Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Dec 2024)

Acute Effects of Cannabis Inhalation on Arterial Stiffness, Vascular Endothelial Function, and Cardiac Function

  • Christian P. Cheung,
  • Alexandra M. Coates,
  • Ryleigh E. Baker,
  • Jamie F. Burr

DOI
https://doi.org/10.1161/JAHA.124.037731
Journal volume & issue
Vol. 13, no. 23

Abstract

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Background The cardiovascular impact of cannabis use is incompletely understood. Although evidence links chronic use to an increased risk of disease and adverse cardiovascular events, few studies have investigated the acute effects of cannabis inhalation on subclinical dysfunction. Furthermore, it remains unknown how method of inhalation and cannabinoid profile modify risk. While controlling for inhalation method and the effects of either Δ‐9‐tetrahydrocannabinol (THC) or cannabidiol (CBD), we examined the acute cardiovascular effects of cannabis use on arterial stiffness, vascular endothelial responsiveness, and cardiac function, as markers of cardiovascular impairment. Methods and Results Twenty‐two young, healthy, cannabis users were assessed for arterial stiffness via pulse wave velocity, vascular endothelial function via brachial artery flow mediated dilation, and cardiac function via echocardiography, before and after (1) smoking THC‐predominant cannabis (S‐THC), (2) vaporizing THC‐predominant THC (V‐THC), and (3) vaporizing cannabidiol‐predominant cannabis (V‐CBD). S‐THC and V‐THC increased heart rate (S‐THC: ∆17±15 bpm, V‐THC: ∆16±16 bpm;both P0.05). After inhalation, pulse wave velocity increased (S‐THC: ∆0.29±0.75 m/s, V‐THC: ∆0.42±0.74 m/s, V‐CBD: ∆0.10±0.44 m/s; P=0.002) and diastolic function was reduced ([early/late ratio] S‐THC: ∆‐0.2±0.53, V‐THC: ∆‐0.33±58, V‐CBD: ∆0.01±66; P=0.03). Differences in heart rate were related to changes in pulse wave velocity (r2=0.2; P=0.0002) and diastolic function (r2=0.26; P<0.0001). Inhalation method did not alter these cannabinoid‐dependent responses. Conclusions THC predominant, but not cannabidiol predominant, cannabis elicits increases in heart rate and blood pressure irrespective of inhalation method, which may increase arterial stiffness and reduce diastolic function. These findings implicate THC as a relevant factor for cannabis‐related subclinical cardiovascular dysfunction. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04693884.

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