Does marijuana help with hypertension?

Marijuana Does Not Help with Hypertension and May Actually Increase Blood Pressure

Marijuana is not recommended for treating hypertension as it may actually increase blood pressure in some users and poses cardiovascular risks that outweigh any potential benefits.

Effects of Marijuana on Blood Pressure

Acute and Chronic Effects

• Marijuana causes an acute increase in blood pressure and heart rate shortly after use 1
• While some studies show a potential reduction in blood pressure in older adults (5.0 mmHg systolic and 4.5 mmHg diastolic) 2, more comprehensive population data indicates increased risks:
  • Heavy marijuana users have 1.80 higher odds of elevated blood pressure compared to non-users 3
  • Marijuana use is an independent predictor of heart failure and cerebrovascular accidents even after adjusting for other cardiovascular risk factors 4

Withdrawal Effects

• Abrupt cessation of heavy cannabis use can cause clinically significant increases in blood pressure (up to 22.8 mmHg systolic and 12.3 mmHg diastolic) 5
• This withdrawal effect poses additional risks for patients with pre-existing hypertension

Guidelines on Substances That Increase Blood Pressure

The 2020 International Society of Hypertension guidelines specifically identify illicit drugs among substances that may increase blood pressure or interfere with antihypertensive medications 1. These guidelines recommend:

• Screening all hypertensive patients for substances that may increase blood pressure
• Considering reduction or elimination of substances that raise blood pressure
• Implementing lifestyle modifications as the first line of antihypertensive treatment

Cardiovascular Risks Associated with Marijuana

Marijuana use is associated with increased risk of:

• Heart failure (odds ratio = 1.1) 4
• Cerebrovascular accidents (odds ratio = 1.24) 4
• Elevated blood pressure, particularly with heavy use 3

Recommended Approaches for Hypertension Management

Instead of marijuana, guidelines recommend the following evidence-based approaches for managing hypertension:

1. Lifestyle modifications 1:

   • Weight reduction in overweight individuals
   • Regular physical activity
   • Reduction of salt intake
   • Moderation of alcohol consumption
   • Smoking cessation
   • Increased fruit and vegetable intake

2. Pharmacological treatment when indicated 1:

   • Thiazide diuretics
   • Angiotensin-converting enzyme inhibitors
   • Angiotensin II receptor blockers

Common Pitfalls and Caveats

• Conflicting research: While some small studies suggest potential blood pressure reduction with marijuana 2, larger population studies and guidelines indicate increased cardiovascular risks 3, 4
• Self-medication risk: Patients may attempt to self-medicate with marijuana without medical supervision
• Withdrawal effects: Abrupt cessation of regular marijuana use can cause significant blood pressure increases 5
• Drug interactions: Marijuana may interact with prescribed antihypertensive medications
• Legal and quality concerns: Variable potency and composition of non-prescribed marijuana products

Conclusion

Current medical evidence and guidelines do not support the use of marijuana for treating hypertension. The potential cardiovascular risks, including increased blood pressure (particularly with heavy use), heart failure, and stroke risk, outweigh any potential benefits. Patients should be counseled to follow evidence-based approaches for hypertension management, including lifestyle modifications and appropriate pharmacological treatment when indicated.