Millions With Heart Disease Use Pot, Risking Harm

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Any heart risks of marijuana would be most serious in people who have established heart disease. And that’s not an uncommon scenario, based on data from a federal health survey.

Vaduganathan’s team estimates that more than 2 million Americans with heart disease have used marijuana, either currently or in the past.

There are many unknowns, including how commonly people keep using marijuana after a heart disease diagnosis, and whether they think it’s safe.

“I think a next step would be to conduct focus groups, to ask patients about current use and their perceptions of the risks,” Vaduganathan said.

One concern is that marijuana may interact with the medications heart disease patients commonly use, including statins, certain blood pressure drugs, and the blood thinner warfarin.

“Medication levels in the blood would be anticipated to change,” Vaduganathan said.

His advice to patients is to avoid marijuana use during “high-risk” periods, such as after a heart attack.

“And we discourage any use of synthetic cannabinoids or vaping in people with established heart disease,” Vaduganathan added.

Synthetic cannabinoids — which go by names like K2, Spice and Kronic — are human-made chemicals similar to those found in marijuana plants. They can be much more potent than marijuana, Vaduganathan noted. Similarly, he said, vaping can boost the potency of marijuana — and is not a “safer” alternative to smoking.

Dr. Salim Virani is a cardiologist with the Michael DeBakey VA Medical Center, in Houston, and chair of the American College of Cardiology’s Prevention Section and Leadership Council.

“We don’t have as strong an evidence base for marijuana and heart disease as we do for cigarette smoking,” Virani said. “So there’s a big need for research in this area. What are the risks? And what is the magnitude of the risks?”

In some cases, he said, doctors may want to screen patients for marijuana use — such as people younger than 55 who have an unexplained heart attack.

Virani also encouraged heart disease patients to tell their doctors about any marijuana use.

“As doctors,” he said, “we have to be open to having a discussion about it, and be clear about what we know and what we don’t know.”


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Sources

SOURCES: Muthiah Vaduganathan, M.D., M.P.H., cardiologist, Brigham and Women’s Hospital, Boston; Salim S. Virani, M.D., Ph.D., staff cardiologist, Michael DeBakey VA Medical Center, professor, medicine, Baylor College of Medicine, Houston, and chair, Prevention Section and Leadership Council, American College of Cardiology; Jan. 28, 2020,Journal of the American College of Cardiology




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