Medical cannabis tied to higher risk for new heart rhythm disorders

People with chronic pain who use medical cannabis have a higher risk for heart rhythm disorders versus nonusers, according to a study presented at the European Society of Cardiology Congress 2022, held from Aug. 26 to 29 in Barcelona, Spain.

Anders Holt, M.D., from Gentofte University Hospital in Hellerup, Denmark, and colleagues examined the risk for new-onset arrhythmias (tachy- or bradyarrhythmia and conduction disorders), acute coronary syndrome (ACS), and heart failure following use of prescribed medical cannabis. The analysis included a cohort of patients with chronic pain who were followed from 2018 to 2021, with those initiating first-time treatment with medical cannabis (4,562 patients) matched 1:10 to controls within the cohort.

According to the abstract submitted for the presentation, the risk for new-onset arrhythmia was elevated among exposed patients versus nonexposed patients, with 180-day absolute risks of 0.71 percent versus 0.43 percent, yielding a risk ratio of 1.64 (95 percent confidence interval, 1.04 to 2.23). The risk for new-onset ACS and heart failure was not higher for those initiating cannabis versus those not initiating cannabis (180-day absolute risks of 0.13 versus 0.11 percent and 0.13 versus 0.14 percent, respectively, yielding risk ratios of 1.2 [95 percent confidence interval, 0.3 to 2.1] and 0.9 [95 percent confidence interval, 0.2 to 1.7], respectively).

"Since medical cannabis is a relatively new drug for a large market of patients with chronic pain, it is important to investigate and report serious side effects," a coauthor said in a statement. "Even though the absolute risk difference is small, both patients and physicians should have as much information as possible when weighing up the pros and cons of any treatment."

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