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Cannabis & Heart Disease


Dear Cannabis RN,

I read a recent study which suggested that cannabis can be bad for people with heart disease. My husband has afib {atrial fibrillation}. He also had a heart attack and a stent placed in February of 2019. Is cannabis bad for people with heart disease?

-A concerned wife



Wow what a great question! Heart disease is the most common cause of death for Americans and cannabis is the fastest growing consumer product in the US. Due to the sheer number of people’s health potentially affected by this information, we are wise to discuss the issue. Before we dive in, a few clarifications: this article does not represent medical advice, it is for informational purposes only. heart disease is an umbrella term that has within it many different conditions, so for clarity's sake, we're going to talk primarily about the disease that causes many heart attacks: coronary artery disease. Instead of asking if cannabis is harmful for people with heart disease, let us pose a different question: Can cannabis be a gateway to wellness for individuals dealing with heart disease, and if so, how?


HEART ATTACKS, STATINS, AND THE GREAT CHOLESTEROL MYTH

When I worked at a large cardiology practice associated with a hospital, I had a patient named Roy who was in his 60s and had suffered a heart attack. In advance of his annual appointment he sent me an email asking me to print out a research study on coronary artery disease and give it to his physician to read.  

 I replied to the email and told him I would be happy to have her to look at it. 

Unfortunately, the cardiologist wasn’t very keen on his request.

I can still see her raised eyebrows and quizzical expression on her face as she laughed and replied, “Yeah right like I have time to read a 30-page research study prior to his 15-minute appointment.” She walked away and dropped the paper in the recycling.


I fished it out, took it home and read it instead. 

What I read turned my world upside down and called into question many of the underlying assumptions about heart disease that I had taken for granted. It completely shattered my confidence in how I was caring for and educating patients who had cardiovascular disease.  


As healthcare providers, we are taught to accept the established paradigm without question, which presents the cause of cardiovascular disease as if it’s beyond question. In actuality, the science has continued to evolve so that decades after research first commenced, we have an updated understanding. After reading this study (and dozens of others after), I realized that contrary to what I learned in school, and contrary to the manner in which I was being urged to practice, one of the established risk factors-high cholesterol- was less of a cause and more of a symptom caused by the body’s attempt to heal itself from chronic unchecked inflammation.

The study concluded that one of the mainstays of heart attack treatment and prevention, lowering cholesterol through using of statin therapy, was not helpful in reducing death from heart disease. Quite the opposite, it showed an association between lower cholesterol levels and higher risk of death, especially in people over 65. 


I assumed, like most healthcare providers that cholesterol was a risk factor and potential cause of heart attacks. For decades, we have been educating people that cholesterol was a “bad substance” that could clog the arteries of the heart and cause heart attacks. Federal agencies and healthcare institutions supported this view that eating cholesterol was bad for your health.