How marijuana affects heart failure

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Can marijuana facilitate symptoms of heart failure, or could it make the situation worse? An increasing number of U.S. states have legalized marijuana for medical or recreational use, but some experts say it may not be reasonable or even safe to use if you have it. heart failure.

“The more I learned over the last few years, the more information suggested the potential for harm, not benefit,” says Ersilia DeFilippis, MD, a cardiology associate at Columbia University’s Irving Medical Center in New York City. “While we are still learning more, we think marijuana can affect heart in a cigarette-like manner smoking, and may interact with some drugs. ”

But marijuana may offer limited or no benefit to heart failure patients, says Larry Allen, MD, medical director of the advanced heart failure program at the University of Colorado Anschutz Medical Campus.

“We would say that routine cannabis use probably has more cardiovascular downsides than positives, but that doesn’t mean there are no benefits and there are no situations where that might be appropriate,” he says.

Symptoms that marijuana could help with

As part of the cannabis plant family, marijuana is usually smoked or eaten. There are two main connections in it cannabidiol (CBD) and tetrahydrocannabinol (THC). It’s the THC that gives you “high,” Allen explains. CBD The extract is available on its own in many over-the-counter products, although there is no guarantee that they do not contain THC or contain the advertised amount of CBD.

First legalized in California in 1996 for medical use, marijuana is now legal for adults in nearly a dozen U.S. states and approved only for medical purposes in 36 states. Some of the listed benefits of the drug for other health conditions may also appeal to people with certain symptoms of heart failure, Allen says.

“I meet with patients who use cannabis medically for help pain control and anxiety“Says Allen, who is a co-author of the American Heart Association’s statement of all cannabis products. But some people also tell him that it helps with the discomfort associated with chronic swelling of the abdomen or legs, common heart failure symptom.

“Patients with severe heart Failure can also develop poor appetite and cardiac cachexia, ”or severe weight loss and muscle loss, he says. “I had some of these patients who said marijuana helped them nausea and appetite. ”

But Allen and DeFilippis warn that studies have not shown that marijuana can alleviate these signs of heart failure.

“There is no evidence that marijuana use directly helps with heart failure symptoms,” says DeFilippis. “On an individual level, people may feel perceived benefits, but there is no evidence to suggest this on a large scale.”

How marijuana can be harmful

In fact, marijuana can worsen heart failure in several ways, experts say. Can:

  • Narrow arteries. Like smoking cigarettes and vaping, smoking marijuana can constrict blood vessels around the heart, making it difficult to pump. “My patients are surprised to hear that, because I think it’s something that’s not well advertised,” says DeFilippis.
  • Lower pumping capacity. Some animal research suggests that cannabis may reduce the heart’s ability to contract or pump. “We’ve seen cases where people start with normal heart function but use cannabis,” they get heart disease that increases or worsens heart failure, DeFilippis says.
  • Exacerbate irregular heartbeat. If your heart is already out of rhythm, marijuana can make it even more unstable.
  • Raise blood pressure.High blood pressure is already a problem for many people with heart failure, and the use of marijuana can increase it even more. “It simply came to our notice then heart failure management more challenging, ”says Allen.

Drug interactions

When you use marijuana, your liver they broke it. But marijuana can affect enzymes, things your liver produces to help process the medications you take for heart failure. That means medications can leave your body faster or slower than they should, Allen says.

“This can upset the balance of drugs in the body that should be there,” he says.

Medications for heart failure that may be affected include:

  • Beta-blockers to lower heart rate and blood pressure
  • statins to lower cholesterol levels
  • Nitrates to alleviate chronic chest pain
  • Certain blood thinners to prevent clotting
  • Calcium channel blockers open the arteries and facilitate the pumping of the heart blood
  • Immunosuppressants to prevent rejection in people who have had a heart transplant

Allen notes that heavy marijuana use can also affect your ability to stay on medication and stick to a healthy lifestyle, such as training and eat properly. “Every drug like marijuana should obviously be used responsibly,” he says, “and almost always, its overuse can cause health problems.”

Total heart risks

Cannabis products do not offer overall benefits for heart health, according to a scientific statement from the American Heart Association. The association concluded that marijuana may be associated with a higher risk of heart failure or arrhythmias. atrial fibrillation, as well as higher odds of a heart attack.

But much more research is needed on the health effects of the pot, say Allen and DeFilippis. Because the U.S. government still classifies marijuana as a controlled substance, it is difficult for scientists to do in-depth studies.

“A lot is unknown in terms of its health effects. There’s not a lot of big clinical research on people that says exactly what they are, ”says Allen. “But in general, the recommendation is that cannabis use probably has more downsides than positives.”

One reality is that the increasing legalization of marijuana is leading to more and more people with heart failure and other conditions being open about its use, he says.

If you have heart failure and smoke or eat marijuana, talk to your doctor about what to look out for. If you are just thinking about trying to alleviate some of the symptoms of your condition, consult your doctor first.

“It’s become more common to argue,” Allen says, “and in general, I think it’s good if people feel better talking to their health care providers, because there can be positive and negative effects ”of cannabis use when you have heart failure.

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