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Cannabis by any name does not smell as sweet: potential cardiovascular events with medical cannabis

Recently, attitudes towards cannabis and its use have changed dramatically and continue to evolve worldwide. In 2014, many states in the USA started legalizing cannabis, thus increasing the availability of medical and recreational cannabis and creating an entire cannabis industry with dispensaries on many street corners.1 Within most of the European Union (EU), cannabis remains illegal; however, recently many countries have begun to legalize cannabis for limited therapeutic purposes. Countries such as Germany, the Czech Republic, Denmark, Germany, Italy, and Poland now permit the cultivation of cannabis for medical purposes, with the cultivation and subsequent processing taking place under the usually strict rules applicable to agricultural, manufacturing, distribution, security, and clinical good practice.2 Close pharmacovigilance of cannabis, as well as its safety and efficacy, have been limited by decades of worldwide illegality and by the ongoing classification of cannabis as a Schedule 1 controlled substance in the USA. Nonetheless, with increased cannabis decriminalization and legalization across the globe, the association between cannabis exposure and incident cardiovascular (CV) events has emerged as an important safety signal.