A recent study published in Addiction assessed the association of cannabis use disorder (CUD) with the occurrence of heart problems (CVD).

Background

Cannabis is utilized by over 200 million people worldwide; the hostile effects related to cannabis have profound consequences. CUD affects 27–34% of cannabis users and has turn out to be a major public health priority as a result of lack of treatment and limited access to behavioral interventions.

Although research suggests hostile health effects from cannabis use, the link between cannabis and heart problems is less studied. Current evidence shows an increased incidence of cardiovascular events amongst young cannabis users. Cannabis has also been linked to serious events comparable to stroke, myocardial infarction, arrhythmias, atherosclerosis and cardiomyopathies.

Concerning the study

In the current study, investigators assessed associations between CUD and CVD outcomes using health administrative databases from Alberta, Canada. They used population-level data from the Discharge Abstract Database (DAD), the National Ambulatory Care Reporting System (NACRS), the Alberta Practitioner Claims Database, the Pharmaceutical Information Network, and the Alberta Population Registry from 2012 to 2019.

The NACRS, Practitioner Claims Database, and DAD databases were used to discover individuals with CUD. Each CUD patient was matched on age and sex to an unexposed control subject with no documented CUD diagnosis code. Matched controls were also assigned the index date of the case at which they were first diagnosed with CUD.

The first endpoint of the study was cardiovascular events (myocardial infarction, ischemic heart disease, unstable angina, peripheral vascular disease, cardiac arrhythmias, ischemic stroke, or heart failure). Individuals with a history of CVD events were excluded. Each subject was followed until CVD event, death, or December 31, 2019.

Study covariates were: Charlson comorbidity index (CCI), material deprivation index (MDI) and social deprivation index (SDI), variety of anatomical therapeutic substance subgroups (ATC), mental health comorbidities, and health care utilization. The mid-2012 population of Alberta was used to estimate the incidence of CUD. Survival evaluation was performed using the Kaplan-Meier method.

The log-rank test calculated associations between CUD and CVD, controlling for censoring on mortality. Crude rate ratios (RRs) and 95% confidence intervals were estimated in stratified analyses. The Mantel-Haenszel technique was used to pool estimates when stratum-specific estimates were similar, leading to adjusted RRs. The dose-response relationship was also assessed.

Results

59,528 people, i.e. 29,764 couples, participated within the study. The general incidence of CUD was roughly 0.8%. The median CCI was zero in cases and controls. Cases and controls had similar MDI (4) and SDI (3) scores. Individuals with CUD were more more likely to be in probably the most deprived quartiles and fewer more likely to be within the least deprived quartiles.

The median variety of prescriptions within the six months before the index date was two in cases and one in controls. Individuals with CUD had a median of 5 physician, emergency department (ED), and hospital visits six months before the index date, whereas controls had just one visit. Roughly 2.4% of cases and 1.5% of controls had a minimum of one CVD event. The general association between CUD and CVD scores was significant.

The strength of the association increased in a dose-dependent manner with increasing CUD severity (more CUD diagnosis codes). The RRs were 1.32, 2.47, and a couple of.67 for those with one, two to 4, and five or more CUD diagnosis codes, respectively. CUD was significantly related to shorter time to CVD events. Individuals with higher RR were those with no prescription, with comorbidities, having used health care within the last six months, and with comorbid mental illnesses.

Conclusions

In summary, adults with CUD had a 60% higher risk of an hostile cardiovascular event compared with age- and sex-matched controls. The outcomes suggest an increased risk of cardiovascular events amongst healthy individuals with no medical or medication history in the event that they have CUD. Of note, the study did not associate higher risk with CUD. Furthermore, the researchers couldn’t explain the confounding brought on by smoking as a result of the unreliability of the available data.

Furthermore, the evaluation did circuitously measure the quantity of marijuana used. As a substitute, he relied on the variety of CUD diagnosis codes as a proxy for CUD validity.

Overall, the study highlights the upper risk of CVD events in individuals with CUD, although no causal relationship has been established, and that cannabis use may increase CVD risk in healthy people. Subsequently, it is amazingly necessary to coach patients in regards to the potential risks of cannabis use and CUD.