Lehrer Steven, Rheinstein Peter H
Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York City, USA.
Family Medicine, Severn Health Solutions, Severna Park, USA.
Cureus. 2022 Feb 9;14(2):e22054. doi: 10.7759/cureus.22054. eCollection 2022 Feb.
Atrial fibrillation, ventricular tachycardia, acute coronary syndromes, and cardiac arrest have been attributed to marijuana. But the National Academy of Science's 2017 Report, , found limited evidence that acute marijuana smoking is positively associated with an increased risk of acute myocardial infarction, and uncovered no evidence to support or refute associations between any chronic effects of marijuana use and increased risk of myocardial infarct (MI).
We sought to determine the association of marijuana smoking with MI in the UK Biobank cohort. Because red wine is a mood-altering substance, we compared the effect of marijuana with red wine on MI incidence.
Our analysis included all subjects with MI. The diagnosis was ascertained using the 10 Revision of the International Classification of Diseases (ICD10 I21). Marijuana was recorded in UKB Category 143, medical conditions, marijuana use. Cigarette smoking information was from UKB Category 100058, smoking. To compare marijuana smoking with the effect of wine drinking we used data from UKB Category 10051, alcohol.
With marijuana use, MI incidence decreased (p < 0.001, two tail Fisher exact test). Red wine was associated with lower MI incidence, although the incidence begins to rise at 11 or more glasses per week (p < 0.001, two tail Fisher exact test). Multivariate analysis was done with logistic regression, MI dependent variable, cigarette pack-years, diabetes type 2, sex, BMI, hypertension, marijuana use, age, red wine consumption, independent variables. Odds ratio (O.R.) 0.844 associated with marijuana use indicates that MI was less likely in marijuana users and was comparable to the effect of red wine (O.R. 0.847).
Marijuana, which has not been shown to have the favorable physiologic effects of red wine on the heart, does reduce MI risk to an extent comparable to red wine. Perhaps both affect the heart by reducing stress.
心房颤动、室性心动过速、急性冠状动脉综合征和心脏骤停都被认为与大麻有关。但美国国家科学院2017年的报告发现,仅有有限证据表明急性吸食大麻与急性心肌梗死风险增加呈正相关,且未发现证据支持或反驳大麻使用的任何慢性影响与心肌梗死(MI)风险增加之间的关联。
我们试图在英国生物银行队列中确定吸食大麻与心肌梗死之间的关联。由于红酒是一种能改变情绪的物质,我们比较了大麻与红酒对心肌梗死发病率的影响。
我们的分析纳入了所有心肌梗死患者。诊断依据国际疾病分类第10版(ICD10 I21)确定。大麻使用情况记录在英国生物银行第143类“医疗状况,大麻使用”中。吸烟信息来自英国生物银行第100058类“吸烟”。为了比较吸食大麻与饮酒的影响,我们使用了英国生物银行第10051类“酒精”的数据。
使用大麻时,心肌梗死发病率降低(p < 0.001,双侧Fisher精确检验)。红酒与较低的心肌梗死发病率相关,尽管每周饮用11杯或更多杯时发病率开始上升(p < 0.001,双侧Fisher精确检验)。采用逻辑回归进行多变量分析,以心肌梗死为因变量,香烟包年数、2型糖尿病、性别、体重指数、高血压、大麻使用、年龄、红酒消费量为自变量。与大麻使用相关的比值比(O.R.)为0.844,表明大麻使用者患心肌梗死的可能性较小,且与红酒的影响相当(O.R. 0.847)。
大麻虽未显示出红酒对心脏具有的有益生理作用,但在降低心肌梗死风险方面与红酒相当。也许两者都是通过减轻压力来影响心脏的。