Caffeine & Marijuana effects on the Heart
Caffeine is a worldwide low-grade stimulant that, when used rationally, has been shown useful in cognitive focusing, and motivation, improved mood and outlook. Many cultures have used caffeine in forms of teas and coffees for centuries to help with concentration and spirituality, and for its mind altering properties. More recently considered a vice, it has enjoyed more widespread notoriety with the likes of coffee houses such as Starbucks and teashops such as Teavana. Like some vices or luxuries, it can be overused and lead to side-effects.
Many people, including yours truly, are happy to note the morning requirement for the “get up and go” feeling of that AM cup, as well as a few more during the day (if needed) to help with productivity and focus. When we detoxify off of heavy caffeine intake, many of us have experienced the relatively mild withdrawal symptoms.
As it relates to heart disease, more data are noting the positive benefits of caffeine as well as antioxidants in teas and coffee when consumed in appropriate amounts. Less diabetes and major adverse cardiac effects, less weight gain and decreased obesity rates, reduced Alzheimer’s dementia, and ever fewer gallstones have been noted with several cups of your favorite tea/coffee beverage (as long as it’s not over-adulterated with sugar-sweetened additives).
Moderate and regular coffee drinking (2 and perhaps 3 caffeinated beverages daily)have also been shown to reduce the risk of developing type 2 diabetes and to lower risk of heart failure. It has also been reported improved awareness & alertness, suggestion of less depression and more motivational behavioral, and perhaps less obesity (with black coffee and not caffeine infused nutritionally barren colas/high energy diet supplement drinks).
However, heavy coffee consumption can contribute to worse heart failure outcomes. Overall, neutral to possibly beneficial outcomes were seen with regard to CAD, HF, CVA, and hypertension as well as possible neurodegenerative disorders in one study. Possible benefits need to be weighed against side effects such as tremors, insomnia, hyperactive behavior, arrhythmias, and palpitations.
In addition, over-caffeinating i.e. ‘red bull’ and high-caffeine weight loss products have been shown to lead to arrhythmias and sudden cardiac death. Over the years, I too have seen patients in the ER from arrhythmias and CNS overdoses of their recreational/medicinal use.
As for marijuana, a recent analysis has revealed a myocardial infarction effect and variable blood pressure effects, as well as the lung toxin effects of inhaled smoke. Short-term use has been associated with peripheral vasodilation, postural hypotension, and triggering sinus tachycardia and enhanced cardiac output. As a result and, for unclear but hypothesized chemical reasons, serving as a possible angina precipitant, it has recently been associated with higher MI risk.
Also, small studies have made a connection with THC and atrial fibrillation in young males with structurally normal hearts. Suggestions of elevated cerebrovascular events of TIA and ischemic stroke have also been put forth as marijuana-related elevated risk. De-motivational but relaxed frame of mind and more spirituality and analgesia have been well-popularized with THC use . Again, it’s important to note that associations are not causations. It’s worth noting that beta blockers and IV hydration could be first line treatments for those patients presenting with palpations and a hypertensive BP response to either caffeine or THC overdose in the proper clinical setting.
As physicians, many of our patients have confided in us about their recreational or medicinal use of THC, as well as caffeine use for not just their AM “cup of joe”. I have chosen the ‘moderation approach’ to caffeinated beverage recommendation for my otherwise healthier patients, and limited caffeine to decaf beverage use for my true cardiac patients. From a cardiovascular standpoint, I tell everyone tobacco smoking as well as THC smoking and other THC-use, cessation is best. I’m not qualified to comment on other uses of THC.
Rimma Sherman MD
