Question: Is chronic cannabis use associated with endothelial dysfunction? YES!
Findings: In this cross-sectional study of 55 participants, vascular endothelial function was impaired in both chronic marijuana smokers and tetrahydrocannabinol (THC)–edible users, whereas serum from marijuana smokers but not THC-edible users blunted nitric oxide production in cultured endothelial cells.
Meanings: Endothelial dysfunction was observed in otherwise healthy cannabis users, suggesting an increased risk of early development of vascular disease.
Abstract
Importance: Recreational and medicinal cannabis legalization has led to increased cannabis use. To understand the consequences for vascular health, we initiated the Cannabis: Does It Damage Endothelium (CANDIDE) study.
Objective: To investigate whether cannabis use is associated with vascular endothelial dysfunction.
Design, Setting, and Participants: In this cross-sectional study, sex- and age- matched healthy adults, aged 18 to 50 years, living in the San Francisco Bay Area, California, who neither smoke tobacco nor vape and were not frequently exposed to second-hand smoke were recruited into 3 cohorts: 2 chronic cannabis user groups (marijuana smokers and tetrahydrocannabinol [THC]–edible users) and 1 nonuser group. Participants were recruited from October 25, 2021, through August 1, 2024; analysis was completed September 2024. Participants’ arterial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (PWV) were measured. Human umbilical vein endothelial cells (HUVECs) were exposed to participant sera with and without vascular endothelial growth factor (VEGF) to assess the effects of user serum on endothelial nitric oxide production.
Conclusions: This cross-sectional study found that chronic cannabis smoking and THC ingestion were associated with endothelial dysfunction similar to that observed in tobacco smokers, although apparently occurring via distinct mechanisms. "vascular endothelial function was impaired in both chronic marijuana smokers and tetrahydrocannabinol (THC)–edible users" (Source: JAMA Network Cardiology)