Cardiovascular effects of marijuana and synthetic cannabinoids: The good, the bad, and the ugly

Pal Pacher, Sabine Steffens, G. Haskó, Thomas H. Schindler, George Kunos

Research output: Contribution to journalReview article

51 Citations (Scopus)

Abstract

Dysregulation of the endogenous lipid mediators endocannabinoids and their G-protein-coupled cannabinoid receptors 1 and 2 (CB1R and CB2R) has been implicated in a variety of cardiovascular pathologies. Activation of CB1R facilitates the development of cardiometabolic disease, whereas activation of CB2R (expressed primarily in immune cells) exerts anti-inflammatory effects. The psychoactive constituent of marijuana, Δ9 -tetrahydrocannabinol (THC), is an agonist of both CB1R and CB2R, and exerts its psychoactive and adverse cardiovascular effects through the activation of CB1R in the central nervous and cardiovascular systems. The past decade has seen a nearly tenfold increase in the THC content of marijuana as well as the increased availability of highly potent synthetic cannabinoids for recreational use. These changes have been accompanied by the emergence of serious adverse cardiovascular events, including myocardial infarction, cardiomyopathy, arrhythmias, stroke, and cardiac arrest. In this Review, we summarize the role of the endocannabinoid system in cardiovascular disease, and critically discuss the cardiovascular consequences of marijuana and synthetic cannabinoid use. With the legalization of marijuana for medicinal purposes and/or recreational use in many countries, physicians should be alert to the possibility that the use of marijuana or its potent synthetic analogues might be the underlying cause of severe cardiovascular events and pathologies.

Original languageEnglish
Pages (from-to)151-166
Number of pages16
JournalNature Reviews Cardiology
Volume15
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

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Cannabinoids
Cannabis
Endocannabinoids
Dronabinol
CCR10 Receptors
Medical Marijuana
Pathology
Cannabinoid Receptors
Cardiovascular System
Heart Arrest
Cardiomyopathies
Cardiac Arrhythmias
Anti-Inflammatory Agents
Cardiovascular Diseases
Central Nervous System
Stroke
Myocardial Infarction
Physicians
Lipids

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cardiovascular effects of marijuana and synthetic cannabinoids : The good, the bad, and the ugly. / Pacher, Pal; Steffens, Sabine; Haskó, G.; Schindler, Thomas H.; Kunos, George.

In: Nature Reviews Cardiology, Vol. 15, No. 3, 01.03.2018, p. 151-166.

Research output: Contribution to journalReview article

Pacher, Pal ; Steffens, Sabine ; Haskó, G. ; Schindler, Thomas H. ; Kunos, George. / Cardiovascular effects of marijuana and synthetic cannabinoids : The good, the bad, and the ugly. In: Nature Reviews Cardiology. 2018 ; Vol. 15, No. 3. pp. 151-166.
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