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大麻使用:先天性心脏病成人中的一种新风险行为。

Cannabis Use: A New Risk Behaviour Among Adults With Congenital Heart Disease.

作者信息

Bailey Barbara, Dimas Michelle A, Oechslin Erwin, Soldevilla Shereli, Styra Rima

机构信息

Toronto Adult Congenital Heart Disease Program, Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, and University of Toronto, Toronto, Ontario, Canada.

Toronto General Hospital, University Health Network (UHN), Center for Mental Health, and University of Toronto, Toronto, Ontario, Canada.

出版信息

CJC Pediatr Congenit Heart Dis. 2023 Sep 7;2(6Part B):484-489. doi: 10.1016/j.cjcpc.2023.09.001. eCollection 2023 Dec.

Abstract

BACKGROUND

Cannabis use has increased in Canada and can be associated with adverse cardiovascular events. Given increased use and accessibility to cannabis, there is a need among clinicians to better understand cannabis use in adults with congenital heart disease.

METHODS

A cross-sectional survey (May to September 2018) was used to investigate cannabis use among 252 patients with adult congenital heart disease in a quaternary care centre.

RESULTS

Of the 252 patients, 53 (21%) reported using cannabis. The majority of cannabis users were men (62%), between the ages of 25 and 39 years (mean age = 32 ± 16 years), and more likely to use tobacco (n = 9, 17%;  = 0.001) and alcohol (n = 37, 60%;  = 0.001). Significant differences ( = 0.011) were found between the age of onset for tobacco use among cannabis users (mean age: 16 ± 8 years) and non-cannabis users (mean age: 20 ± 3 years). Users reported consuming cannabis for recreational purposes (n = 29, 55%), anxiety (n = 22, 42%), depression (n = 15, 28%), and pain management (n = 4, 8%).

CONCLUSIONS

This study supports our clinical experience that a high proportion of patients with adult congenital heart disease use cannabis. Cannabis users represent a patient population who may demonstrate less optimal health behaviours, including tobacco and alcohol use. Assessment of cannabis use should be an integral part of risk behaviour and cardiovascular risk profile at each clinic visit. Given the current legalization of cannabis in Canada and the growing increase of cannabis use, educational support should be provided to patients and caregivers.

摘要

背景

加拿大的大麻使用呈上升趋势,且可能与不良心血管事件相关。鉴于大麻使用的增加以及其可及性,临床医生有必要更好地了解患有先天性心脏病的成年人的大麻使用情况。

方法

采用横断面调查(2018年5月至9月),对一家四级护理中心的252例成年先天性心脏病患者的大麻使用情况进行调查。

结果

在252例患者中,53例(21%)报告使用过大麻。大多数大麻使用者为男性(62%),年龄在25至39岁之间(平均年龄 = 32 ± 16岁),且更有可能使用烟草(n = 9,17%;P = 0.001)和酒精(n = 37,60%;P = 0.001)。大麻使用者(平均年龄:16 ± 8岁)和非大麻使用者(平均年龄:20 ± 3岁)开始使用烟草的年龄存在显著差异(P = 0.011)。使用者报告使用大麻的目的包括娱乐(n = 29,55%)、焦虑(n = 22,42%)、抑郁(n = 15,28%)和疼痛管理(n = 4,8%)。

结论

本研究支持了我们的临床经验,即很大一部分成年先天性心脏病患者使用大麻。大麻使用者代表了一个健康行为可能不太理想的患者群体,包括使用烟草和酒精。在每次门诊就诊时,对大麻使用情况的评估应成为风险行为和心血管风险评估的一个组成部分。鉴于加拿大目前大麻已合法化且使用不断增加,应向患者和护理人员提供教育支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02c1/10777198/ea15dd04614a/ga1.jpg

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2020 ESC Guidelines for the management of adult congenital heart disease.
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