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Association Between Chronic Use Of Recreational Cannabis And Risk Factors Of Cvd

2542 words - 11 pages

SPECIFIC AIMS:
Cannabis is the most widely used illicit drug worldwide with current rates in the United States (US) at a decade high and unlikely to decrease following the legalization of recreational use in three states1, 2. A suggested link between cannabis use and cardiovascular disease (CVD) has been recognized for over 40 years, but the true effect of cannabis on CVD risk is still unclear3. CVD is the most common cause of death in the US and about one third of the US adult population currently lives with a form of CVD2, 3. The combination of elevated systolic and/or diastolic blood pressure, fasting glucose, lipids, and central adiposity, referred to as metabolic syndrome, results in a ...view middle of the document...

The study objective addresses the need for a study to examine the relationship between chronic recreational cannabis use and individual CVD risk factors in addition to the combined metabolic syndrome and assess how varied definitions of cannabis use may change the association. We anticipate that chronic cannabis use will be associated with higher proportions of metabolic syndrome compared to non-users and that the relationship will follow a dose-response pattern with greater cannabis use leading to a greater magnitude of association. With the recent legalization of recreational cannabis use in three states and other states looking to follow, assessing its association with cardiovascular health is critical for understanding the potential increase in disease burden and may guide future public health planning, policy, and implementation regarding legalization and monitoring of recreational cannabis.
BACKGROUND AND SIGNIFICANCE:
According to the National Survey on Drug Use and Health (NSDUH), the prevalence of individuals reporting cannabis use in the past 30 days seems to be increasing among youth and adults in the US with higher estimates in Colorado (CO) and Washington State (WA) compared to the general US population. In 2010-2011, 16% and 10% of CO residents 12 to 20 years of age and 21 years or older reported using cannabis during the previous 30 days4. In the US, prevalence of metabolic syndrome, a strong predictor of cardiovascular disease, has continued to increase with the greatest increases among men and women 20 to 39 years old2. Cannabis use is hypothesized to be a risk factor for CVD and its risk factors, but the true relationship is still unclear. This knowledge gap is problematic as the number of cannabis users is likely to increase further as the legalization of recreational cannabis continues to gain popularity. Without solid evidence regarding the harmful effects of cannabis, the prevalence of its recreational use is unlikely to decrease and in turn, the higher prevalence of cannabis use could contribute to the increasing prevalence of CVD and its risk factors.
Multiple studies and case series have evaluated the short-term effects of cannabis use and found it to have effects on cardiac function, likely caused by the increased heart rate associated with cannabis smoking, to which healthy young adults using cannabis daily quickly develop tolerance, but the long-term effects of these acute changes remain unclear5-7. Multiple observational studies have examined the association between cannabis use and CVD mortality or CVD hospitalizations, but the outcomes of interest are inconsistent between studies therefore limiting the ability to compare results between studies. Sydney et al. reported no association between cannabis use and mortality or hospitalization among a cohort of over 65,000 men and women5, Mukamal et al. found a dose-response relationship between cannabis use and mortality over 3.8 years following MI with a 4.2-fold...

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