Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis
<i>Background and Objectives</i>: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with canna...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/10/1465 |
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| author | Rupak Desai Akhil Jain Waleed Sultan Zainab Gandhi Athul Raj Raju Vivek Joseph Varughese Geethu Jnaneswaran Charu Agarwal Bisharah Rizvi Zeeshan Mansuri Puneet Gupta Gautam Kumar Rajesh Sachdeva |
| author_facet | Rupak Desai Akhil Jain Waleed Sultan Zainab Gandhi Athul Raj Raju Vivek Joseph Varughese Geethu Jnaneswaran Charu Agarwal Bisharah Rizvi Zeeshan Mansuri Puneet Gupta Gautam Kumar Rajesh Sachdeva |
| author_sort | Rupak Desai |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). <i>Material and Methods</i>: Young adult hospitalizations (18–44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015–December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. <i>Results</i>: Young CUD+ had higher prevalence of HC (0.7%, <i>n</i> = 4675) than CUD- (0.5%, <i>n</i> = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06–1.24, <i>p</i> = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01–1.36, <i>p</i> = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, <i>p</i> = 0.154). Propensity-matched CUD+ cohort (<i>n</i> = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55–12.91, <i>p</i> < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38–2.17, <i>p</i> < 0.001) and stroke (aOR 1.46, 95%CI:1.02–2.10, <i>p</i> = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. <i>Conclusions</i>: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke. |
| first_indexed | 2024-03-09T19:50:45Z |
| format | Article |
| id | doaj.art-c633a6456ad04df4b0a6b2d5073be7e0 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T19:50:45Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-c633a6456ad04df4b0a6b2d5073be7e02023-11-24T01:11:41ZengMDPI AGMedicina1010-660X1648-91442022-10-015810146510.3390/medicina58101465Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide AnalysisRupak Desai0Akhil Jain1Waleed Sultan2Zainab Gandhi3Athul Raj Raju4Vivek Joseph Varughese5Geethu Jnaneswaran6Charu Agarwal7Bisharah Rizvi8Zeeshan Mansuri9Puneet Gupta10Gautam Kumar11Rajesh Sachdeva12Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USADepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, PA 19153, USADepartment of Family Medicine, Conemaugh Memorial Medical Center, Johnstown, PA 15905, USADepartment of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711, USADepartment of Medicine, Karuna Medical College, Chittur-Thathamangalam 678103, Kerala, IndiaDepartment of Internal Medicine, Government Medical College, Thiruvananthapuram 695011, Kerala, IndiaDepartment of Medicine, SUT Academy of Medical Sciences, Thiruvananthapuram 695028, Kerala, IndiaDepartment of Medicine, Sri Siddhartha Medical College, Tumakuru 572107, Karnataka, IndiaDepartment of Internal Medicine, Saint Agnes Medical Center, Fresno, CA 93720, USADepartment of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USADepartment of Cardiology, Baptist Health Deaconess Madisonville, Madisonville, KY 42431, USADivision of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USADivision of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA<i>Background and Objectives</i>: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). <i>Material and Methods</i>: Young adult hospitalizations (18–44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015–December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. <i>Results</i>: Young CUD+ had higher prevalence of HC (0.7%, <i>n</i> = 4675) than CUD- (0.5%, <i>n</i> = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06–1.24, <i>p</i> = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01–1.36, <i>p</i> = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, <i>p</i> = 0.154). Propensity-matched CUD+ cohort (<i>n</i> = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55–12.91, <i>p</i> < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38–2.17, <i>p</i> < 0.001) and stroke (aOR 1.46, 95%CI:1.02–2.10, <i>p</i> = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. <i>Conclusions</i>: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke.https://www.mdpi.com/1648-9144/58/10/1465cannabismarijuanahypertensionhypertensive crisishypertensive emergencyin-hospital mortality |
| spellingShingle | Rupak Desai Akhil Jain Waleed Sultan Zainab Gandhi Athul Raj Raju Vivek Joseph Varughese Geethu Jnaneswaran Charu Agarwal Bisharah Rizvi Zeeshan Mansuri Puneet Gupta Gautam Kumar Rajesh Sachdeva Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis Medicina cannabis marijuana hypertension hypertensive crisis hypertensive emergency in-hospital mortality |
| title | Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis |
| title_full | Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis |
| title_fullStr | Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis |
| title_full_unstemmed | Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis |
| title_short | Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis |
| title_sort | hypertensive crisis related hospitalizations and subsequent major adverse cardiac events in young adults with cannabis use disorder a nationwide analysis |
| topic | cannabis marijuana hypertension hypertensive crisis hypertensive emergency in-hospital mortality |
| url | https://www.mdpi.com/1648-9144/58/10/1465 |
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