Commonly used and abused recreational drugs have been linked to the development of atrial fibrillation (AF) in a new study by UC San Francisco. The study determined substances like cocaine, methamphetamine, opiates and even cannabis pose previously unidentified risks for the development of AF.
Researchers analyzed data from diagnostic codes from hospital admission, emergency room visits and medical procedures in California from between 2005 and 2015. Through the study, some one million people who had no preexisting AF but later developed the condition during these years were identified.
Among the patients examined in the database:
- 132,834 used cannabis
- 98,271 used methamphetamine
- 48,700 used cocaine
- 10,032 used opiates
One notable finding, published in the European Heart Journal, revealed that marijuana users had a 35% increased likelihood of developing AF later.
“Despite exhibiting a weaker association with incident AF than the other substances, cannabis use still exhibited an association of similar or greater magnitude to risk factors like dyslipidemia, diabetes mellitus, and chronic kidney disease. Furthermore, those with cannabis use exhibited similar relative risk of incident AF as those with traditional tobacco use,” the study authors reported.
AF is characterized by an abnormally disordered pumping rhythm that arises from electrical disturbances in the upper chamber of the heart, the atria. In severe cases, clots can form in the atria, potentially breaking off in the bloodstream and causing deadly strokes. There are more than 150,000 deaths in the U.S. annually caused by AF-related strokes.
“To my knowledge, this is the first study to look at marijuana use as a predictor of future atrial fibrillation risk,” said principal investigator Gregory Marcus, MD, MAS, a UCSF professor of medicine with the Division of Cardiology.
What is noteworthy about the study’s finding is that unlike cocaine or methamphetamine, both stimulants that are known to sometimes cause sudden cardiac deaths due to disruptions in orderly electrical signaling and pumping within the heart, there’s no demonstrated mechanism for marijuana to cause hearth arrhythmias.
However, evidence from previous studies does indicate that particulate matter can increase the likelihood of an AF episode among those already diagnosed with the condition.
“It’s also intriguing to consider that inhaled substances travel directly from the lungs to pulmonary veins, which empty into the left atrium, and that the pulmonary veins and the left atrium are especially important in generating AF,” Marcus said.
Marcus hopes to conduct controlled studies in humans to more directly study the effects cannabis has on heart rhythm and investigate the mechanisms through which the use of other drugs may lead to increased AF risk.
The study also found that of all the drugs tracked in the database, methamphetamine posed the highest risk for AF.
Published: October 18, 2022
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