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I appreciate the study calls out that most cannabis is smoked, and it may be general smoke inhalation driving these results rather than an inherent property of

I appreciate the study calls out that most cannabis is smoked, and it may be general smoke inhalation driving these results rather than an inherent property of cannabis

LegitShady 5y ago
It doesn't say that at all. >The effect estimates for history of MI were similar across methods of consumption, including among people using other forms of cannabis, including edibles, as a primary method of consumption. This finding is consistent with a case study reporting an acute MI triggered after consumption of a lollipop containing a large dose of Δ-9-tetrahydrocannabinol.36 The Canadian government recently legalized cannabis edibles;2 however, the risks associated with edibles are poorly understood and are of concern to Canadian physicians.37 Edibles are often perceived as a safer alternative for cannabis consumption, but recent evidence suggests that edible cannabis is attributed to a larger proportion of cannabis-related emergency department visits for cardiovascular symptoms compared with inhaled cannabis
- oxymoran 5y ago
  “Although a similarly elevated odds of history of MI was observed across methods of recent cannabis consumption, only smoking as a primary method achieved statistical significance.“
  - this_user 5y ago
    That is honestly a pretty confusing sentence in need of clarification. My read would be that statistical significance was not achieved due to the small sample size of users who are primarily using other methods of consumption than smoking.
    - galaxyLogic 5y ago
      If there isn't statistical significance there isn't statistical significance. It does not matter what caused the lack of it. Without statistical significance there is "no evidence".
eurasiantiger 5y ago
It very likely is due to smoke inhalation or even mixing with tobacco; IIRC inhalation of any kind of micro- and nanoparticles is linked to higher risk of myocardial infarction.
- datavirtue 5y ago
  I got a few new sativa vapes recently and was hitting them both pretty hard. I got smacked with a really disturbing heart issue that felt like it was being severely over worked. It was so bad I was on my front porch in n the dark resolved to dying. I didn't in now what was going to happen. I'll admit that I'm a lightweight but I had to stop with the "turpine pens." Now I just smoke dry herb because I know how to regulate it and it never presented any issues like I experienced. In the run up to that I did experience heart issues (racing/skipping?) but it was no where near that episode. I have noticed that sugar greatly exasperates the heart issues for me.
  - newsclues 5y ago
    Sativa can give people anxiety and it can feel like a heart issue. Pens make it easier to get a bigger hit than a normal joint dose, so take smaller puffs.
    - eurasiantiger 5y ago
      I think it is completely dependent on the person. Some people get anxiety from the bodily effects of indicas while some people seek out those muscle-relaxing, stress-clearing ”stoned” effects. Some people get anxiety from the high-flying thoughts brought about by sativas and some people seek out those idea-provoking cerebral ”high” effects.
  - zardo 5y ago
    Of course I can't rule out that you actually had a cardiovascular problem, but of the people who get really high and think they have a medical problem, it's usually an anxiety attack.
crazy_horse 5y ago
> Smoking cannabis was the most prevalent primary method of consumption (76.3%, 95% CI 74.3%–78.4%) relative to vapourization (11.3%, 95% CI 9.8%–12.8%) and other forms of consumption, including edibles (12.4%, 95% CI 10.8%–13.9%). > Compared with nonusers, the prevalence of recent cannabis use was higher among males (62.9% v. 49.3%), unmarried respondents (68.0% v. 46.4%), current combustible cigarette users (31.6% v. 13.2%), current e-cigarette users (18.1% v. 5.1%) and heavy alcohol drinkers (17.4% v. 5.2%). You run into cannabis users that have massively high tolerances because they dab all day. I wonder how d8, d10, etc would come out, cause that's probably a big part of the future, that an other cannaboid mixes.
barbazoo 5y ago
I too wonder if it is due to the way it was consumed primarily (smoking). There is a bit about the impact of cannabinoids on the cardiovascular system however. > The impact of exogenous cannabinoids on the cardiovascular system has been well described.7,33 After acute exposure, cannabis induces dose-dependent tachycardia and, in some cases, decreased ventricular contractility, palpitations, atrial fibrillation and arrhythmia. Table 2 differentiates the form of consumption but I couldn't find them controlling for it. Did I miss that somehow?
- quickcheck 5y ago
  In the "Interpretation" section of the paper they specify: "Although a similarly elevated odds of history of heart attacks was observed across methods of recent cannabis consumption, only smoking as a primary method achieved statistical significance."
- ozzmotik 5y ago
  >After acute exposure, cannabis induces dose-dependent tachycardia and, in some cases, decreased ventricular contractility, palpitations, atrial fibrillation and arrhythmia i feel like this is saying what a lot of us already know about cannabis usage, more specifically about THC as this won't be found as much in low THC strains: higher doses have a tendency to cause anxiety sometimes. all of those symptoms tend to be, at least in my experience, pretty comorbid with a state of high anxiety, and more often than not, I would think, the more easily observable ones than the neurological or psychological effects associated therewith.
hncurious 5y ago
This study is really just "smoking linked to higher risk".
- notJim 5y ago
  I think it's any marijuana use, not just smoking: The primary exposure for our study was any recent cannabis use, categorized as a binary outcome. In the BRFSS, participants were asked, “During the past 30 days, on how many days did you use [marijuana or hashish (2017)] [marijuana or cannabis (2018)]?” We defined any recent cannabis use as using cannabis 1 or more time during the past 30 days.
  - bialpio 5y ago
    Results for other methods of consumption were not statistically significant: "Similarly, a higher odds of history of MI was observed with vapourization as a primary method of cannabis consumption (adjusted OR 2.26, 95% CI 0.58–8.82) and other forms of cannabis consumption, including edibles (adjusted OR 2.36, 95% CI 0.81–6.88) when compared with nonusers; however, these were not statistically significant."
    - elliekelly 5y ago
      When they say "primary method of cannabis consumption" do they mean the primary method of consumption in the past 30 days? Or do they mean the primary method of lifetime consumption? I'm also not sure "primary method of consumption" is the right question to ask? If someone smokes three days a week and has edibles the other four their primary method would be edibles but that doesn't erase the risk of the smoking.
      - bialpio 5y ago
        CDC has archival surveys at https://www.cdc.gov/brfss/questionnaires/index.htm https://www.cdc.gov/brfss/questionnaires/index.htm The phrasing based on 2018 form was: "During the past 30 days, which one of the following ways did you use marijuana the most often? Did you usually…"
beerandt 5y ago
Not likely- the odds ratio vs non-users for smoking (2.01) is lower than that for vaping (2.26) and "other" (2.36). They say that this is not statistically significant, however all forms of cannabis use vs non-users is statistically significant, with an odds ratio of 2.07 overall, and 2.31 for frequent users. So if anything, the data suggests the opposite: smoking was lowest odds ratio. Also, they adjust the findings to account for users that smoke, vape, etc, so it's not due to the fact that users are also more likely to smoke (compared to non-users).

I appreciate the study calls out that most cannabis is smoked, and it may be general smoke inhalation driving these results rather than an inherent property of cannabis

LegitShady 5y ago

It doesn't say that at all. >The effect estimates for history of MI were similar across methods of consumption, including among people using other forms of cannabis, including edibles, as a primary method of consumption. This finding is consistent with a case study reporting an acute MI triggered after consumption of a lollipop containing a large dose of Δ-9-tetrahydrocannabinol.36 The Canadian government recently legalized cannabis edibles;2 however, the risks associated with edibles are poorly understood and are of concern to Canadian physicians.37 Edibles are often perceived as a safer alternative for cannabis consumption, but recent evidence suggests that edible cannabis is attributed to a larger proportion of cannabis-related emergency department visits for cardiovascular symptoms compared with inhaled cannabis

oxymoran 5y ago
“Although a similarly elevated odds of history of MI was observed across methods of recent cannabis consumption, only smoking as a primary method achieved statistical significance.“
- this_user 5y ago
  That is honestly a pretty confusing sentence in need of clarification. My read would be that statistical significance was not achieved due to the small sample size of users who are primarily using other methods of consumption than smoking.
  - galaxyLogic 5y ago
    If there isn't statistical significance there isn't statistical significance. It does not matter what caused the lack of it. Without statistical significance there is "no evidence".

eurasiantiger 5y ago

It very likely is due to smoke inhalation or even mixing with tobacco; IIRC inhalation of any kind of micro- and nanoparticles is linked to higher risk of myocardial infarction.

datavirtue 5y ago
I got a few new sativa vapes recently and was hitting them both pretty hard. I got smacked with a really disturbing heart issue that felt like it was being severely over worked. It was so bad I was on my front porch in n the dark resolved to dying. I didn't in now what was going to happen. I'll admit that I'm a lightweight but I had to stop with the "turpine pens." Now I just smoke dry herb because I know how to regulate it and it never presented any issues like I experienced. In the run up to that I did experience heart issues (racing/skipping?) but it was no where near that episode. I have noticed that sugar greatly exasperates the heart issues for me.
- newsclues 5y ago
  Sativa can give people anxiety and it can feel like a heart issue. Pens make it easier to get a bigger hit than a normal joint dose, so take smaller puffs.
  - eurasiantiger 5y ago
    I think it is completely dependent on the person. Some people get anxiety from the bodily effects of indicas while some people seek out those muscle-relaxing, stress-clearing ”stoned” effects. Some people get anxiety from the high-flying thoughts brought about by sativas and some people seek out those idea-provoking cerebral ”high” effects.
- zardo 5y ago
  Of course I can't rule out that you actually had a cardiovascular problem, but of the people who get really high and think they have a medical problem, it's usually an anxiety attack.

crazy_horse 5y ago

> Smoking cannabis was the most prevalent primary method of consumption (76.3%, 95% CI 74.3%–78.4%) relative to vapourization (11.3%, 95% CI 9.8%–12.8%) and other forms of consumption, including edibles (12.4%, 95% CI 10.8%–13.9%). > Compared with nonusers, the prevalence of recent cannabis use was higher among males (62.9% v. 49.3%), unmarried respondents (68.0% v. 46.4%), current combustible cigarette users (31.6% v. 13.2%), current e-cigarette users (18.1% v. 5.1%) and heavy alcohol drinkers (17.4% v. 5.2%). You run into cannabis users that have massively high tolerances because they dab all day. I wonder how d8, d10, etc would come out, cause that's probably a big part of the future, that an other cannaboid mixes.

barbazoo 5y ago

I too wonder if it is due to the way it was consumed primarily (smoking). There is a bit about the impact of cannabinoids on the cardiovascular system however. > The impact of exogenous cannabinoids on the cardiovascular system has been well described.7,33 After acute exposure, cannabis induces dose-dependent tachycardia and, in some cases, decreased ventricular contractility, palpitations, atrial fibrillation and arrhythmia. Table 2 differentiates the form of consumption but I couldn't find them controlling for it. Did I miss that somehow?

quickcheck 5y ago
In the "Interpretation" section of the paper they specify: "Although a similarly elevated odds of history of heart attacks was observed across methods of recent cannabis consumption, only smoking as a primary method achieved statistical significance."
ozzmotik 5y ago
>After acute exposure, cannabis induces dose-dependent tachycardia and, in some cases, decreased ventricular contractility, palpitations, atrial fibrillation and arrhythmia i feel like this is saying what a lot of us already know about cannabis usage, more specifically about THC as this won't be found as much in low THC strains: higher doses have a tendency to cause anxiety sometimes. all of those symptoms tend to be, at least in my experience, pretty comorbid with a state of high anxiety, and more often than not, I would think, the more easily observable ones than the neurological or psychological effects associated therewith.

hncurious 5y ago

This study is really just "smoking linked to higher risk".

notJim 5y ago
I think it's any marijuana use, not just smoking: The primary exposure for our study was any recent cannabis use, categorized as a binary outcome. In the BRFSS, participants were asked, “During the past 30 days, on how many days did you use [marijuana or hashish (2017)] [marijuana or cannabis (2018)]?” We defined any recent cannabis use as using cannabis 1 or more time during the past 30 days.
- bialpio 5y ago
  Results for other methods of consumption were not statistically significant: "Similarly, a higher odds of history of MI was observed with vapourization as a primary method of cannabis consumption (adjusted OR 2.26, 95% CI 0.58–8.82) and other forms of cannabis consumption, including edibles (adjusted OR 2.36, 95% CI 0.81–6.88) when compared with nonusers; however, these were not statistically significant."
  - elliekelly 5y ago
    When they say "primary method of cannabis consumption" do they mean the primary method of consumption in the past 30 days? Or do they mean the primary method of lifetime consumption? I'm also not sure "primary method of consumption" is the right question to ask? If someone smokes three days a week and has edibles the other four their primary method would be edibles but that doesn't erase the risk of the smoking.
    - bialpio 5y ago
      CDC has archival surveys at https://www.cdc.gov/brfss/questionnaires/index.htm https://www.cdc.gov/brfss/questionnaires/index.htm The phrasing based on 2018 form was: "During the past 30 days, which one of the following ways did you use marijuana the most often? Did you usually…"

beerandt 5y ago

Not likely- the odds ratio vs non-users for smoking (2.01) is lower than that for vaping (2.26) and "other" (2.36). They say that this is not statistically significant, however all forms of cannabis use vs non-users is statistically significant, with an odds ratio of 2.07 overall, and 2.31 for frequent users. So if anything, the data suggests the opposite: smoking was lowest odds ratio. Also, they adjust the findings to account for users that smoke, vape, etc, so it's not due to the fact that users are also more likely to smoke (compared to non-users).