's risk of heart attacks increased five times in the first hour after marijuana use. This five-fold increase in risk is a little higher than the risk for sex, about the same as that for intense exercise, and much less than the risk caused by cocaine, which increases one's chance of having a heart attack 25-fold, the researchers told reporters last year.

    Previous studies have also suggested marijuana use could increase heart rate and blood pressure, and reduce the blood's ability to carry oxygen, which may contribute to the higher risk for heart attacks.

    Altogether, the new findings and evidence from previous studies suggest that, like any other drug, marijuana has its own share of risks.

    "There is clear clinical evidence to suggest a therapeutic benefit of inhaled marijuana for the management of a number of chronic, debilitating conditions. However, clinical evidence also suggests the potential for serious cardiovascular risks associated with marijuana use, including myocardial infarction, serious cardiac arrhythmias, stroke and even death," Dr. Shereif Rezkalla, a cardiologist at the Marshield Clinic, in Marshield, Wisc., wrote in an editorial accompanying the new study.

    Bahar Gholipour




  1. OTCJ
    I want to see the study where they control for method of administration.

    If they do a 4000 person study of people that exclusively EAT weed and come to the same conclusion, I'll be a little better swayed since is it not possible that smoking any sort of plant matter is associated with an increased risk of cardiovascular disease?
  2. rhino236
    I find it bullshit to be completely honest. Marijuana is the most harmless drug known to man. It's been used for hundreds of thousands of years. Of course taking the first initial rip of weed(I medicate from a large water bong) with some potent mmj your going to have a increase in heart rate,blood pressure etc.But I find it subsides after the initial smoke of the day.I think Indicas and cannabinoids are better for medication purpose. Sativas contain much lower CBDs and much higher THC levels. All in all I disagree Marijuana can CAUSE any heart problems.
  3. Wanderer
    Where's the study, who funded it, and how was it peer reviewed?

    Note this:
    Call me skeptical, but I seriously doubt the risk is higher than that with alcohol and tobacco.

    Be well...
  4. RoboCodeine7610
    It can be found in the New England Journal of quackery, pg. 287.

    Obviously this is just one among 100s of "studies" that coincidentally came out right after legalization in Colorado aimed at creating confusion among those who can't tell science from pseudoscience.

  5. idfma
    Based on my personal experience, there may be some merit to this study. When I use cannabis my blood pressure goes way up. I have had to cut way back because the increase in heart rate and BP can get really uncomfortable. My BP has been as high as 170/100, but I didn't care enough to measure it over multiple experiences. I also get very cold and shiver uncontrollably, if I don't put on a jacket, even in the summer.

    This developed (or I noticed it) much later in life--probably my 30's. It is likely it was earlier, but that's when I noticed it.

    This is a great example of what utter bullshit the US govt ban on real research creates. If there was real information, there wouldn't be all this speculation, and no matter what, I still want the choice to put whatever the hell I want into my body. These medical and media scare tactics of, 'it might not be as safe as we thought' are ridiculous. Yes, it's as safe as we think, it's just like everything, though: it's not absolutely guaranteed to be safe. So fucking what?

    Legos aren't completely safe, cars aren't completely safe, just about everything has a risk, so why are there these constant, 'it may not be as safe as we thought' articles published? That's a rhetorical question, btw.

    The fact is it's as safe as we thought, but it sounds like there are some risks that some people didn't know about. Research can take care of that, but I certainly hope not as a basis for a ban--only so everyone can know what they are getting into, so they can decide if it's for them.

    Guns are everywhere in the US, and their risks are pretty clear, and there is really no discussion of making them illegal, but as soon as one motherfucker with a genetic predisposition dies from his genetic predisposition, and it looks like cannabis might have contributed, we have to call into question the whole legalization movement--even though there are already plenty of other legal substances and behaviors that could trigger the same thing--alcohol being a perfect example. It's absurd.
  6. Wanderer
    Here we go, the article is in The American Heart Association:

    Cannabis Use: Signal of Increasing Risk of Serious Cardiovascular Disorders
    J Am Heart Assoc. 2014;3:e000638 doi: 10.1161/JAHA.113.000638

    Cannabis Use: Signal of Increasing Risk of Serious Cardiovascular Disorders

    Here's the key issue:
    I don't see how there could be any real agenda here.

    Now, most people who smoke and drink, and the article mentions these as additional factors, but also many people live sedentary lives, eat the wrong foods, especially if they are smoking and drinking a bit of alcohol and are already prime candidates for heart disease.

    Cut back on the smoking (of anything), and the drinking and you know what? The rates of heart disease goes down. Getting off one's gluteous maximus once in a while and taking a walk for a bit of fresh air also might help too. Cutting back on that bag of Doritos or Little Debbie Snack cakes which are high in fat, might also help too.

    Be well...
  7. MikePatton
    Even if this is true, it's completely missing the point. Do we not know that Tobacco, fast food, Alcohol, cheese, meat, and even sex are linked with heart problems? Did that cause us to make all of these illegal? This is why I think this is completely irrelevant to the legalization debate.
  8. Docta
    I a got a question?

    DO pot heads smoke this shit everyday?
  9. Wanderer
    Some do. Some all day, it becomes a state of being I believe.

    Been there done that a longtime ago in a galaxy far far away. Hasn't interested me in a long time.

    Be well...
  10. (NS)-M-Lo-Reason
    I have seen this claim before, marijuana has been known to be a possible factor in heart attacks for years, especially in older people.

    This article came out quite a while ago:


    Cannabis, and most likely synthetic cannabinoids cause an undeniable increase in heart rate and blood pressure for my manticore. These are known factors that can complicate heart problems, and are harmful for people prone to them. What I read before was marijuana's causality in heart attacks was not established, and most cases were in people with existing cardiovascular issues, but there is a correlation between being stoned and having a heart attack in certain populations.

    I think the lesson here is that no drug is harmless. This is not a reason to call pot a dangerous drug, it still has a LONG history of non-problematic use, which cannot be said about most drugs, but it is one to give all those folks who bristle at the thought of their beloved marijuana being a psychoactive drug, and not a holy herb and sacrament, a reality check
  11. Docta
    Hard to define the classic addiction group then. Having no first hand experience with this form of addiction I've no idea of the steepness of the redoes curve. Is it purely driven by THC saturation or is it a combination of habituate, for wont of a better word sacrament with the drug addiction?

    Do the users recognize themselves as drug addicts?
  12. M0RPH3US
    I read somewhere that there's at least 1 death a year caused by cannabis, through a heart attack.
    I can't find the link anywhere now, and i don't know if it's true or not, has anybody read this too, and have the link?
  13. Dr.Evil
    So I posted in a thread very similar to this one a little while ago (Cannabis confirmed reason for death for the first time). It was a report of sudden cardiac death with cannabis use. I dug into the literature and found that there are more case reports than I thought about it.

    Here is the copy/paste from what I found and my thoughts on it. I also re-uploaded the case reports I could get access to for anyone who is interested.

    My first reaction to this is that there is way too little information, but it is a very intriguing question. So I did what I usually do when I want to figure something out ---ENGAGE LITERATURE SEARCH--- what I found was surprising.

    There are way more case reports than I thought describing this phenomenon. Still not a huge number but I figured there would only be 2-3, and I found more like 10-12 (I only searched for ~10 mins). I uploaded all of the ones that I have institutional access for. You can read them, but I figured I would go ahead and explain what I got from them and from thinking about cannabis pharmacologic actions on the heart.

    Non-science explanation
    At low doses THC has been shown to rapidly increase heart rate depending on how much you smoke, and also slightly increases blood pressure. At high doses it dilates your blood vessels and slows down your heart rate which can lead to low blood pressure and oxygen levels. This effect is additive with the fact that your blood cannot carry as much oxygen when you have recently smoked. There is a study that showed that (even when controlling for other factors) your risk of a heart attack is 4x higher in the 1st hour after smoking than a normal person.

    Biomedical Explanation
    The effects of THC are mediated (mainly) by CB1 receptors that are mainly present in the central and peripheral nervous system. Activating CB1 leads to inhibition of the sympathetic nervous system. This causes vasodilation, which in turn, leads to hypotension and bradycardia (mediated by the endogenous cannabinoid neurotransmitters anandamide and 2-AG).

    Cardiovascular manifestations of cannabis are from a biphasic dose-dependent effect on the autonomic nervous system (composed of both parasympathetic + sympathetic systems). Low-to-moderate doses (most likely) have a partial agonist effect; partially activating and partially blocking the CB1 receptors resulting in an increase in sympathetic output----leading to tachycardia and increased blood pressure (along with cardiac output). High doses (most likely) have a full agonist effect on the CB1 receptors; activating them and therefore inhibiting sympathetic output. This results in bradycardia and hypotension by indirectly increasing parasympathetic activity.

    This biphasic effect could also be occurring from other phenomenon that are well described in adrenergic receptors. It is possible that different CB1 receptor subtypes with different binding affinities for THC could be preferentially activating the sympathetic and parasympathetic nervous systems and low and high doses respectively. This same effect could be the result of receptor densities being higher on sympathetics, so lower doses will preferentially increase its output, while the parasympathetic neurons override the sympathetic activation (once activated by higher doses). That being said, the true physiology of this is somewhat irrelevant, because we do know that THC does have a biphasic effect on the cardiovascular system.

    The issue with all of this is that for myocardial infarction to happen, there has to be some myocardial tissue ischemia. This could be due to numerous factors such as, increase in oxygen demand secondary to increased heart rate, decreased oxygen supply secondary to rise in carboxyhemoglobin levels post smoking, or reduced coronary vessel blood flow secondary to coronary artery vasospams.

    Another issue with this is that people how use cannabis very commonly abuse tobacco products and/or alcohol. They also have a higher incidence of cocaine usage. Even if these substances were not present in the body at the time of death (e.g. didnt show up in autopsy toxicology) they still have potentiating effects on the pathophysiology mentioned above.

    Most myocardial infarctions (heart attacks) are not actually from complete occlusion of coronary vessels over time. What actually happens is that once the slow occlusion builds up to about 70% theplaque causing the partial occlusion becomes unstable. This unstable plaque can then rupture. This rupture is a magnet for platelet aggregation. The body thinks a blood vessel has broken and is trying to clot it off. So this ruptured plaque becomes the "seed" of a clot that grows until it blocks off the coronary vessel. If this clot is in the right spot, such as the left anterior descending coronary artery (also known as the widowmaker), it will kill enough heart tissue that the heart cannot pump blood anymore causing death. There is some limited data that suggests that cannabis use (along with alcohol and cocaine) increase the risk of plaque rupture.

    With all of this being said, there are other factors that are obviously at play in these cases. If cannabis use = sudden cardiac death we would know about it because people would be dropping like flies. After looking through the VERY limited literature it is very possible that cannabis use can increase and/or potentiate the risk of cardiac death in the presence of other risk factors. That being said, there is no way to know for sure because of the minimal amount of information we have. In my honest opinion, these cases probably have either some yet unidetified genetic predisposition towards coronary artery disease, arrhythmia, and/or coronary vasospasm.......or there are other risk factors that these people had that we are not aware of.

    Super-Duper Conclusion
    It is very possible that cannabis-use increases the risk of sudden cardiac death, but the above studies are all case-reports, retrospective studies, and theories with tons of confounding factors. In other words, if you cited this as "hard evidence" to a medical team....you would be laughed out of the room.

  14. Docta
    Bull shit! No body is getting laughed out of the room here.

    The Johns Hopkins University School of Medicine. Are they laughing?

    Harvard Medical School.(Massachusetts General Hospital) Are they laughing?

    International Information Systems Forensics Association (IISFA) Are they laughing?

    Ludwig Maximilians in Munich, Germany. Are they laughing?

    Asan Medical Center in Seoul, South Korea Are they laughing?

    American College of Preventive Medicine (ACPM) Are they laughing?

    We are way past that bullshit. Something related to the smoking of cannabis is killing people at a time in there live when they are in the low mortality age group. Did you even stop for a second and think of the ramification of a possible new pathogenic agent within the 20-40 year old age group. This emerging worldwide occurrence of cannabis smoke related sudden cardiac death is no laughing matter and I can tell you the University's and Medical School's are coordinating all data no matter how scientifically well referenced in an attempt to solve this puzzle and divert what could be a worldwide catastrophic event.

    Cannabis is becoming higher in THC content and worldwide deregulation is just around the corner we got to identify this fast before its to late to put a risk protocol in place. Its to late to shut the gate after the house has bolted.

    The number of these deaths are starting to get out of hand I think it maybe time to stop joking around.
  15. Dr.Evil
    Whoa there buddy. Pump the brakes a second. First, I used the "laughed out of the room" cliche not in the literal sense. Of course people dying is not a laughing matter. I was just trying to get the point across that no medical person would read these case reports, and say cannabis is for sure causing sudden cardiac death.

    You are being extremely hyperbolic and sensationalist in saying things like "worldwide occurrence" and "worldwide catastrophic event". I looked at every single study linking sudden cardiac death and cannabis use on PubMed, which is almost every single study published. There were less than 20 reports in the literature, but I will be extremely generous and use five times that amount for my example.

    I look at this like a researcher, not like a layperson. It is awful that anyone might have died from this, and we should do everything we can to understand and hopefully prevent it from happening.....if it is even happening. 100 cases would be almost nothing in the terms of epidemiologic and statistical data, if there even are that many cases. Most legitimate studies of this nature that would be considered "evidence" in the medical world are at least an order of magnitude higher in terms of patients. That isn't even getting into all the problems that can be found we using case reports.

    If you want to discuss a real epidemic and catastrophe pick something that we know is actually happening like lung cancer due to smoking. According to the Annals of Oncology if the current data trend holds there will be around 159,260 deaths in the United States alone this year, with a 2% - 5 year survival rate.

    This is all besides the fact that if, instead of just reading the conclusion and jumping down my throat, you would have seen that I explained....in detail.... not only how I think that cannabis could contribute to sudden cardiac death..... but even went very in depth into the most likely biologic and pathophysiologic mechanisms behind it.

  16. TheBigBadWolf
    I think that Docta has a point, tho.

    what we have is a number of reporting of anxiety attacks that are going out of hand.

    which is, as I think must not be discussed due to the fact of a misplaced relation of THC and CBD content.

    I havent experienced one single panic attack in 35 years of cannabis consumption. Due to the fact that in Central Europe there is a consistent avaiability of hashish from the traditional production areas od northern Africa and middle east, there is no good reason to swap to marijuana that is bred in Europe (and higher in price on top ;)).
    It is these high THC breeds that cause all the youngsters to post on here with reports and questions, some really high in anxiety.

    Now I see at least a conincedency between reported heart deaths that happened after having smoked cannabis and the anxiety-heightening properties of high THC/out-of-proportion thc-cbd strains.

    Any old tokers around that had anxiety attacks in the 70s and 80s of the last century before that stuff was around? I would love to draw back my conclusions if I had them, as I am absolutely a cannabis promoter.

    I think there should be looked much more into this, espescially in the proportion bewteen the main actives and how their properties change inside the spectrums from high to low content and back.

    But, Docta: an epidemic is a bit something different ...
    Governments were so intelligent to prohibit this devilz drug some time ago... Probably they already have these studies we want to have done ;)

  17. RoboCodeine7610
    There's a big difference between how strong of an agonist a drug is and the dose of a drug. A molecule of THC won't be any stronger of an agonist just because you have a lot it in your bloodstream.

  18. MikePatton
    We do need to get the information out about the possible dangers of cannabis with a very high THC content and low Cbd content. This is a side effect of the illegal trade in which breeders have been working for decades to create strains with a super high THC content and with absolutely no regard for CBD (because there was little knowledge of its importance and/or because they don't care). This could, as stated above pose a physical and mental health risk for some people, whereas CBD rich cannabis products are far less likely to do that.

    We need to get this information out to every cannabis user. We need to properly oversee and regulate the genetics and psychoactive contents of Cannabis. We need to brand every cannabis product with its THC and CBD content and we need a lot more research about their effects and those of the ratio between them.

    The only way to do that and to protect people's health is by legalizing and regulating it.
  19. idfma
    BBW, I go back to the 80s. I have had no panic attacks, and I attribute the paranoia to my personality, since I tend to overanalyze things no matter what state of mind I'm in or what substance I've ingested. Cannabis has exacerbated this at times, but I would say that is amplification of an existing tendency, kind of like the heart risk discussed in this thread.

    However, even back then I noticed the vasoconstriction, elevated heart rate, and (what I now know is) the increase in blood pressure. However, I have a genetic predisposition to heart disease, so,it's not just cannabis that causes those symptoms. Antihistamines, alcohol, and other substances also do the same thing, as Wanderer mentions above.

    I think the more potent strains definitely warrant investigation, though. We don't know for sure, but the much higher potency could have a bunch of variables that change the risks significantly.
  20. Dr.Evil
    This is how basic pharmacology principles are taught, and for the most part you are right. The thing is that we have recently started to discover/realize that it is not that simple.

    There are a handful of drugs and endogenous substances in the body that have different physiological effects depending on their concentration. Like I said, the most well studied phenomenon is related to varying receptor density and placement. More recently we are discovering that there are some drugs and endogenous substances that have altered binding profiles/affinities depending on their concentration. There is also an interesting new theory that could be playing into this known as "functional selectivity".

    Anyways went a little off topic there. I only said that it is possible that it could be happening, and frankly I don't have the time/patience/energy to explain a lectures worth of adv pharmacology, thermodynamics, and enzyme kinetics........so take my word on it ....or don't....won't bother me either way.

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