Habitual cannabis use is associated with altered cardiac mechanics and arterial stiffness, but not endothelial function in young healthy smokers

Cigarette smoking is among the most detrimental behaviors to cardiovascular health, resulting in arterial stiffening, endothelial dysfunction, and structural/functional alterations to the myocardium. Similar to cigarettes, cannabis is commonly smoked, and next to alcohol, is the most commonly used recreational substance in the world. Despite this, little is known about the long-term cardiovascular effects of smoking cannabis. This study explored the associations of cardiovascular structure and function with cannabis use in ostensibly healthy young participants (n = 35). Using echocardiography, carotid-femoral pulse wave velocity (cfPWV), and brachial flow-mediated dilation (FMD), we performed a cross-sectional assessment of cardiovascular function in cannabis users (n = 18) and controls (n = 17). There were no differences in cardiac morphology or traditional resting measures of systolic or diastolic function between cannabis users and controls (all P > 0.05), whereas cannabis users demonstrated reduced peak apical rotation compared with controls (cannabis users: 5.5 +/- 3.8, controls: 9.6 +/- 1.5; P = 0.02). Cannabis users had higher cfPWV compared with controls (cannabis users: 5.8 +/- 0.6 m/s, controls: 5.3 +/- 0.7 m/s; P = 0.05), whereas FMD was similar between cannabis users and controls (cannabis users: 8.3 +/- 3.3%, controls: 6.8 +/- 3.6%; P = 0.7). Young, healthy, and cannabis users demonstrate altered cardiac mechanics and greater aortic stiffness. Further studies should explore causal links between cannabis smoking and altered cardiovascular function. NEW & NOTEWORTHY Recreational cannabis is the most widely used substance in the world, other than alcohol. Yet, the effects of cannabis use on cardiovascular function and health are not well understood. Our cross-sectional data demonstrate that young, ostensibly healthy cannabis users have greater arterial stiffness and altered cardiac mechanics compared to nonusers. These findings suggest that cannabis users may be at greater risk of the development of future cardiovascular disease.