Cannabis and Cardiovascular Disease.
The use of recreational drugs has increased globally, with the most commonly used recreational drug being cannabis. As of 2019, 10 states and the District of Columbia have legalized cannabis for recreational use, with more states potentially joining this movement. With the increased legalization of cannabis, leading to even greater recreational and medicinal use, it is important to recognize its effect on cardiovascular health. We propose to review the current literature regarding the pathophysiology of endocannabinoids, their hemodynamic effects, and their association with acute and chronic cardiovascular outcomes. The demonstrated effects of the endocannabinoid system on the cardiovascular system at the cellular level have led to great interest regarding its potential clinical impact. A number of studies have attempted to characterize the hemodynamic effects of cannabis use as well as its potential negative impact on the cardiovascular system, but the data are inconclusive at this time. The largest prospective study to date, the CARDIA study, failed to show an association between lifetime or recent cannabis use and cardiovascular events. There is suggestion on a molecular level and based on retrospective analyses that cannabis may have a negative impact on the cardiovascular system. However, prospective clinical data has not confirmed these suggested findings. Further research is needed to better elucidate the association, if any, between cannabis and cardiovascular disease.