Using Cannabis to Control Blood Pressure After Spinal Cord Injury: A Case Report
Authors: Tom E. Nightingale, Tahira Tejpar, Colleen O'Connell, Andrei V. Krassioukov
Journal: Annals of Internal Medicine (2020)

Letters20 October 2020Using Cannabis to Control Blood Pressure After Spinal Cord Injury: A Case ReportTom E. Nightingale, PhD, Tahira Tejpar, MSc, Colleen O'Connell, MD, and Andrei V. Krassioukov, MD, PhDTom E. Nightingale, PhDUniversity of Birmingham, Birmingham, United Kingdom (T.E.N.), Tahira Tejpar, MScUniversity of British Columbia, Vancouver, British Columbia, Canada (T.T.), Colleen O'Connell, MDStan Cassidy Centre for Rehabilitation, Fredericton, New Brunswick, Canada (C.O.), and Andrei V. Krassioukov, MD, PhDUniversity of British Columbia and G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada (A.V.K.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0090 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Spinal cord injury disrupts autonomic pathways, which impairs cardiovascular control and leads to episodes of transient hypertension in a process termed autonomic dysreflexia. These episodes can be severe enough to cause life-threatening medical emergencies (1). They can be triggered by routine peripheral stimuli, such as bladder or bowel events or management, and by the pain and spasticity that frequently accompany spinal cord injury (2). Cannabis alleviates chronic pain and spasticity in adults with multiple sclerosis and has been shown to modulate blood pressure (BP) in humans (3).Objective: To document how a patient with spinal cord injury self-manages autonomic ...References1. Wan D, Krassioukov AV. Life-threatening outcomes associated with autonomic dysreflexia: a clinical review. J Spinal Cord Med. 2014;37:2-10. [PMID: 24090418] doi:10.1179/2045772313Y.0000000098 CrossrefMedlineGoogle Scholar2. Sezer N, Akkus S, Ugurlu FG. Chronic complications of spinal cord injury. World J Orthop. 2015;6:24-33. [PMID: 25621208] doi:10.5312/wjo.v6.i1.24 CrossrefMedlineGoogle Scholar3. National Academies of Sciences, Engineering, and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. National Academies Pr; 2017. doi:10.17226/24625 CrossrefGoogle Scholar4. Burchiel KJ, Hsu FP. Pain and spasticity after spinal cord injury: mechanisms and treatment. Spine (Phila Pa 1976). 2001;26:S146-60. [PMID: 11805622] CrossrefMedlineGoogle Scholar5. Cardenas DD, Jensen MP. Treatments for chronic pain in persons with spinal cord injury: a survey study. J Spinal Cord Med. 2006;29:109-17. [PMID: 16739554] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Birmingham, Birmingham, United Kingdom (T.E.N.)University of British Columbia, Vancouver, British Columbia, Canada (T.T.)Stan Cassidy Centre for Rehabilitation, Fredericton, New Brunswick, Canada (C.O.)University of British Columbia and G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada (A.V.K.)Acknowledgment: The authors thank Dr. Rahul Sachdeva for his critical review of the manuscript and Mr. Adam Mesa for his help with the figures (International Collaboration on Repair Discoveries at University of British Columbia). They also thank the patient for his participation in this case study and provision of detailed information.Financial Support: Dr. Nightingale is a recipient of a 2018/2020 Michael Smith Foundation for Health Research/International Collaboration on Repair Discoveries Research Trainee Award (#17767). The equipment used for this case report was supported by a Canada Foundation for Innovation/B.C. Knowledge Development Fund grant (#35869) to Dr. Krassioukov.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0090.Corresponding Author: Andrei V. Krassioukov, MD, PhD, Division of Physical Medicine & Rehabilitation, Department of Medicine, International Collaboration on Repair Discoveries-Blusson Spinal Cord Centre, University of British Columbia, 818W 10th Avenue, Vancouver, BC V5Z 1M9, Canada; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMarijuanaCannabis Use Is Inversely Associated with Metabolic Disorders in Hepatitis C-Infected Patients (ANRS CO22 Hepather Cohort) 20 October 2020Volume 173, Issue 8Page: 668-670KeywordsBladderBlood pressureCannabisCannabis useHeart rateHypotensionNeuropathic painRehabilitation medicineSleepSpinal cord injury ePublished: 16 June 2020 Issue Published: 20 October 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...