Earl Morris, PhD
University of Florida
Co-Authors: Fatemeh Mehrabi1, Sebastian Jugl1, Amie J Goodin1
1University of Florida
Background: Medical cannabis use is increasing, and prior research suggests its use may be associated with a broad range of adverse cardiovascular (CV) outcomes, and the American Heart Association has emphasized the need for observational research to better understand the epidemiology of medical cannabis and its usage among individuals with pre-existing CV disease.
Objective: To assess whether pre-existing CV disease is associated with differences in demographic and clinical characteristics among a population of Florida Medicaid beneficiaries dispensed medical cannabis.
Methods: We used data from the Medical Marijuana clinical Outcomes RepositorY (MEMORY), which contains Medical Marijuana Use Registry data linked to Florida Medicaid claims. We identified beneficiaries newly dispensed medical cannabis who were aged 19-65 with ≥ 365 days of continuous Medicaid enrollment. Next, we assessed for pre-existing CV disease during the 365-day baseline period prior to first medical cannabis dispensing, which was defined as a composite of acute myocardial infarction, atrial fibrillation, heart failure, hypertension, ischemic heart disease, peripheral vascular disease, stroke/transient ischemic attack, or unstable angina. We compared differences in demographic and clinical characteristics using Chi-squared tests or t-tests, where applicable.
Results: We identified 70,968 medical cannabis new users (63.2% female; 53.3% non-Hispanic white; 16.8% non-Hispanic black; 16.2% Hispanic; mean age 35.0) who met eligibility criteria for our study. Of those, 4,554 (6.4%) had pre-existing CV disease, with hypertension (5.9%), ischemic heart disease (1.0%), and heart failure (0.7%) occurring most frequently. Medical cannabis new users with pre-existing CV disease were more likely to be older (mean age: 46.2 vs. 34.3, p<0.0001), male (41.8% vs. 36.4%, p<0.0001), and non-Hispanic (90.5% vs. 82.4%, p<0.0001), compared to those without CV disease.
Conclusions: We found that more than one out of every fifteen Florida Medicaid beneficiaries newly initiating medical cannabis had pre-existing CV disease. More research is needed to better understand medical cannabis epidemiology and associated risks among those with CV disease to optimize medication safety and improve outcomes.