The positive and negative cardiovascular effects of cannabis

ABSTRACT

Introduction

The use of cannabis and its derivatives have increased steadily over the past few decades, prompting patients and clinicians to increasingly inquire about its health effects and safety profile. However, despite promising evidence suggesting therapeutic utilization, cannabis remains a controlled substance in most countries and is largely considered to have no medical or recreational benefit; thus, a lack of observational studies and randomized control trials exist to outline positive and negative health implications. Ultimately, this leaves patients, health-care professionals, and policymakers without necessary evidence required to make informed decisions on cannabis use.

Areas covered

This review outlines cannabis in a clinical setting and delves into specific effects of cannabinoids on cardiovascular health and disease. It discusses positive and negative health implications associated with cannabis, mechanisms in cardiovascular disease, and reveals methods guiding cannabis use in the clinical setting.

Expert opinion

Advances in research are necessary to guide decisions regarding cannabinoid use. Countries that have federally legalized cannabis have a unique opportunity to study cardiovascular implications in an unbiased and comprehensive manner. Ultimately, as cannabis use will inevitably increase, researchers, clinicians, and policymakers must work together to ensure cannabis is utilized in a way that is therapeutically beneficial.

KEYWORDS:

• Cannabidiol
• cannabinoid
• cannabis
• cardiovascular disease
• heart failure
• marijuana
• tetrahydrocannabinol

Abbreviations

Table

Article highlights

• Cannabis use is rapidly increasing yearly worldwide.

• Increase in use and potency has led to concern regarding the health implications and safety profile of cannabis.

• Cannabis is a controlled substance in many countries; thus, few randomized clinical trials exist to elucidate the effects of cannabis on cardiovascular risk and guide clinical decisions.

• Observational studies reveal both positive and negative effects of cannabis, however most studies do not control for contributing factors which may greatly influence their results.

• As cannabis use will inevitably continue to increase, clinicians, patients, policymakers, and scientists must work together to ensure cannabis research is conducted rigorously via randomized control trials.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.