Cannabis has long been considered an ill health-evoking substance by many; however, a new large-scale study has come up with some surprising revelations in regards to cannabis users who have suffered heart attacks.
An Extensive Study. Two Decades of Data
The researchers examined nearly all (9,900,000) admission records of patients hospitalized in the USA for treatment of acute myocardial infarction between 2001 and 2020. Among these individuals, approximately 117,000 reported using cannabis.
In the study published in Archives of Medical Science Atherosclerotic Diseases, researchers have looked into how marijuana use might impact outcomes following a heart attack.
What makes this study so really quite compelling is how enormous in scope it is.
They were able to paint a very clear picture of cannabis use and heart attack outcomes for a wide demographic because they pulled from two decades of data from patients between the ages of 18 and 80.
The study also applied the latest statistical techniques to consider confounding variables and achieve maximum accuracy of results, including propensity score matching and multivariate regression models.
Surprising Findings. Lower Risks and Better Survival Rates
The results were, in some ways, rather counterintuitive.
Users of cannabis who were admitted with heart attacks proffered smaller odds of cardiogenic shock when controls were adjusted for the different factors, decreased risk of acute ischemic stroke, and cardiac arrest.
They also had a lower rate of use of percutaneous coronary interventions and reduced need for intra-aortic balloon pump support.
Most interestingly, in-hospital mortality was significantly decreased compared to non-users of cannabis.
This same results persisted even after accounting for differences in age and other possible confounding factors.
The findings create a paradox: whereas cannabis use is thought to be associated with cardiovascular risk factors, patients who smoke it seem to have better short-term outcomes following a heart attack.
This phenomenon parallels the so-called “smoker’s paradox” among tobacco users, where sometimes great short-term survival rates show themselves following a heart attack or other medical treatments.
Unraveling the Paradox. Possible Explanations
There could be many reasons for what is called the “cannabis paradox,” say researchers.
Age and if risk factors can play a big role. Study participants who used cannabis were much younger altogether—nevertheless, averaging an age of 51 versus the non-users’ age, at an average of 63—and had fewer conventional cardiovascular risks, such as hypertension, diabetes, and prior cardiac procedures.
The researchers tried to adjust for those factors in their analysis, but age-related variables could still be at play in the results.
Another possibility could be that cannabis restores cardio-protection. Animal and in vitro studies indeed reveal that activation of a few types of cannabinoid receptors—again, at least CB2—is cardio-protective.
These receptors might help reduce inflammation, limit infarct size, and prevent adverse remodeling of heart tissue after a heart attack. While more research is needed, this could partially explain the better outcomes observed in cannabis users.
The researchers also speculate that the primary mechanism of heart attacks in cannabis users may differ from the typical atherosclerotic plaque rupture seen in many cases.
Cannabis should be held directly responsible for some changes in the heart rate, blood pressure, and associated coronary blood flow; this could give a different type of heart attack type (type 2 myocardial infarction) with possibly less aggressive long-term consequences.
This study only involved patients who managed to live long enough to be admitted to a health facility; so there could potentially be a problem regarding a selection bias of the study sample.
Implications and Future Directions
The results of this study are against our present understanding of cannabis and cardiovascular health.
While it is important to note that this study in no way revealed that cannabis use protects against heart attacks or should be prescribed as a preventive measure, it does put forward the need to further study complex interactions between cannabinoids and the cardiovascular system.
These results have profound implications for clinical practice.
This information may lead to evidence that forces doctors to reconsider how they assess and treat heart attack patients who use cannabis.
Such patients differ in terms of needs and outcomes compared to their non-user counterparts.
On the whole, the observed cardioprotective effects must be considered a novel insight and enough to give new impetus for the development of targeted therapies, according to the new study and every other forthcoming study resulting from this one.
Study of the mechanism that underlies these effects could help unveil new strategies for intervention that may enhance the outcomes for all heart attack survivors.
These findings do add an extra layer to the complexity of the overall public health discussion on cannabis use. As marijuana use grows far more common, public health officials and educators will increasingly have to lead a more sophisticated discussion not only of hazards but putative benefits.
The surprising results underscore a necessity for wider scope, long-term research in the human population if the use of cannabis and its association with cardiovascular health is to be delineated. Further work on mechanisms and long-term consequences of exercise should be planned.
A Call for Nuanced Understanding
The “cannabis paradox” is a reminder of the complexities of human biology and the often-surprising ways in which substances interact with our bodies.
Although the research demonstrated pretty exciting short-term benefits for the users of cannabis following a heart attack, caution is essential when interpreting these findings.
This research opens up completely new avenues for study and the necessity of a more diverse understanding of the positive changes in the human body caused by cannabis.
