The Effects of Cannabinoids and Route of Cannabis Administration on Subclinical Cardiovascular Disease Risk

大麻素和大麻给药途径对亚临床心血管疾病风险的影响

• 批准号: 10030174
• 负责人: Denise Christina Vidot
• 金额: $ 69.74万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10030174
• 关键词: Acute; Address; Age; Alcohol or Other Drugs use; Anti-Inflammatory Agents; Antioxidants; Arrhythmia; Arteries; Blood; Blood Pressure; Blood Vessels; Buffers; Cannabidiol; Cannabinoids; Cannabis; Cardiovascular Diseases; Cardiovascular system; Cigarette; Cohort Studies; Collaborations; Diabetes Mellitus; Disease; Dose; Electronics; Energy Intake; Epidemiologist; Equipoise; Ethnic Origin; Event; Fasting; Fibrinogen; Forensic Medicine; Glucose; Goals; Health; Heart Rate; Heart failure; High Prevalence; Income; Insulin; Investigation; Joints; Lipids; Matched Group; Measurement; Measures; Mediating; Metabolic syndrome; Myocardial Infarction; National Heart, Lung, and Blood Institute; Obesity; Oxidants; Paper; Participant; Patient Self-Report; Phase; Physiologic pulse; Pilot Projects; Plant Leaves; Platelet aggregation; Play; Policies; Population; Prediabetes syndrome; Property; Psychologist; Psychotropic Drugs; Publishing; Race; Recommendation; Reporting; Research; Risk; Risk Factors; Role; Route; Sampling; Testing; Tetrahydrocannabinol; Time; Titrations; Tobacco; Triglycerides; United States National Academy of Sciences; Urine; Vasodilation; Vasospasm; Vision; Work; base; brachial artery; cardioprotection; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; cohort; design; health difference; indexing; marijuana use; marijuana user; modifiable risk; multidisciplinary; recruit; sex; tobacco exposure; vaping; vascular inflammation; waist circumference

ABSTRACT The potency of the psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC), has increased from 3.7% to 30% over the last decade; yet, the impact of THC on cardiovascular disease (CVD) risk is unclear. Studies suggest that THC may play a role in adverse cardiovascular health; however, the combined levels of THC and other compounds within cannabis, such as cannabidiol (CBD), on CVD risk are understudied. Accumulating evidence suggests that the CBD has anti-inflammatory and antioxidant properties that are beneficial to the cardiovascular system. The overarching goal of this study (N=400) is to examine the impact of blood- and urine-quantified THC/CBD among 18-to-30-year-old cannabis users by route of administration, versus nonusers, on objective measures of subclinical CVD risk. The study will examine the impact of THC/CBD on subclinical CVD risk via: 1) traditional CVD risk factors (i.e., waist circumference, blood pressure, fasting lipid profile, glucose, and CRP); 2) measures of vascular function (i.e., brachial artery flow-mediated dilation testing and pulse wave velocity measurements of arterial compliance). Specific aims are to: 1) Examine the difference in measures of subclinical CVD risk between cannabis users and nonusers; 2) Analyze the difference in measures of subclinical CVD risk by route of cannabis administration; and 3) Determine the impact of THC/CBD blood and urine levels on measures of subclinical CVD risk, within the cannabis groups. Participants will be recruited into an age-, sex-, race/ethnicity-, and income-matched group (n=100 each) from an established sampling frame in the team’s studies. Group 1 will be cannabis users who most often use via blunts (cannabis rolled into a tobacco leaf). Group 2 will be cannabis users who do not smoke tobacco cigarettes and who most often use cannabis via joint (cannabis rolled in paper with no added tobacco). This group will have no tobacco exposure. Group 3 will be cannabis users who most often use cannabis via electronic device (vape). Group 4 will be nonusers of cannabis and tobacco. Measures will be collected at baseline and a repeated, confirmatory measurement at 12-months. We hypothesize that there will be a differential effect of subclinical CVD risk by route of administration; and that higher blood- and urine-quantified THC levels will be positively related to subclinical CVD risk. Pilot studies on a cohort of 50 cannabis users with similar cannabis use and subclinical CVD risk ascertainment (PI: Vidot) confirmed feasibility and informed study aims and hypotheses. We will leverage Dr. Vidot’s (epidemiologist) cannabis expertise in collaboration with a multidisciplinary team of experts: Drs. Martinez (cardiologist), Gonzalez (substance use psychologist), Reidy (forensic toxicologist), Arheart (biostatistician), Sidney (cardiovascular consultant), Anthony (design consultant), and Alshaarawy (mechanistic consultant) to accomplish the overarching goal. Study findings will identify THC/CBD levels associated with positive/deleterious CVD risk to inform cannabinoid titration for users at increased CVD risk.

抽象的 大麻的精神活性成分 Δ9-四氢大麻酚 (THC) 的效力已从 过去十年中，THC 的比例为 3.7% 至 30%；然而，THC 对心血管疾病 (CVD) 风险的影响尚不清楚。 研究表明，THC 可能会导致心血管健康不良；然而，THC 的综合水平可能会导致不良心血管健康。 THC 和大麻中的其他化合物（例如大麻二酚 (CBD)）对 CVD 风险的影响尚未得到充分研究。 越来越多的证据表明 CBD 具有抗炎和抗氧化特性 本研究（N=400）的总体目标是检查对心血管系统的影响。 通过给药途径对 18 至 30 岁大麻使用者的血液和尿液中的 THC/CBD 进行定量，对比 该研究将探讨 THC/CBD 对非使用者的亚临床 CVD 风险的影响。 亚临床 CVD 风险通过：1）传统 CVD 风险因素（即腰围、血压、空腹血脂） 2) 血管功能测量（即肱动脉血流介导的扩张测试） 和动脉顺应性的脉搏波速度测量）具体目标是： 1）检查差异。 大麻使用者和非使用者之间亚临床 CVD 风险的衡量标准 2) 分析大麻使用者和非使用者之间的差异； 通过大麻给药途径衡量亚临床 CVD 风险；以及 3) 确定 THC/CBD 的影响； 大麻组内的血液和尿液水平对亚临床心血管疾病风险的测量。 从既定的年龄、性别、种族/民族和收入匹配的群体中招募（每组 n = 100） 该团队研究中的抽样框架将是最常通过大麻（大麻）使用的大麻使用者。 第 2 组是不吸烟草且吸食最多的大麻使用者。 经常通过联合使用大麻（用纸卷成的大麻，不添加烟草）。 第 3 组是最常通过电子设备（vape）使用大麻的大麻使用者。 将在基线和重复确认的情况下收集措施。 我们敢说，亚临床 CVD 风险会产生不同的影响。 给药途径；并且较高的血液和尿液定量 THC 水平将与 对 50 名具有类似大麻使用和亚临床症状的大麻使用者进行的试点研究。 CVD 风险确定（PI：Vidot）证实了可行性并告知了研究目标和假设。 与多学科专家团队合作，利用 Vidot 博士（流行病学家）的大麻专业知识： Martinez 博士（心脏病专家）、Gonzalez（药物使用心理学家）、Reidy（法医毒理学家）、Arheart （生物统计学家）、Sidney（心血管顾问）、Anthony（设计顾问）和 Alshaarawy（机械学顾问） 顾问）以实现总体目标 研究结果将确定与 THC/CBD 相关的水平。 阳性/有害 CVD 风险，为 CVD 风险增加的使用者提供大麻素滴定信息。