Abstract P200: The Heart and Cannabis Cohort (THC Cohort): Associations Between Cannabis Use and Cardiovascular Health at Cohort Inception

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Salomeh Keyhani ◽  
Beth Cohen ◽  
Dawn M Bravata ◽  
Marzieh Vali ◽  
Katherine Hoggatt ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Use ◽  
Systolic Blood Pressure ◽  
Prospective Cohort ◽  
Cardiovascular Events ◽  
Cardiovascular Health ◽  
Beta Blockers ◽  
Cannabis Use ◽  
Free Text ◽  
Primary Care Visit

Background: Cannabis use may adversely impact cardiovascular health through the smoking of particulate matter or through the potential adverse hemodynamic effects of Tetrahydrocannabinol (THC). We assembled a prospective cohort of older Veterans with coronary artery disease (CAD) to examine the effects of cannabis use on: medication use, blood pressure control, and cardiovascular events. Methods: We identified all Veterans 65 to 67 years of age in the Veterans Health Administration (VA) with CAD using national VA data. We included Veterans with at least 1 primary care visit in the prior 2 years. We used text processing to identify mentions of cannabis use (e.g., marijuana, cannabis) in the free text of the medical record and preliminarily categorized patients as potential users and non-users. We then randomly selected patients from each group and performed in-depth telephone health interviews to ascertain cannabis use (e.g., frequency, route), and other important health behaviors and measures, including tobacco and alcohol use, physical activity, depression, and post-traumatic stress disorder. We collected baseline information on blood pressure and comorbid conditions from national VA data. Associations of current cannabis use (past 30 days) with receipt of appropriate medications (i.e., statins, antiplatelets, and beta blockers) were evaluated with multivariable logistic regression. Using linear regression, we also examined associations of current marijuana use with systolic blood pressure and body mass index (BMI). Results: We assembled 792 current cannabis users and 2098 current non-users with CAD. At baseline, the cohort’s mean age was 66 years; 98% were male, 75% white and 18% black. Smoking was the predominant form of cannabis use (90%). The cannabis users had higher use of tobacco cigarettes (42% vs 25%), heavy drinking (31% vs 18%) and other drug use (2.8% vs 1.3%) than non-users (p<0.001). In contrast, cannabis users had lower prevalence of diabetes (36% vs 49%) and hyperlipidemia (76% vs 81%) than non-users (p<0.001). After adjusting for baseline sociodemographic, tobacco, alcohol, drug use, and mental health factors, cannabis use was associated with lower odds of receiving statins (OR 0.74, 95% CI 0.62 to 0.89), antiplatelets (OR 0.68, 95% CI 0.56 to 0.83) and beta blockers (OR 0.71, 95% CI 0.59 to 0.85). Current cannabis use was also associated with higher systolic blood pressure (2 mmHg, 95% CI (0.67, 3.465)) and lower BMI (-1.3 kg/m 2 , 95%CI (-1.87, -0.88)) after adjusting for baseline factors. Conclusions: Cannabis use is associated with lower receipt of guideline-recommended cardiovascular medications among Veterans with CAD. Cannabis use is also associated with higher systolic blood pressure, but lower BMI. Future analyses of this prospective cohort will determine whether cannabis use has independent associations with cardiovascular events.

scholarly journals Effect of visit-to-visit blood pressure variability on cardiovascular events in populations with different body mass indexes: a prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035836
Author(s):  
Haojia Chen ◽  
Youren Chen ◽  
Weiqiang Wu ◽  
Jianhuan Huang ◽  
Zekai Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Systolic Blood Pressure ◽  
Prospective Cohort ◽  
Cardiovascular Events ◽  
Blood Pressure Variability ◽  
Risk Model ◽  
Normal Weight ◽  
Weight Group ◽  
Body Mass Indexes

ObjectiveThis study was performed to explore the effects of visit-to-visit blood pressure variability (BPV) on cardiovascular events (CVEs) in people with various body mass indexes (BMIs).DesignProspective cohort study.SettingThe average real variability of systolic blood pressure (ARVSBP) was the indicator for visit-to-visit BPV. The participants were divided into three groups: normal weight, overweight and obesity. We further divided these groups into four subgroups based on the ARVSBP. A Cox regression model was used to calculate the HRs of the ARVSBP on CVEs in the same and different BMI groups. Additionally, a competitive risk model was used to calculate the HRs of the ARVSBP on CVEs in the same BMI group.ParticipantsIn total, 41 043 individuals met the inclusion criteria (no historical CVEs or tumours, no incidence of CVEs or tumours and no death during the four examinations) and had complete systolic blood pressure and BMI data.ResultsA total of 868 CVEs occurred. The cumulative incidence of CVEs increased as ARVSBP rose in both the normal weight and overweight groups. In same BMI groups, the risk of CVEs significantly increased as ARVSBP increased only in the normal weight group (highest quartiles of ARVSBP: HR (95% CI) 2.20 (1.46–3.31)). In the different BMI groups, the risk of CVEs in the ARVSBP subgroup in each BMI group was higher than that the least quintile of ARVSBP in the normal weight group (highest quartiles of ARVSBP in obesity: HR (95% CI) 2.28 (1.47–3.55)). The result of the competitive risk model did not change.ConclusionsAs BMI and ARVSBP increase, the risk of CVEs increases. However, the risk of visit-to-visit BPV on CVEs varies in different BMI groups, especially in people of normal weight.Trial registration numberCHiCTR-TNC1100 1489.

scholarly journals The Heart and Cannabis (THC) Cohort: Differences in Baseline Health and Behaviors by Cannabis Use

2022 ◽  
Author(s):  
Salomeh Keyhani ◽  
Beth E. Cohen ◽  
Marzieh Vali ◽  
Katherine J. Hoggatt ◽  
Dawn M. Bravata ◽  
...  
Keyword(s):  
Cohort Study ◽  
Drug Use ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cardiovascular Health ◽  
Cannabis Use ◽  
Behavioral Risk ◽  
Cohort Differences ◽  
Multivariable Analyses ◽  
Artery Disease

Abstract Background Evidence on the cardiovascular health effects of cannabis use is limited. We designed a prospective cohort study of older Veterans (66 to 68 years) with coronary artery disease (CAD) to understand the cardiovascular consequences of cannabis use. We describe the cohort construction, baseline characteristics, and health behaviors that were associated with smoking cannabis. Objective To understand the cardiovascular consequences of cannabis use. Design We designed a prospective cohort study of older Veterans (66 to 68 years) with CAD. Participants A total of 1,015 current cannabis smokers and 3,270 non-cannabis smokers with CAD. Main Measures Using logistic regression, we examined the association of baseline variables with smoking cannabis in the past 30 days. Results The current cannabis smokers and non-current smokers were predominantly male (97.2% vs 97.1%, p=0.96). Characteristics associated with recent cannabis use in multivariable analyses included lack of a high school education (odds ratio [OR] 2.15, 95% confidence interval [CI]: 1.10 to 4.19), financial difficulty (OR 1.47, 95% CI: 1.02 to 2.11), tobacco use (OR 3.02, 95% CI: 1.66 to 5.48), current drug use (OR 2.82, 95% CI: 1.06 to 7.46), and prior drug use (OR 2.84, 95% CI: 2.11 to 3.82). In contrast, compared to individuals with 0 to 1 comorbid conditions, those with 5 chronic conditions or more (OR 0.43, 95% CI: 0.27 to 0.70) were less likely to smoke cannabis. Conclusions In this older high-risk cohort, smoking cannabis was associated with higher social and behavioral risk, but with fewer chronic health conditions.

scholarly journals Hypertensive response in exercise - a tool to predict stroke risk?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TE Graca Rodrigues ◽  
N Cunha ◽  
P Silverio-Antonio ◽  
P Couto Pereira ◽  
B Valente Silva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Exercise Test ◽  
Cardiovascular Events ◽  
Protective Factor ◽  
Independent Predictor ◽  
Stress Test ◽  
Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Introduction There is some evidence suggesting that exaggerated hypertensive response to exercise (HRE) may be associated with higher risk of future cardiovascular events, however the relationship between systolic blood pressure (SPB) during exercise test and stroke is not fully understood. Purpose To evaluate the ability to predict the risk of stroke in patients with HRE in exercise test. Methods Single-center retrospective study of consecutive patients submitted to exercise test from 2012 to 2015 with HRE to stress test. HRE was defined as a peak systolic blood pressure (PSBP) &gt; 210 mmHg in men and &gt; 190 mmHg in women, or a rise of the SBP of 60 mmHg in men or 50 mmHg in women or as a diastolic blood pressure &gt; 90 mmHg or a rise of 10 mmHg. Patient’s demographics, baseline clinical characteristics, vital signs during the stress test and the occurrence of stroke during follow-up were analysed Results We included 458 patients with HRE (76% men, 57.5 ± 10.83 years). The most frequent comorbidities were hypertension (83%), dyslipidaemia (61%), previously known coronary disease (32%), diabetes (28%) and smoking (38%). Atrial fibrillation was present in 5.9% of patients. During a mean follow-up of 60 ± 2 months, the incidence of stroke was 2.1% (n = 8), all with ischemic origin. Considering the parameters analysed on exercise test, only PSBP demonstrated to be an independent predictor of stroke (HR 1.042, CI95% 1.002-1.084, p = 0.039,) with moderate ability to predict stroke (AUC 0.735, p = 0.0016) with a most discriminatory value of 203 mmHg (sensibility 56%, specify 67%). Regarding baseline characteristics, after age, sex and comorbidities adjustment, previously controlled hypertension was found to be an independent protective factor of stroke (OR 4.247, CI 95% 0.05-0.9, p = 0.036) and atrial fibrillation was an independent predictor of stroke occurrence (HR 8.1, CI95% 1.4-46.9, p = 0.018). Atrial fibrillation was also associated with hospitalization of cardiovascular cause and major cardiovascular events occurrence (mortality, coronary syndrome and stroke). Baseline SBP was associated with atrial fibrillation development (p = 0.008). Conclusion According to our results, PSBP during exercise test is an independent predictor of stroke occurrence and should be considered as a potencial additional tool to predict stroke occurrence, particularly in high risk patients. The identification of diagnosed hypertension as a protective factor of stroke may be explained by the cardioprotective effect of antihypertensive drugs.

scholarly journals Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Javier I. Ottaviani ◽  
Abigail Britten ◽  
Debora Lucarelli ◽  
Robert Luben ◽  
Angela A. Mulligan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Vascular Function ◽  
Cardiovascular Health ◽  
Vascular Diseases ◽  
Inverse Association ◽  
Cvd Risk ◽  
Lower Systolic Blood Pressure ◽  
Cross Sectional ◽  
Salt Reduction

Abstract Flavan-3-ols are a group of bioactive compounds that have been shown to improve vascular function in intervention studies. They are therefore of great interest for the development of dietary recommendation for the prevention of cardio-vascular diseases. However, there are currently no reliable data from observational studies, as the high variability in the flavan-3-ol content of food makes it difficult to estimate actual intake without nutritional biomarkers. In this study, we investigated cross-sectional associations between biomarker-estimated flavan-3-ol intake and blood pressure and other CVD risk markers, as well as longitudinal associations with CVD risk in 25,618 participants of the European Prospective Investigation into Cancer (EPIC) Norfolk cohort. High flavan-3-ol intake, achievable as part of an habitual diet, was associated with a significantly lower systolic blood pressure (− 1.9 (− 2.7; − 1.1) mmHg in men and − 2.5 (− 3.3; − 1.8) mmHg in women; lowest vs highest decile of biomarker), comparable to adherence to a Mediterranean Diet or moderate salt reduction. Subgroup analyses showed that hypertensive participants had stronger inverse association between flavan-3-ol biomarker and systolic blood pressure when compared to normotensive participants. Flavanol intake could therefore have a role in the maintenance of cardiovascular health on a population scale.

scholarly journals Systolic Blood Pressure Levels Among Adults With Hypertension and Incident Cardiovascular Events

2014 ◽  
Vol 174 (8) ◽  
pp. 1252 ◽  
Author(s):  
Carlos J. Rodriguez ◽  
Katrina Swett ◽  
Sunil K. Agarwal ◽  
Aaron R. Folsom ◽  
Ervin R. Fox ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Cardiovascular Events

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

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