The prevalence of obesity continues to increase and represents one of the principal
causes of cardiovascular morbidity and mortality. After the discovery of a specific receptor of the
psychoactive principle of marijuana, the cannabinoid receptors and their endogenous ligands,
several studies have demonstrated the role of this system in the control of food intake and energy
balance and its overactivity in obesity. Recent studies with the CB1 receptor antagonist rimonabant
have demonstrated favorable effects such as a reduction in body weight and waist circumference
and an improvement in metabolic factors (cholesterol, triglycerides, glycemia etc).
Therefore, the antagonism of the endocannabinoid (EC) system, if recent data can be confirmed,
could be a new treatment target for high risk overweight or obese patients. Obesity is a growing
problem that has epidemic proportions worldwide and is associated with an increased risk of
premature death (1-3). Individuals with a central deposition of fats have elevated cardiovascular
morbidity and mortality (including stroke, heart failure and myocardial infarction) and, because of
a growing prevalence not only in adults but also in adolescents, it was reclassified in AHA guidelines
as a “major modifiable risk factor” for coronary heart disease (4, 5). Although first choice
therapy in obesity is based on correcting lifestyle (diet and physical activity) in patients with abdominal
obesity and high cardiovascular risk and diabetes, often it is necessary to use drugs
which reduce the risks. The EC system represents a new target for weight control and the improvement
of lipid and glycemic metabolism (6, 7). (Heart International 2007; 3: 27-34)
Endocannabinoid system, Obesity, CB1 antagonists
Dr. Savina Nodari, Associate Professor, Section of Cardiovascular Diseases, Dept. of Experimental and Applied Medicine, University of Brescia c/o Spedali Civili, P.zza Spedali Civili, 1, 25123 Brescia – Italy, nodari@med.unibs.it
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