Dysregulation of the endogenous lipid mediators endocannabinoids and their G-protein-coupled cannabinoid receptors 1 and 2 (CB₁R and CB₂R) has been implicated in a variety of cardiovascular pathologies. Activation of CB₁R facilitates the development of cardiometabolic disease, whereas activation of CB₂R (expressed primarily in immune cells) exerts anti-inflammatory effects. The psychoactive constituent of marijuana, Δ⁹-tetrahydrocannabinol (THC), is an agonist of both CB₁R and CB₂R, and exerts its psychoactive and adverse cardiovascular effects through the activation of CB₁R in the central nervous and cardiovascular systems. The past decade has seen a nearly tenfold increase in the THC content of marijuana as well as the increased availability of highly potent synthetic cannabinoids for recreational use. These changes have been accompanied by the emergence of serious adverse cardiovascular events, including myocardial infarction, cardiomyopathy, arrhythmias, stroke, and cardiac arrest. In this Review, we summarize the role of the endocannabinoid system in cardiovascular disease, and critically discuss the cardiovascular consequences of marijuana and synthetic cannabinoid use. With the legalization of marijuana for medicinal purposes and/or recreational use in many countries, physicians should be alert to the possibility that the use of marijuana or its potent synthetic analogues might be the underlying cause of severe cardiovascular events and pathologies.

内源性脂质介质内源性大麻素及其与G蛋白偶联的大麻素受体1和2（CB ₁ R和CB ₂ R）的失调与多种心血管疾病有关。CB ₁ R的激活促进了心脏代谢疾病的发展，而CB ₂ R的激活（主要在免疫细胞中表达）发挥了抗炎作用。大麻的精神成分，Δ ⁹ -四氢大麻酚（THC），是CB两者的激动剂₁ R和CB ₂ R，和通过CB的活化来发挥其精神和不良心血管作用₁R在中枢神经和心血管系统中。在过去的十年中，大麻的四氢大麻酚含量增加了近十倍，而用于娱乐用途的高效合成大麻素的可用性也有所增加。这些变化伴随着严重的不良心血管事件的出现，包括心肌梗塞，心肌病，心律不齐，中风和心脏骤停。在这篇评论中，我们总结了内源性大麻素系统在心血管疾病中的作用，并严格讨论了大麻和合成大麻素的使用对心血管的影响。在许多国家，出于药用和/或娱乐目的使用大麻的合法化，