Marijuana Use and Long-Term Mortality among Survivors of Acute Myocardial Infarction

Few studies have examined the long-term impact of marijuana use, particularly in relation to the public health concern of cardiovascular disease or coronary artery disease, which are already known to be a risk for aging baby boomers.

Cannabinoids have both protective and harmful effects, and they are associated with CB2 and CB1 receptors. THC, the main active constituent of marijuana, is a mixed agonist for CB2 and CB1 receptors. Activation of CB1 receptors may increase lipid resistance and cause chronic cardiovascular dysfunction and obesity. Additionally, THC’s analgesic properties may delay the treatment of chest pain.

It is hypothesized that there would be a dose-response relationship between the frequency of marijuana use and higher mortality rates. In order to include a larger sample size, we extended our analysis of the previous study, MIOS, by following up with 109 marijuana users and 3886 participants for a period of 18 years. It remains unclear whether the use of marijuana is associated with increased mortality among survivors over longer follow-up times. In our preliminary analysis of MIOS, which included 1913 participants reporting marijuana use in the year prior to a myocardial infarction (MI), we found that those who used marijuana once or more per week had a higher mortality rate compared to those who did not report marijuana use. Several studies have reported a higher mortality rate associated with habitual marijuana use, but not all studies have shown this relationship. Regarding the risk of all-cause mortality and heavy cannabinoid use, there is a reported relationship. We previously showed that the rate of myocardial infarction (MI) is 2.4 to 9.5 times higher within an hour of marijuana use compared to other times. Little is known about the association between marijuana use and survival among those who have survived an MI, particularly those at the highest cardiovascular risk.

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