NORML: 高血壓

高血壓（Hypertension）是美國約四分之一成人所面臨的健康問題，會對心臟與血管造成壓力，並大幅增加中風與心臟疾病的風險。​

內源性大麻素系統在調節血壓方面扮演一定角色，儘管其作用機制尚未完全明瞭[1]。動物研究顯示，花生四烯乙醇胺（anandamide）及其他內源性大麻素能顯著抑制高血壓狀態下的心肌收縮力，並有助於血壓正常化[2–3]，因此有專家推測，調控內源性大麻素系統「可能為多種心血管疾病提供新的治療途徑」[4]。​

外源性大麻素的施用在人體與實驗動物中產生了多種心血管效應[5–9]，這些效應可能受劑量、給藥途徑及耐受性等因素影響。​

部分在實驗條件下接受大麻或大麻素的受試者會出現輕微且短暫的心率與血壓上升。然而，這些效應通常會隨著重複使用而迅速產生耐受性，且使用純化或合成大麻素引發嚴重心血管事件的風險似乎較低[10–12]。​

在動物實驗中，大麻素的施用與血管擴張、短暫性心動過緩及低血壓（血壓下降）有關[13]，並可抑制動脈粥樣硬化（動脈硬化）的進展[14–16]。​

近期的人體資料重現了部分臨床前研究的結果。​2018年一項觀察性研究報告指出，終生使用大麻與年輕至中年成人動脈粥樣硬化風險增加無獨立關聯[17]。​2021年一項針對57,000名美國成人的研究評估大麻使用與心血管疾病的關聯，結論為：「在控制多項混雜變數後，我們發現大麻使用者的心血管事件發生率有所下降」[18]。​然而，其他觀察性研究則得出相反的結果[19]。​

一項近期針對高齡高血壓患者的觀察性試驗中，受試者透過油劑萃取物或吸入大麻花進行為期三個月的治療，結果顯示「收縮壓與舒張壓及心率皆有所下降」[20]。​同樣地，一項涵蓋46項臨床試驗的文獻回顧指出，使用純化或合成大麻素（包括THC）進行醫療用途時，治療期間常伴隨低血壓的發生[21]。​

最新的2021年文獻回顧分析了67項研究，並發表於《美國醫學期刊》（American Journal of Medicine），結論為：「大麻本身似乎與過度的心血管風險因素無獨立關聯」，但作者也提醒：「大麻可能與其他不健康行為（如飲酒與吸菸）相關，這些行為對心血管健康有害」[22]。​

目前，針對使用大麻素治療高血壓的臨床研究仍處於初期階段[23]，專家通常建議高風險族群（如已有心血管疾病者）應限制接觸大麻煙霧[24]。

參考文獻

[1] Franjo Grotenhermen. 2006. Clinical pharmacodynamics of cannabinoids. In Russo et al (Eds) Handbook of Cannabis Therapeutics. Binghampton, New York: Haworth Press.

[2] Batkai et al. 2004. Endocannabinoids acting at cannabinoid-1 receptors regulate cardiovascular function in hypertension. Circulation 110: 1996-220.

[3] Pacher et al. 2005. Blood pressure regulation by endocannabinoids and their receptors. Neuropharmacology 48: 1130-1138.

[4] Ibid.

[5] Cecilia Hillard. 2000. Endocannabinoids and vascular function. Journal of Pharmacology and Experimental Therapeutics. 294: 27-32.

[6] Kunos et al. 2000. Endocannabinoids as cardiovascular modulators. Chemistry and Physics of Lipids 108: 159-168.

[7] Reese Jones. 2002. Cardiovascular system effects of marijuana. Journal of Clinical Pharmacology. 42: 58-63.

[8] Ribuot et al. 2005. Cardiac and vascular effects of cannabinoids: toward a therapeutic use? Annales de Cardiologie et d’Angeiologie (France) 54: 89-96.

[9] Steven Karch. 2006. Cannabis and cardiotoxicity. Forensic Science, Medicine, and Pathology. 2: 13-18.

[10] Ibid.

[11] Rodondi et al. 2006. Marijuana use, diet, body mass index and cardiovascular risk factors. American Journal of Cardiology 98: 478-484.

[12] Watanabe et al. 2021. A systemic review and meta-analysis of randomized controlled trials for cardiovascular toxicity of medical cannabinoids. Journal of the American Pharmacists Association [online ahead of print].

[13] Reese Jones. 2002. op. cit.

[14] Steffens and Mach. 2006. Towards a therapeutic use of selective CB2 cannabinoid receptor ligands for atherosclerosis. Future Cardiology 2: 49-53.

[15] Steffens et al. 2005. Low dose oral cannabinoid therapy reduces progression of atherosclerosis in mice. Nature 434: 782-786.

[16] Steffens and Mach. 2006. Cannabinoid receptors in atherosclerosis. Current Opinion in Lipidology 17: 519-526.

[17] Auer et al. 2018. Lifetime marijuana use and subclinical atherosclerosis: The Coronary Artery Risk Development in Young Adults (CARDIA) study. Addiction 113: 845-856.

[18] Jivanji et al. 2021. Association between marijuana use and cardiovascular disease in US adults. Cureus [online publication].

[19] Shah et al. 2020. Association of Marijuana Use and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Data Analysis of 133,706 US Adults. American Journal of Medicine [online ahead of print].

[20] Abuhasira et al. 2021. Cannabis is associated with blood pressure reduction in older adults: A 24-hours ambulatory blood pressure monitoring study. European Journal of Internal Medicine 86: 79-85.

[21] Watanabe et al. 2021. op. cit.

[22] Pasha et al. 2021. Cardiovascular Effects of Medical Marijuana: A Systemic Review. American Journal of Medicine 134: 182-193.

[23] Francois Mach. 2006. New anti-inflammatory agents to reduce atherosclerosis. Archives of Physiology and Biochemistry 112: 130-137.

[24] Thomas et al. 2014. Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know. American Journal of Cardiology 113: 187-190.

原文標題：《Human Immunodeficiency Virus (HIV)》

原文作者：NORML

原始網站：https://norml.org

翻譯者：大麻101

翻譯日期：2025年4月

翻譯聲明：本文章由原文翻譯而來，原文發表於NORML。如需閱讀原文，請訪問 https://norml.org/marijuana/library/recent-medical-marijuana-research/human-immunodeficiency-virus-hiv/