From the Department of Health Administration and Policy, George Mason University, Fairfax, VA (T.P.).
Franconia Pediatrics Associates, Alexandria, VA (S.P.).
Stroke. 2020 Jan;51(1):308-310. doi: 10.1161/STROKEAHA.119.027828. Epub 2019 Nov 11.
Background and Purpose- Amidst legalization of therapeutic and recreational use of marijuana/cannabis in the United States, cerebrovascular effects of marijuana use remain largely unknown, especially among young adults. We aimed to examine the association between marijuana use (18-44 years) among young adults and stroke events. Methods- The study analyzed pooled data from the Behavioral Risk Factor Surveillance System (2016-2017)-a nationally representative cross-sectional survey collected by the Centers for Disease Control and Prevention. Weighted logistic regression models were used to examine an association of recent marijuana use (within the last 30 days) and stroke in young adults (18-44 years) adjusting for patient demographics, risk behavior, and relevant comorbidities. Results- Overall, 13.6% of participants (n=43 860; weighted 35.5 million; 49.9% men) reported using marijuana recently (in the last month), with 63.3% of them being men. Compared with nonusers, marijuana users were often younger (18-34 years; 73.8% versus 61%), non-Hispanic white or black, and with some college education. Marijuana users were often physically active (81.8% versus 77.5%), heavy drinkers (16.8% versus 4.9%), current combustible cigarette users (37.9% versus 15%) and had lower prevalence of hypertension, diabetes mellitus, and hyperlipidemia as compared with nonusers (<0.01). Young adults with recent marijuana use showed 1.82× higher odds (adjusted odds ratio, 1.82 [95% CI, 1.08-3.10]) of stroke compared with nonusers, which further increased to 2.45× higher (adjusted odds ratio, 2.45 [95% CI, 1.31-4.60]) among frequent marijuana users (>10 days/month). Compared with nonusers, stroke odds were even higher among frequent marijuana users with concomitant combustible cigarette use (adjusted odds ratio, 3.12 [95% CI, 1.40-6.97]) and e-cigarette use (adjusted odds ratio, 2.63 [95% CI, 1.07-6.46]), respectively. Conclusions- There may be a significantly higher odds of stroke in young marijuana users (18-44 years) as compared with nonusers with even greater odds among frequent users (>10 days/month).
背景与目的-在美国，大麻/大麻的治疗和娱乐用途合法化之际，大麻使用对脑血管的影响在很大程度上仍不为人知，尤其是在年轻人中。我们旨在研究年轻人（18-44 岁）中近期大麻使用与中风事件之间的关联。
方法-该研究分析了疾病控制与预防中心收集的行为风险因素监测系统（2016-2017 年）-一项全国代表性的横断面调查的汇总数据。使用加权逻辑回归模型，在调整患者人口统计学，风险行为和相关合并症后，研究了近期（在过去 30 天内）大麻使用与年轻人（18-44 岁）中风之间的关联。
结果-总体而言，有 13.6%的参与者（n=43860；加权 3550 万；49.9%为男性）报告最近使用了大麻（在过去一个月内），其中 63.3%为男性。与非使用者相比，大麻使用者通常更年轻（18-34 岁；73.8%比 61%），为非西班牙裔白人或黑人，且受过一定的大学教育。与非使用者相比，大麻使用者通常更活跃（81.8%比 77.5%），酗酒者（16.8%比 4.9%），当前可燃香烟使用者（37.9%比 15%），高血压，糖尿病和高血脂的患病率较低（<0.01）。与非使用者相比，最近使用大麻的年轻人中风的几率高 1.82 倍（调整后的优势比，1.82[95%置信区间，1.08-3.10]），而频繁使用大麻（>10 天/月）的年轻人中风的几率进一步增加到 2.45 倍（调整后的优势比，2.45[95%置信区间，1.31-4.60]）。与非使用者相比，在经常使用大麻且同时使用可燃香烟（调整后的优势比，3.12[95%置信区间，1.40-6.97]）和电子烟（调整后的优势比，2.63[95%置信区间，1.07-6.46]）的情况下，中风的几率甚至更高。
结论-与非使用者相比，年轻人（18-44 岁）中风的几率可能明显更高，而频繁使用者（>10 天/月）的几率则更高。
