Cannabis use linked to 37% higher stroke risk in massive study

 

Since you're not likely to be a long term user post stroke maybe you'd rather hear of benefits than this Debbie Downer stuff!

My 13 reasons for marijuana use post-stroke.  June 2014

Here's What Medical Marijuana Can Do for Older Patients  May 2026

Don't follow me, I'm not medically trained, and I don't have a Dr. in front of my name. 

Decide for yourself.

• marijuana (163 posts to February 2011)

Cannabis use linked to 37% higher stroke risk in massive study

Cialis is an erectile dysfunction drug. Could it also help you live longer?

 Since the stroke already has me in the high risk category of cardiovascular disease I'm already taking Cialis daily. Better blood flow to the brain. Hasn't your doctor immediately put you on this to save some neurons from the neuronal cascade of death in the first week? 

And this:

Erectile Dysfunction Drugs May Protect Against Alzheimer’s August 2024

Cialis is an erectile dysfunction drug. Could it also help you live longer?

Tadalafil – better known by its brand name Cialis – is one of the most commonly prescribed drugs for erectile dysfunction.

But in some biohacking and wellness circles, it's increasingly being repurposed for an entirely different reason.

Online clinics and influential figures are promoting it as a kind of all-purpose longevity drug – delivering benefits for the cardiovascular system, brain and even athletic performance.

The drugs aren't approved for preventing heart attack and stroke, let alone for extending life.

However, the enthusiasm does reflect growing interest among some experts in the field of cardiology and men's health that tadalafil and other drugs in its class could have a legitimate role in preventive health.

"It's a serious area of discussion," says Dr. Robert Kloner, director of cardiovascular research at the Huntington Medical Research Institutes and a professor at the University of Southern California. 

"Cardiovascular disease remains the number one killer – and we have these drugs that may have a potential benefit, but we have to learn a lot more."

The buzz of longevity

Tadalafil belongs to the same class of drugs as sildenafil, i.e., Viagra – with the primary difference being that its effect lasts considerably longer.

While both have been on the market for decades, a handful of large studies, many of them published in recent years, have shown that men taking the drug fare better: They have lower rates of cardiovascular disease and death, and, in some cases, are less likely to develop dementia.

The major studies in this area are observational – and retrospective – meaning they can only show associations, not that tadalafil was the definitive cause.

Want the latest stories on the science of healthy living? Subscribe to NPR's Health newsletter.

But the findings are remarkably "consistent" across the literature, says Kloner, whose lab has studied these medications extensively. "It's a very interesting signal."

The research has surfaced in the online longevity conversation, and prominent voices – from Stanford neuroscientist and podcaster Andrew Huberman to the immortality-seeking tech mogul Bryan Johnson – have talked up the idea of taking tadalafil for more than sex.

Even some women are getting on board.

"It seemed very harmless," says Kristi Sawicki, who holds a doctorate in molecular oncology and has built a following on social media around longevity.

"If anything it's going to help blood flow and that can be beneficial to our brain and our heart," she told NPR.

Sawicki started taking tadalafil about a year ago.

It was one of the offerings in the online telehealth clinic she used for her GLP-1 prescription. That prompted her to dig into the research herself.

"It's a very well-understood mechanism," she says.

As someone with a family history of heart disease, she saw taking tadalafil as "low-hanging fruit" for cardiovascular health – and has also noticed other benefits, like a better pump in the gym.

The studies

While mostly used for erectile dysfunction, both tadalafil and sildenafil are approved for treating a rare form of high blood pressure affecting the lungs. Tadalafil can also be prescribed for symptoms of an enlarged prostate in men.

In essence, these medications – known as PDE-5 inhibitors – work by preventing the breakdown of a signaling molecule, which in turn helps relax smooth muscle cells and dilate blood vessels.

This not only improves blood flow in one particular region but also relaxes and widens blood vessels throughout the body, Kloner says.

Sildenafil – approved in the late '90s – was famously developed as a drug to treat chest pain caused by poor blood flow to the heart, until its "side effects" were recognized and drug makers changed course.

There's evidence – mostly from small trials in humans – that PDE-5 inhibitors like tadalafil may benefit blood-vessels. Plus, lab and animal research have suggested these drugs can also have anti-inflammatory effects.

The studies drawing on medical records of men who were prescribed these drugs, primarily for erectile dysfunction, have shown sizable effects.

For example, an analysis by Kloner of more than 8,000 men taking tadalafil found they had a 55% lower rate of dying from cardiovascular causes and a 44% lower rate of overall mortality during the study period.

Another study – this based on more than half a million patients – showed a 32% lower risk of dementia among those taking tadalafil, along with improved mortality.

"We were particularly fascinated by the dementia piece," says Dr. Dietrich Jehle, chair of emergency medicine at the University of Texas Medical Branch in Galveston and lead author of the analysis, noting that data from the U.K. has also indicated a lower risk of Alzheimer's disease.

Researchers like Kloner and Jehle emphasize that without prospective studies – ideally randomized trials – these findings need to be read with caution. There could be unknown factors that influence why men who seek out medications for erectile dysfunction are less likely to die and develop certain diseases. Kloner also acknowledges the drugs are not as well studied in women.

The problem, he says, is that pharmaceutical companies aren't incentivized to run these costly studies because generic versions of the drugs are already available.

"It's not something that cardiologists are routinely recommending, I'll tell you that," Kloner says. "But these drugs in general are very safe."

The online marketplace

Much of the current marketing around tadalafil comes from direct-to-consumer online clinics, where it's often advertised alongside other trendy wellness and longevity therapies.

For example, AgelessRx – a company that Sawicki promotes in her online content – sells a monthly $70 prescription of low dose tadalafil for longevity purposes.

In an interview with NPR, the company's medical director, Dr. Jenell Decker said she felt the data were strong enough to warrant offering it to both men and women over 40.

"In longevity, that's what you have to do with a lot of things, you have to infer," she says, "because if you wait until a person is already showing symptoms, you're already behind."

But some experts are troubled by this off-label use of the medication, without better data in humans.

"Absence of evidence of harms doesn't mean there isn't harm," says Dr. Steve Nissen, chief academic officer of the Cleveland Clinic Heart, Vascular & Thoracic Institute. "In the absence of randomized controlled trial data, it's pretty hard to justify."

Expert panel evaluating the merits

There are signs tadalafil could be gaining wider acceptance outside of the online wellness and optimization world.

The topic came up recently during the latest meeting of an influential medical group, known as the Princeton Consensus Panel, which focuses on men's sexual function and cardiovascular health.

The group of medical experts – which included Kloner and other preventive cardiologists – arrived at consensus language that low dose tadalafil is "appropriate" for a subset of men who are at elevated risk of developing cardiovascular disease due to the build up of plaque in their arteries, according to Dr. Martin Miner, who co-chaired the June conference. (Their formal recommendations are not yet published.)

In an email to NPR, Miner acknowledged some were "hesitant" to endorse this broader use of tadalafil because there were no randomized controlled trials, but ultimately decided to do so, based on the existing observational research.

"This is not for all men," says Miner, who directs the Men's Health Center at Brown University in Providence, R.I., though he does prescribe it for many of his patients who're at higher risk of cardiovascular disease.

"I believe men need all the help we can give them due to the longevity gap in this country," he added.

Inhaled cannabis reduces number of daily ectopic heart beats

 Since I'm sure your doctor never prescribed marijuana post stroke you'll never hear of this.

My 13 reasons for marijuana use post-stroke.  June 2014

Here's What Medical Marijuana Can Do for Older Patients  May 2026

Don't follow me, I'm not medically trained, and I don't have a Dr. in front of my name. 

An ectopic heartbeat is an extra or early heartbeat that interrupts your normal heart rhythm. It can make your heart feel like it skipped a beat, paused, or gave a strong thump. Most extra beats are harmless, very common, and do not mean you have a serious heart disease. 

Inhaled cannabis reduces number of daily ectopic heart beats

Key takeaways:

• Lower rates of ectopic heart beats on days in which habitual users inhaled cannabis vs. days of nonuse.
• Cannabis use in this cohort had no impact on daily steps, sleep duration or blood glucose.

Inhaled cannabis use was associated with acute reductions in ectopic heart beats vs. nonuse, mainly driven by reductions in premature atrial contractions, researchers reported.

The present study among habitual cannabis users identified certain acute effects of the drug on cardiac function, but no impact on daily steps count, sleep duration and glucose changes on days of use vs. nonuse was observed, according to data published in the Journal of the American College of Cardiology.

“Recreational cannabis is now legal in more than half the U.S. and is becoming more commonly used, but we know very little about the true health effects of the drug. At the same time, there is a growing interest in identifying modifiable risk factors that may influence risks of common heart rhythm disturbances. Prior work related to cannabis and arrhythmias has generally suggested harm, but has been conflicting,” Gregory M. Marcus, MD, MAS, cardiologist and Endowed Professor of Atrial Fibrillation Research in the division of cardiology at the University of California, San Francisco, told Healio.

The MARY-JANE trial was a prospective, randomized study conducted at the University of California, San Francisco. Researchers enrolled 108 habitual cannabis users who reported inhaled cannabis use at least once in the past month and 4 or more days within a week at least once in the past year. Participants had to be willing to abstain from cannabis use for at least 2 consecutive days over the 14-day trial period, according to the study methods.

Participants received a continuously recording ECG patch (Zio XT Patch, iRhythm), a Bluetooth-enabled, wrist-worn accelerometer and sleep monitoring device (Fitbit INSPIRE devices, Fitbit) and a Bluetooth-enabled continuous glucose monitor device (Dexcom G7, Dexcom).

Participants were randomly assigned via daily text message to either use or abstain from inhaled cannabis.

The primary outcome was daily cardiac ectopy, defined as total daily premature atrial and ventricular contractions. Mean daily steps, sleep duration per night and daily glucose changes were also evaluated, according to the study methods.

The researchers reported that although the mean age of study participants was 32 years, individuals representing each decade of life from age 21 into their 70s participated (59% women; 37% white).

Adherence to daily randomization was reported to be a challenge in the present study. However, the researchers wrote “it should not explain false positive results with regard to our prespecified primary endpoint or assessments of autonomic tone”

Inhaled cannabis was associated with a 9% reduction in ectopic beats (rate ratio [RR] = 0.91; 95% CI, 0.85-0.98; P = .02); a 10% reduction in daily premature atrial contractions (RR = 0.9; 95% CI, 0.82-0.97; P = .012); and no change in premature ventricular contractions (P = .83) compared with nonuse, according to the study.

Researchers reported that each inhalation of cannabis was associated with an approximately 2% reduction in ectopic beats (RR = 0.98; 95% CI, 0.97-0.99; P = .043).

“Contrary to our hypothesis, we failed to show that random assignment to use inhaled cannabis increased common cardiac ectopy. Of note, increasing frequencies of premature atrial contractions are an important predictor of atrial fibrillation, and those with more premature ventricular contraction frequencies have a higher risk for heart failure. In fact, we found a small decrease in cardiac ectopy, driven mainly by less premature atrial contractions, on days when participants were randomly assigned to smoke or vape cannabis,” Marcus told Healio. “At the same time and after excluding those ectopic beats from the continuous ECG data, we did see evidence of increased punctuated sympathetic activity on days randomized to cannabis, consistent with an increase in THC exposure on those days. Other methods to assess compliance suggested that participants generally followed their randomization assignment most of the time.”

Mean daily steps, sleep duration per night and daily glucose changes were not significantly different between inhaled cannabis use and nonuse, according to the study.

“This single study should not be considered sufficient to change clinical practice or recommendations, but should justify opening up future investigations and lines of inquiry as to how cannabis might actually have antiarrhythmic properties. It also challenges the notion that all inhaled smoke is the same, particularly given quite clear evidence that inhaled tobacco smoke has been consistently associated with more cardiac ectopy,” Marcus told Healio.

For more information:

Gregory M. Marcus, MD, MAS, can be reached at greg.marcus@ucsf.edu or X @gregorymmarcus.

What happens to your kidneys when you drink coffee every day

 With another benefit to coffee your INCOMPETENT? doctor and hospital will once again continue their INCOMPETENCE STREAK!

Still no 24 hour coffee station!

What happens to your kidneys when you drink coffee every day

Key Points

• Drinking coffee daily can help protect against chronic kidney disease and lower risk of kidney stones.
• Caffeine can potentially increase blood pressure and stress on kidneys, especially with hypertension.
• Limit added sugars and saturated fat in your coffee while being mindful of amounts for kidney health.

Your kidneys play an important role in filtering out waste and excess water from the body while balancing electrolytes. Healthy kidneys will do this automatically, but damage to the kidneys can potentially lead to chronic kidney disease (CKD), a progressive loss of kidney function that may require treatments like dialysis to mimic the role of the kidneys. If you’re one of the many Americans having coffee daily, your kidneys are being put to work filtering your favorite beverage. Which makes us wonder: Is coffee safe for kidney health?

Major health organizations, like the American Heart Association, recommend that healthy adults can enjoy up to 400 milligrams of caffeine per day without negative health effects—that’s around 4 cups of coffee. “Current evidence suggests that moderate coffee intake, about 2 to 3 standard 8-ounce cups per day, is safe for most people with chronic kidney disease and may even support kidney health,” says Sara Prato, M.S., RDN, CSD. “The amount that is right for an individual can vary depending on factors such as blood pressure, caffeine sensitivity and overall health.”

Learn more about what happens to your kidneys when you drink coffee every day, as well as the best way to enjoy your morning cup for long-term kidney health.

Coffee May Lower Risk of Kidney Disease

Great news for those who enjoy drinking coffee daily: Research indicates drinking coffee may help lower the risk of developing CKD. “A meta-analysis found that people who drank 2 or more cups of coffee daily had a 14% lower risk of developing kidney disease,” says Melanie Betz, M.S., RD, CSR, FNKF, FAND. The reason for this may be related to the beneficial compounds in coffee that can aid in reducing inflammation and oxidative stress.

Related video: How much coffee is too much? New guidelines reveal the surprising answer (Woman's World)“Coffee contains more than 1,000 naturally occurring compounds, including chlorogenic acids, polyphenols and melanoidins, which have antioxidant and anti-inflammatory properties,” says Prato. “Many of these potential benefits come from coffee’s naturally occurring compounds rather than caffeine itself, which is why decaffeinated coffee may provide many of the same benefits with much less caffeine.”

For people with existing kidney disease, drinking coffee may benefit kidney function. “Coffee may also be helpful for people who already have kidney disease, as it was associated with a lower risk of progression to end-stage kidney disease, protein in urine and mortality,” says Betz.

Coffee May Lower Risk of Kidney Stones

The causes of kidney stones are multifactorial, with both genetic and diet-related factors at play. However, if you drink coffee regularly, you may have a lower risk of developing kidney stones. This is for a few different reasons, according to Prato. “Coffee may help by increasing urine volume, which can dilute and flush out stone-forming minerals before they have a chance to form crystals,” she says. “Caffeine may also increase urine production, which may contribute to this protective effect.”

In general, both Betz and Prato recommend staying hydrated to prevent kidney stones. “At the end of the day, the most important thing to prevent kidney stones is to drink (a lot!) of fluid,” says Betz. She says coffee contributes fluid, which helps dilute urine and reduces the risk of forming all types of kidney stones.

Caffeine May Raise Blood Pressure

From the AHA is this: Habitual coffee intake: BP neutral/↓;

Hypertension can eventually cause kidney disease due to a narrowing of the blood vessels that lead to the kidneys, creating a cycle of impairing the ability to properly remove waste and therefore increasing blood pressure due to excess fluid. Caffeinated coffee may influence blood pressure, but the association between caffeine intake and hypertension has been debated. Some research has found that drinking coffee may reduce the risk of hypertension, but others have shown the opposite. Still, those with existing hypertension may need to use caution when adding caffeine to their daily diet. 

“More caffeine could raise blood pressure, which can directly damage kidneys,” says Betz. When blood pressure is already high or is borderline high, even the slightest increase could be a cause for concern. “If you have uncontrolled high blood pressure, it may be best to limit caffeinated coffee to 1 to 2 cups per day and monitor your blood pressure, since larger amounts of caffeine consumed at one time can temporarily raise blood pressure,” says Prato.

How to Enjoy Coffee for Kidney Health

• Limit Added Sugar. “The health benefits of coffee come from black coffee. Adding too much sugar and/or cream could easily outweigh those benefits,” says Betz. This is important since so many popular coffee drinks contain added sugar. “A sugary coffee drink can easily have three times your daily sugar limit,” warns Betz. If you regularly add sugar to your coffee at home or when ordering coffee from a restaurant, try cutting back in small increments over time. For people who typically choose flavored coffee drinks or blended coffee with added sugar, it’s important to review the nutrition facts and understand what you’re drinking. In many cases, substitutions can be made to reduce or eliminate the added sugar.
• Limit Saturated Fat. Betz cautions against adding cream to your coffee, as sources of saturated fat can increase risk for heart disease and ultimately kidney disease. If you currently put creamer in your coffee, consider adding less or switching to an alternative option. “Skim or low-fat milk can be great substitutes for cream to help reduce calories and saturated fat,” says Betz.(Really? You haven't heard of the benefits of dairy fat? So, you ARE that incompetent!)
• Find a Roast You Like. Sometimes people add extra sugar and cream to their coffee because they don’t enjoy the taste of the coffee itself. In those cases, you can try modifying the type of coffee you drink. For example, you may prefer a light roast instead of a dark roast. This switch may make your coffee more enjoyable without the need for extra sugar and cream.
• Be Mindful of Total Quantity. Prato says that even though plain black coffee is safe for people with kidney disease, the total amount matters. While caffeine is something to be mindful of when drinking coffee, other nutrients, like potassium, also need to be taken into consideration. “An 8-ounce cup contains about 100 milligrams of potassium, which is appropriate for many people with CKD,” says Prato. “However, if you drink several cups per day, the potassium content can add up. People who need to limit potassium or have high potassium blood levels may need to adjust their intake based on their individual needs.”

Our Expert Take

Drinking your daily cup of coffee can be beneficial for your kidneys by helping to protect against kidney disease and kidney stones. However, experts recommend no more than 400 mg of caffeine daily, because too much caffeine can potentially raise blood pressure, especially in those who already have hypertension, which increases stress on the kidneys and can lead to damage over time. (I'm way over that because I have genes that process caffeine fast and  you still haven't told me EXACTLY how much coffee to drink to prevent Parkinsons and dementia.)

“Overall, coffee can be a healthy habit when enjoyed in moderation and tailored to an individual’s health needs,” says Prato. Additionally, additives like sugar and saturated fat should be limited to protect long-term kidney health. If you have high blood pressure or existing kidney disease, you may need to limit your coffee intake to just 1 to 2 cups per day. The best approach is to talk with your health care provider to assess your current coffee habit or before adding caffeinated coffee to your daily routine.

Read the original article on EatingWell

Researchers Try to Tie Cannabis to Irregular Heartbeats, Opposite Turns Out True

 Your competent? doctor immediately prescribed marijuana for all the benefits post stroke, right? NO? So UNEDUCATED AND INCOMPETENT? Your board of directors IS THAT FUCKING INCOMPETENT?

My 13 reasons for marijuana use post-stroke.  June 2014

Here's What Medical Marijuana Can Do for Older Patients  May 2026

Don't follow me, I'm not medically trained, and I don't have a Dr. in front of my name. 

Researchers Try to Tie Cannabis to Irregular Heartbeats, Opposite Turns Out True

Key Takeaways

• A randomized crossover trial examined the acute cardiovascular effects of inhaled cannabis among habitual users.
• There was a significant 9% reduction in premature heartbeats on days participants inhaled cannabis compared with days they abstained.
• The finding of reduced cardiac ectopy was questionable given major limitations of the trial, but the data did suggest that there was no increase in these heartbeats.

Defying expectations, regular cannabis users had fewer ectopic heartbeats on the days they reached for the joint or vape, a randomized crossover trial showed.

On days using cannabis, there was a significant 9% reduction in these extra or early heartbeats (median 13 per day on cannabis vs 13.8 per day off cannabis; rate ratio [RR] 0.91, 95% CI 0.85-0.98) among habitual cannabis smokers and vapers who had no history of clinically diagnosed cardiac arrhythmias.

While each cannabis inhalation was associated with a 2% reduction in ectopic beats (RR 0.98, 95% CI 0.97-0.99), Gregory Marcus, MD, MAS, of the University of California San Francisco, and colleagues noted that they were still wary of jumping too quickly to claim causality from this randomized trial.

"Given imperfect adherence, possible carryover, heterogeneous exposure, low baseline ectopy burden, and multiple exploratory analyses, the clinical implications remain uncertain," they wrote in the Journal of the American College of Cardiology.

"Ultimately, the most conservative interpretation of these data may be the clear evidence that inhaled cannabis did not increase cardiac ectopy," Marcus and team conceded.

Study participants were randomly assigned each day to inhale cannabis products or abstain completely via text messages for 14 days. Inhaled cannabis included smoked cannabis (joints, blunts, pipes, and bongs) and vaped cannabis. During follow-up, participants were equipped with a continuously recording ECG patch, a wrist-worn Fitbit activity tracker and sleep monitor, and a continuous glucose monitor for the first 10 days.

No significant differences were observed for step counts, sleep duration, or glucose levels.

"This study examined the acute effects of cannabis in people who use it regularly and was not designed to evaluate the long-term health consequences," Marcus cautioned in a press release. "The overall health effects of inhaled cannabis may still be net negative, but these findings suggest there may be something about cannabis that can teach us more about the biological mechanisms that produce premature atrial contractions. That knowledge could eventually lead to new approaches for preventing or treating abnormal heart rhythms."

Of note, the change in daily ectopy was driven by a decrease in daily premature atrial contractions (PACs), with a median of 7 on cannabis days versus 9.75 on off-cannabis days (RR 0.90, 95% CI 0.82-0.97), whereas premature ventricular contractions (PVCs) were unchanged on days using cannabis (median 3 vs 2.75; RR 1.01, 95% CI 0.91-1.12).

"To our knowledge, no previous randomized trial has demonstrated that any common exposure or lifestyle factor can influence PAC counts," Marcus and colleagues wrote.

The finding naturally leads to the question of whether lower PAC counts amount to tangible protection from a full-blown cardiac arrhythmia.

"Although the current study did not assess AF [atrial fibrillation] as an outcome, previous research has shown that PAC frequencies in the general population were the single most potent predictor of AF," the authors noted. "Indeed, eradication of PACs has been shown to prevent AF in select patients, and PACs, perhaps the most common arrhythmia, can themselves be bothersome and reduce quality of life."

The study included 108 adults who regularly smoked or vaped cannabis and had no history of clinically diagnosed cardiac arrhythmias.

At baseline, average age was 32 years, and 59% were women. None of the participants had diabetes, and 8% had hypertension. The most commonly reported methods of cannabis inhalation were joints (63%) and vape cartridges (57%), ranging in frequency of use from one to four times per month to three times or more per day. Fewer than one in three participants smoked tobacco or vaped nicotine concurrently.

There were a total of 713 days randomized to inhaled cannabis and 616 days randomized to abstinence.

Based on a combination of time-stamped Zio patch button presses at the time of cannabis use, daily surveys, and salivary mass spectrometry, Marcus and colleagues determined that participants followed instructions to inhale or avoid cannabis on most days, with adherence deemed as "moderate."

The authors acknowledged that there were plenty of caveats to the randomized study.

"For example, participants were not blinded to their exposure and were instructed to use their own cannabis products. This allowed for an assessment of the full inhaled cannabis experience that best recapitulated actual drug exposure and enhanced our ability to recruit and retain participants," they wrote. "However, this also resulted in substantial heterogeneity in the types and amounts of cannabis consumed and a consequent reduction in precision in analyzing associations with specific constituents."

Requiring participants to be frequent cannabis users may be a source of selection bias, they added, while the selection criteria further excluded anyone who had a history of AF or heart failure; had an implanted pacemaker or implantable cardioverter-defibrillator; had been prescribed beta-blockers, nondihydropyridine calcium-channel blockers, or Vaughn-Williams class 1 or 3 antiarrhythmic medications; or had a medical reason to avoid cannabis.

Importantly, the trial did not assess other effects of acute cannabis inhalation, nor did it collect data on alcohol consumption, a common co-intervention also linked to more PACs and PVCs.

The same research group previously reported that coffee consumption caused PVCs but not PACs.