The use of cannabis (marijuana) is now commonplace, particularly in those states that have not only legalized it for medical use, but also for recreational use.  Large scale data on the detrimental effects of marijuana and the various methods in which it is used is not available because controlled trials using this drug are illegal.  Of recent concern is the effect marijuana may have on the cardiovascular system.  Smoking marijuana exposed the smoker to many of the cardio toxic compounds produced by smoking tobacco.

    A review of the available data indicates that smoking marijuana is one of the top three triggers of myocardial infarction (heart attack) and 23 studies have linked marijuana use to an increased risk of acute coronary syndrome. A study of 2.5 million marijuana users showed an increase in abnormal heart rhythms, and of those patients that used marijuana in the past year, there was a 3.5 fold increase in the incidence of cerebrovascular events (stroke). Marijuana may also effect many cardiovascular medications, including beta-blockers, statins, calcium channel blockers and drugs to control heart rhythms, to mention just a few.

    It is now recommended that physicians ask patients about their cannabis use for either medical or recreational purposes.  In states where marijuana is still considered illegal, or is not approved for recreational use, many patients may be reluctant to bring up their personal habits. It is also important for patients to bring up their marijuana use if not asked, since it has important medical consequences.