Cardiovascular consequences of marijuana use
Cardiovascular consequences of marijuana use
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DOI：
10.1002/j.1552-4604.2002.tb06005.x
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发表时间：
2002-11-01
影响因子：
2.9
通讯作者：
Sidney, S
中科院分区：
文献类型：
--
作者：
Sidney, S
这篇综述描述了已知的大麻和大麻素对人类生理和疾病结局的影响。大麻的急性生理效应包括显著的剂量依赖性心率增加，通常伴随着轻微的血压升高。直立性低血压可能是由于血管阻力降低而急性发生的。吸食大麻会缩短最大运动试验中的运动试验持续时间，增加次极量运动时的心率。耐受性发展到吸食大麻和三角洲(9)-四氢大麻酚(THC)的急性影响，持续几天到几周。对THC的心血管反应是由自主神经系统介导的，最近的研究也表明，人类大麻素受体系统在调节心血管反应中发挥作用。尽管大麻的使用可能会导致慢性心血管疾病的发展或急性引发心血管事件，存在多种机制，但关于大麻/THC的使用和心血管疾病结局的数据很少。一项大型队列研究表明，大麻的使用与心血管疾病、住院或死亡率没有关联。然而，使用大麻的急性影响包括缩短心绞痛患者出现胸痛的时间；一项研究表明，大麻可能引发心肌梗死，对患有冠心病或冠心病高危人群的患者应警惕使用大麻作为临床事件诱导剂的潜在危险。研究方向可能包括更多关于心血管疾病结局和大麻与心血管危险因素的关系的研究，关于长期使用大麻可能影响心血管疾病风险的代谢和生理影响的研究，增进对大麻受体系统在心血管调节中的作用的了解，以及确定大麻在控制血压或中风后的神经保护方面是否具有治疗作用的研究。《临床药理学杂志》，2002年。
This review describes what is known about effects of marijuana and cannabinoids in relation to human physiological and disease outcomes. The acute physiological effects of marijuana include a substantial dose-dependent increase in heart rate, generally associated with a mild increase in blood pressure. Orthostatic hypotension may occur acutely as a result of decreased vascular resistance. Smoking marijuana decreases exercise test duration in maximal exercise tests, increases the heart rate at submaximal levels of exercise. Tolerance develops to the acute effects of marijuana smoking and Delta(9)-tetrahydrocannibol (THC) over several days to a few weeks. The cardiovascular responses that occur in response to THC are mediated by the autonomic nervous system, with recent findings also demonstrating that the human cannabinoid receptor system plays a role in regulating the cardiovascular response. Although several mechanisms exist by which marijuana use might contribute to the development of chronic cardiovascular conditions or acutely trigger cardiovascular events, there are few data regarding marijuana/THC use and cardiovascular disease outcomes. A large cohort study showed no association of marijuana use with cardiovascular disease hospitalization or mortality. However, acute effects of marijuana use include a decrease of the time until the onset of chest pain in patients with angina pectoris; one study has shown that marijuana may trigger the onset of myocardial infarction, Patients who have coronary heart disease or are at high risk for the development of CHD should be cautioned about the potential hazards of marijuana use as a precipitant for clinical events. Research directions might include more studies of cardiovascular disease outcomes and relationships of marijuana with cardiovasculur risk factors, studies of metabolic and physiologic effects of chronic marijuana use that may affect cardiovascular disease risk, increased understanding of the role of the cannabinoid receptor system in cardiovascular regulation, and studies to determine if there is a therapeutic role for cannabinoids in blood pressure control or for neuroprotection after stroke. Journal of Clinical Pharmacology, 2002.