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大麻在心血管疾病中的作用。

Role of cannabis in cardiovascular disorders.

作者信息

Goyal Hemant, Awad Hamza H, Ghali Jalal K

机构信息

Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA.

Department of community Medicine/Internal Medicine, Mercer University School of Medicine, Macon, GA, USA.

出版信息

J Thorac Dis. 2017 Jul;9(7):2079-2092. doi: 10.21037/jtd.2017.06.104.

Abstract

The growing popularity of medical and recreational consumption of cannabis, especially among the youth, raises immediate concerns regarding its safety and long-terms effects. The cardiovascular effects of cannabis are not well known. Cannabis consumption has been shown to cause arrhythmia including ventricular tachycardia, and potentially sudden death, and to increase the risk of myocardial infarction (MI). These effects appear to be compounded by cigarette smoking and precipitated by excessive physical activity, especially during the first few hours of consumption. Cannabinoids, or the active compounds of cannabis, have been shown to have heterogeneous effects on central and peripheral circulation. Acute cannabis consumption has been shown to cause an increase in blood pressure, specifically systolic blood pressure (SBP), and orthostatic hypotension. Cannabis use has been reported to increase risk of ischemic stroke, particularly in the healthy young patients. The endocannabinoid system (ECS) is currently considered as a promising therapeutic target in the management of several disease conditions. Synthetic cannabinoids (SCs) are being increasingly investigated for their therapeutic effects; however, the value of their benefits over possible complications remains controversial. Despite the considerable research in this field, the benefits of cannabis and its synthetic derivatives remains questionable even in the face of an increasingly tolerating attitude towards recreational consumption and promotion of the therapeutic complications. More efforts are needed to increase awareness among the public, especially youth, about the cardiovascular risks associated with cannabis use and to disseminate the accumulated knowledge regarding its ill effects.

摘要

大麻在医疗和娱乐消费方面越来越受欢迎,尤其是在年轻人中,这引发了人们对其安全性和长期影响的直接担忧。大麻对心血管系统的影响尚不明确。已证实吸食大麻会导致心律失常,包括室性心动过速,并可能引发猝死,还会增加心肌梗死(MI)的风险。吸烟似乎会加剧这些影响,而过度的体力活动,尤其是在吸食后的最初几个小时,会促使这些影响的发生。大麻素,即大麻的活性成分,已被证明对中枢和外周循环有多种不同的影响。已证实急性吸食大麻会导致血压升高,特别是收缩压(SBP)升高,以及体位性低血压。据报道,使用大麻会增加缺血性中风的风险,尤其是在健康的年轻患者中。内源性大麻素系统(ECS)目前被认为是治疗多种疾病的一个有前景的治疗靶点。合成大麻素(SCs)因其治疗效果而受到越来越多的研究;然而,其益处相对于可能的并发症的价值仍存在争议。尽管在这一领域进行了大量研究,但即使面对对娱乐性消费日益宽容的态度以及对治疗并发症的推广,大麻及其合成衍生物的益处仍然值得怀疑。需要做出更多努力,以提高公众,尤其是年轻人对与使用大麻相关的心血管风险的认识,并传播有关其不良影响的积累知识。

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