Marijuana use and coronary artery disease in young adults.
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ABSTRACT:
SUBMITTER: Burt JR
PROVIDER: S-EPMC6988970 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:AimsWe investigated the association between cumulative lifetime and current marijuana use with total abdominal adipose tissue (AT), visceral AT, subcutaneous AT, intermuscular AT, and mean liver attenuation (LA) at mid-life.DesignLongitudinal and cross-sectional secondary data analysis of participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.SettingCARDIA field centers in Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA, USA.ParticipantsCARDIA participants, aged 18-30 years in 1985-1986, who were present at the clinic examination in 2010-2011 (n = 2902).MeasurementsMarijuana use was assessed from responses to self-administered questionnaires at 8 CARDIA examinations over 25 years, determined as cumulative marijuana-years and current use status. Non-contrast computed tomography imaging of the abdomen was obtained in 2010-2011.FindingsIn 2010-2011, 84% of participants reported a history of marijuana use with 11% reporting use within the past 30 days. Before adjustment, we observed greater cumulative marijuana use was associated with lower total abdominal and subcutaneous AT volume and lower LA and current marijuana use was associated with lower subcutaneous AT. However, after adjustment for age, sex, race, field center, cigarette pack-years and current use, regular alcohol consumption, cumulative drink-years, and physical activity, neither cumulative marijuana use nor current use showed an association with any abdominal adipose depot. Our estimates did not differ by age, sex, or race nor after accounting for cohort attrition.ConclusionNeither cumulative marijuana use nor current marijuana use is associated with total abdominal, visceral, subcutaneous, or intermuscular adipose tissue, or liver attenuation in mid-life.
| S-EPMC5847434 | biostudies-literature
Project description:AimsTo evaluate the prevalence of electrocardiogram (ECG) abnormalities in marijuana users as an indirect measure of subclinical cardiovascular disease (CVD).DesignLongitudinal and cross-sectional secondary data analysis from the CARDIA (Coronary Artery Risk Development in Young Adults) study.SettingFour communities in the United States.ParticipantsA total of 2585 participants from the 5115 black and white men and women recruited at age 18-30 years in 1985 to 1986 in CARDIA.MeasurementsECG abnormalities coded as minor and major abnormalities with the Minnesota code of electrocardiographic findings at year 20. Self-reported current (past 30 days) and computed cumulative life-time marijuana use (one 'marijuana-year' corresponds to 365 days of use) through assessments every 2-5 years. We fitted logistic regression models adjusting for sex, race, center, education, age, tobacco smoking, physical activity, alcohol use and body mass index.FindingsAmong the 2585 participants with an ECG at year 20, mean age was 46, 57% were women, 45% were black; 83% had past exposure to marijuana and 11% were using marijuana currently. One hundred and seventy-three participants (7%) had major abnormalities and 944 (37%) had minor abnormalities. Comparing current with never use in multivariable-adjusted models, the odds ratio (OR) for major ECG abnormalities was 0.60 [95% confidence interval (CI) = 0.32-1.15] and for minor ECG abnormalities 1.21 (95% CI = 0.87-1.68). Results did not change after stratifying by sex and race. Cumulative marijuana use was not associated with ECG abnormalities.ConclusionIn a middle-aged US population, life-time cumulative and occasional current marijuana use were not associated with increases in electrocardiogram abnormalities. This adds to the growing body of evidence that occasional marijuana use and cardiovascular disease events and markers of subclinical atherosclerosis are not associated.
| S-EPMC7796923 | biostudies-literature
Project description:AIMS/HYPOTHESIS:The impact of marijuana use on metabolic health is largely unknown. This study sought to clarify the cross-sectional and longitudinal associations between self-reported marijuana use, and prediabetes (defined as fasting glucose 5.6-6.9 mmol/l, 2 h glucose post OGTT 7.8-11.0 mmol/l or HbA1c 5.7-6.4% [39-47 mmol/mol]) and diabetes. METHODS:Data from the community-based Coronary Artery Risk Development in Young Adults (CARDIA) study were used to determine marijuana use and the presence of prediabetes and diabetes among participants. The association between marijuana use and the prevalence of prediabetes and diabetes was examined in 3,034 participants at CARDIA examination year 25 (2010-2011), while the incidence of prediabetes and diabetes according to previous marijuana use was assessed in 3,151 individuals who were free from prediabetes/diabetes at year 7 (1992-1993) and who returned for at least one of the four subsequent follow-up examinations over 18 years. RESULTS:The percentage of individuals who self-reported current use of marijuana declined over the course of the study's follow-up. After multivariable adjustment, higher odds of prediabetes were found for individuals who reported current use of marijuana (OR 1.65 [95% CI 1.15, 2.38]) and a lifetime use of 100 times or more (OR 1.49 [95% CI 1.06, 2.11]), compared with individuals who reported never using marijuana. There was no association between marijuana use and diabetes at CARDIA examination year 25. Over 18 years of follow-up, a greater risk of prediabetes (but not diabetes) was found for individuals who reported a lifetime use of marijuana of 100 times or more (HR 1.39 [95% CI 1.13, 1.71]), compared with individuals who had never used marijuana. CONCLUSIONS/INTERPRETATION:Marijuana use in young adulthood is associated with an increased risk of prediabetes by middle adulthood, but not with the development of diabetes by this age.
| S-EPMC4631659 | biostudies-literature
Project description:ImportanceMarijuana use is increasingly common in the United States. It is unclear whether it has long-term effects on memory and other domains of cognitive function.ObjectiveTo study the association between cumulative lifetime exposure to marijuana use and cognitive performance in middle age.Design, setting, and participantsWe used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 black and white men and women aged 18 to 30 years at baseline from March 25, 1985, to June 7, 1986 (year 0), and followed up over 25 years from June 7, 1986, to August 31, 2011, to estimate cumulative years of exposure to marijuana (1 year = 365 days of marijuana use) using repeated measures and to assess associations with cognitive function at year 25. Linear regression was used to adjust for demographic factors, cardiovascular risk factors, tobacco smoking, use of alcohol and illicit drugs, physical activity, depression, and results of the mirror star tracing test (a measure of cognitive function) at year 2. Data analysis was conducted from June 7, 1986, to August 31, 2011.Main outcomes and measuresThree domains of cognitive function were assessed at year 25 using the Rey Auditory Verbal Learning Test (verbal memory), the Digit Symbol Substitution Test (processing speed), and the Stroop Interference Test (executive function).ResultsAmong 3385 participants with cognitive function measurements at the year 25 visit, 2852 (84.3%) reported past marijuana use, but only 392 (11.6%) continued to use marijuana into middle age. Current use of marijuana was associated with worse verbal memory and processing speed; cumulative lifetime exposure was associated with worse performance in all 3 domains of cognitive function. After excluding current users and adjusting for potential confounders, cumulative lifetime exposure to marijuana remained significantly associated with worse verbal memory. For each 5 years of past exposure, verbal memory was 0.13 standardized units lower (95% CI, -0.24 to -0.02; P = .02), corresponding to a mean of 1 of 2 participants remembering 1 word fewer from a list of 15 words for every 5 years of use. After adjustment, we found no associations with lower executive function (-0.03 [95% CI, -0.12 to 0.07]; P = .56) or processing speed (-0.04 [95% CI, -0.16 to 0.08]; P = .51).Conclusions and relevancePast exposure to marijuana is associated with worse verbal memory but does not appear to affect other domains of cognitive function.
| S-EPMC5109019 | biostudies-literature
Project description:BackgroundGiven changes in marijuana regulations, retail, and products and potential impact on use, we examined young-adult perceptions of different modes of use, the proportion using via different modes (e.g. smoking, vaping, ingesting), and associations with the use levels and stability of use over time.MethodsWe analyzed baseline and one-year follow-up survey data (Fall 2018-2019) among 3,006 young adults (ages 18-34) across six metropolitan areas (Atlanta, Boston, Minneapolis-St. Paul, Oklahoma City, San Diego, Seattle). Measures included marijuana use frequency and mode, sociodemographics, other substance use, and social influences.ResultsParticipants' rated the following modes of use as: least harmful/addictive: topicals, oral pills, joint/bowl; most socially acceptable: joint/bowl, edibles/beverages, vaporized; and most harmful/addictive and least acceptable: wrapped, vaped, or waterpipe/bong with tobacco. Baseline past-month use prevalence was 39.2% (n = 1,178). Most frequent use mode was smoking (joints/bowls/cigar papers; 54.0%), vaping (21.8%), via pipe/bong (15.1%), and ingesting (9.1%). Multinomial logistic regression indicated that participants in states with legalized marijuana retail were at greater odds for using via modes other than smoking; participants more frequently using were at greater odds for using via pipe/bong (vs. smoking) (ps < .001). Regarding most frequent mode across time, most consistent was pipe/bong (53.3%), followed by smoking (49.3%), vaping (44.5%), and ingesting (32.9%). Past-month abstinence at follow-up was most common among those originally ingesting (34.3% abstinent), followed by smoking (23.6%), vaping (18.8%), and pipe/bong (14.8%).ConclusionsOngoing surveillance is needed to understand marijuana use patterns over time across different user groups (particularly by mode) and to inform interventions promoting abstinence.
| S-EPMC8693385 | biostudies-literature
Project description:The majority of young adults who use alcohol and marijuana sometimes use the two substances simultaneously. Understanding why young adults engage in simultaneous alcohol and marijuana (SAM) use may inform interventions and help offset negative consequences. To date, research has not yet examined motives for SAM use. The current study tested a 26-item measure of motives for SAM use in a community sample of young adults to identify the factor structure and to evaluate associations of subscales of SAM motives with alcohol and marijuana motives and substance use. Young adults from the Seattle metropolitan area (N=286; 58% female, 67% White/Caucasian) were asked about their motives for using alcohol, marijuana, and SAM as well as their use of alcohol and marijuana and related consequences in the past month. Exploratory factor analysis with promax rotation identified four factors to characterize motives for SAM use: (1) conformity (8 items, ?=0.87, e.g., "to fit in with a group I like," "pressure from others"), (2) positive effects (6 items, ?=0.88, e.g., "cross-faded effects are better," "to get a better high") (3) calm/coping (3 items, ?=0.77, e.g., "to calm me down," "to cope with anxiety"), and (4) social (5 items, ?=0.78, e.g., "because it is customary on special occasions," "as a way to celebrate"). Results revealed that alcohol, marijuana, and SAM motives were moderately correlated. Even after controlling for alcohol or marijuana motives, SAM motives were associated with SAM use and marijuana use/consequences (but not alcohol use/consequences).
| S-EPMC5614866 | biostudies-literature
Project description:Background and objectivesMarijuana use has become more widely accepted in the United States and has been legalized in many areas. Although it is biologically plausible that marijuana could affect kidney function, epidemiologic data are lacking.Design, setting, participants, & measurementsWe conducted a cohort study among young adults with preserved eGFR (i.e., eGFR?60 ml/min per 1.73 m2) using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. At scheduled examinations occurring every 5 years and starting at study year 10 (calendar years, 1995-1996), cystatin C was collected over a 10-year period, and urine albumin-to-creatinine ratio was collected over a 15-year period. We investigated the cross-sectional association between current and cumulative marijuana use (in marijuana-years; one marijuana-year equals 365 days of marijuana use) and eGFR by cystatin C (eGFRcys) at year 10. In longitudinal analyses, we investigated the association between cumulative marijuana use and eGFRcys change and rapid (?3%/year) eGFRcys decline over two 5-year intervals and prevalent albuminuria (urine albumin-to-creatinine ratio ?30 mg/g) over a 15-year period.ResultsPast or current marijuana use was reported by 83% (3131 of 3765) of the cohort, and the mean eGFRcys was 111 ml/min per 1.73 m2 at year 10. Over the following 10 years, 504 had rapid eGFRcys decline, and over the following 15 years, 426 had prevalent albuminuria. Compared with no use, daily current use and ?5 marijuana-years of cumulative use were associated with lower eGFRcys at year 10: -4.5% (95% confidence interval, -8.1 to -0.7%; P=0.02) and -3.0% (95% confidence interval, -5.6 to -0.4%; P=0.03), respectively. Marijuana use was not significantly associated with eGFRcys change, rapid eGFRcys decline, or prevalent albuminuria.ConclusionsAlthough we identified a modest cross-sectional association between higher marijuana exposure and lower eGFRcys among young adults with preserved eGFR, our findings were largely null and did not demonstrate a longitudinal association between marijuana use and eGFRcys change, rapid eGFRcys decline, or prevalent albuminuria.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2017_08_24_CJASNPodcast_17_10.mp3.
| S-EPMC5628707 | biostudies-literature
Project description:BACKGROUND:Substance abuse is increasingly prevalent among young adults, but data on cardiovascular outcomes remain limited. OBJECTIVES:The objectives of this study were to assess the prevalence of cocaine and marijuana use in adults with their first myocardial infarction (MI) at ≤50 years and to determine its association with long-term outcomes. METHODS:The study retrospectively analyzed records of patients presenting with a type 1 MI at ≤50 years at 2 academic hospitals from 2000 to 2016. Substance abuse was determined by review of records for either patient-reported substance abuse during the week before MI or substance detection on toxicology screen. Vital status was identified by the Social Security Administration's Death Master File. Cause of death was adjudicated using electronic health records and death certificates. Cox modeling was performed for survival free from all-cause and cardiovascular death. RESULTS:A total of 2,097 patients had type 1 MI (mean age 44.0 ± 5.1 years, 19.3% female, 73% white), with median follow-up of 11.2 years (interquartile range: 7.3 to 14.2 years). Use of cocaine and/or marijuana was present in 224 (10.7%) patients; cocaine in 99 (4.7%) patients, and marijuana in 125 (6.0%). Individuals with substance use had significantly lower rates of diabetes (14.7% vs. 20.4%; p = 0.05) and hyperlipidemia (45.7% vs. 60.8%; p < 0.001), but they were significantly more likely to use tobacco (70.3% vs. 49.1%; p < 0.001). The use of cocaine and/or marijuana was associated with significantly higher cardiovascular mortality (hazard ratio: 2.22; 95% confidence interval: 1.27 to 3.70; p = 0.005) and all-cause mortality (hazard ratio: 1.99; 95% confidence interval: 1.35 to 2.97; p = 0.001) after adjusting for baseline covariates. CONCLUSIONS:Cocaine and/or marijuana use is present in 10% of patients with an MI at age ≤50 years and is associated with worse all-cause and cardiovascular mortality. These findings reinforce current recommendations for substance use screening among young adults with an MI, and they highlight the need for counseling to prevent future adverse events.
| S-EPMC6495189 | biostudies-literature
Project description:INTRODUCTIONGiven the relatively limited literature regarding risk factors for progression of alternative tobacco and marijuana use, this study examined initially-used tobacco or marijuana products and psychosocial risk factors such as adverse childhood events (ACEs), mental health (depression, ADHD), and parental substance use, in relation to young adult lifetime and current (past 30-day) tobacco and marijuana use.METHODSUsing cross-sectional data from a 2014–2016 study of 3418 young adult college students in Georgia, we analyzed lifetime and current use of various tobacco products (cigarettes, cigar products, smokeless tobacco, e-cigarettes, hookah) and marijuana among lifetime tobacco or marijuana users (N=1451) in relation to initially-used product as well as sociodemographic characteristics and psychosocial risk factors.RESULTSMultivariable analyses indicated that more products ever used correlated with cigarettes being first used (vs cigars, B=-0.66; e-cigarettes, OR=-1.33; hookah, B=-0.99; and marijuana, B=-1.05; p<0.001), as well as being older (B=0.06), male (B=-0.72) and White (vs Black, B=-0.30; or Asian, B=-0.60), more adverse childhood events (ACEs, B=0.07), and parental marijuana use (B=0.47; p<0.05). Currently-used products correlated with cigarettes being first used (vs cigars, B=-0.18; e-cigarettes, B=-0.37; and hookah, B=-0.18; p<0.05), being younger (B=-0.04), male (B=-0.15), more depressive symptoms (B=0.01), and parental marijuana use (B=0.40; p<0.05). Current cigarette, smokeless tobacco, hookah and marijuana use demonstrated specificity to initially-used products.CONCLUSIONSInitially-used products, specifically cigarettes, with well-documented and communicated risks, correlated with using more products subsequently among young adults, underscoring needed research on such risks and risk communication, and early intervention strategies.
| S-EPMC7291917 | biostudies-literature
Project description:BackgroundCoronary artery disease (CAD) occurs at younger age in India but only a limited number of studies have evaluated risk factors and management status. This is a multisite observational registry to assess risk factors and treatment patterns in young patients presenting with acute coronary syndrome (ACS) and stable ischemic heart disease (IHD).MethodsWe recruited 997 young patients (men <55, women <65y) presenting with ACS or stable IHD successively at 22 centers across India. Details of baseline risk factors and management status were obtained. Descriptive statistics are reported.ResultsMean age of participants was 49.1±8y, 72% were men and 68% had ACS. Family history of CAD was in 50%, diabetes 44%, hypertension 49%, history of dyslipidemia 11%, smoking/tobacco use 39%, and sedentary habits in 20%. 1.3% had "possible familial hypercholesterolemia". Metabolic risk factors (high BMI, diabetes and hypertension) were significantly greater in women (p<0.01). Women were older at diagnosis of CAD and presented more often with non-ST elevation ACS. In the study cohort antiplatelet use was in 85%, beta-blockers 38%, statins 63% and ACE inhibitors/ARBs in 41% while in ACS patients it was 80.5%, 54.6%, 80.8% and 40.8%, respectively. 35.9% patients underwent percutaneous coronary intervention while coronary bypass surgery was performed in 10.4%.ConclusionsConventional risk factors including family history continue to play a pivotal role in premature CAD in Indians. Women have more of metabolic risk factors, present at a later age and have non-ST elevation ACS more often. There is a need to focus on improving use of evidence-based drug therapies and interventions.
| S-EPMC5414957 | biostudies-literature