Cardiovascular effects due to the use of cannabinoids

Objective: To determine the cardiovascular side-effects of smoking marihuana according to that reported in the medical literature. Methods: A search was performed using the MeSH terms, “Cannabis”, “Marijuana smoking” and “adverse effects”, in the PubMed database up to the year 2016. A total of 265 references were obtained. The exclusion criteria were; Letters to the editor, protocols of research in process, paediatrics (less than 18 years), pregnancy, articles in languages other than English or Spanish. Only references associated with cardiovascular effects were collected. Results: Two types of cannabinoid receptors, CB1 and CB2, have been defined and are located in the central nervous system, as well as in endothelial, renal and smooth muscle. The consumption of marijuana is increasing, and doctors know little about its effects, as well as the different marketing names used for this substance. There are protective effects at vascular level, with the slowing down of atherosclerotic plaques, as well as the many undesired effects such as, tachycardia, hypotension, and bradycardia. Many case reports document the association of marijuana with acute myocardial infarction with or without coronary artery lesions, as well as with subarachnoid haemorrhage, but there are no clearly described mechanisms that could explain a direct relationship with these events. Conclusions: The pathophysiology is known, as well as where the cannabinoid receptors act to generate their protective and harmful effects. There is a strong association with cardiovascular disease, mainly acute coronary syndrome, but the pathophysiological is still not clear.