Cannabis use is associated with higher risks of heart attack and stroke, a study of 430,000 adults indicates, stressing the need for awareness of its cardiovascular effects. Credit: SciTechDaily.com
More frequent use of cannabis was associated with higher odds of adverse cardiovascular outcomes, finds a new study in the Journal of the American Heart Association.
Research Highlights:
- An analysis of survey data for 430,000 adults in the U.S. found that using cannabis has a significant association with an increased risk of heart attack and stroke, independent of tobacco use, with higher odds among the adults with more frequent use (more days of use per month). The most common method of cannabis use was smoking, followed by eating or vaporizing it.
- The increase in the combined risk of coronary heart disease, heart attack, and stroke was similar to the risk among the subset of adults who had never used e-cigarettes but did use cannabis.
An analysis of 430,000 adults in the U.S. found that using cannabis, most commonly through smoking, eating or vaporizing it, was significantly associated with a higher risk of heart attack and stroke, even after controlling for tobacco use (combustible cigarettes and other tobacco products) and other cardiovascular risk factors, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
Although cannabis, or marijuana, is illegal at the federal level, 24 states and Washington, D.C., have legalized the use of recreational cannabis. Additionally, the number of people in the U.S. who use cannabis has increased significantly in recent decades, according to the 2019 National Survey on Drug Use and Health from the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services. The annual survey found that in 2019, 48.2 million people ages 12 or older reported using cannabis at least once, compared to 25.8 million people ages 12 or older in 2002, an increase to 17% from 11%.
“Despite common use, little is known about the risks of cannabis use and, in particular, the cardiovascular disease risks,” said lead study author Abra Jeffers, Ph.D., a data analyst at Massachusetts General Hospital in Boston. “The perceptions of the harmfulness of smoking cannabis are decreasing, and people have not considered cannabis use dangerous to their health. However, previous research suggested that cannabis could be associated with cardiovascular disease. In addition, smoking cannabis—the predominant method of use—may pose additional risks because particulate matter is inhaled.”
In this study, researchers reviewed survey data collected for 430,000 adults from 2016 through 2020 to examine the association between cannabis use and adverse cardiovascular outcomes including heart disease, heart attack, and stroke. The survey data was collected through the Behavioral Risk Factor Surveillance System, a national, cross-sectional survey performed annually by the U.S. Centers for Disease Control and Prevention.
The researchers specifically investigated whether cannabis use was associated with adverse cardiovascular outcomes among the general adult population, among people who had never smoked tobacco or used e-cigarettes, and among younger adults (defined as men under age 55 and women under age 65) at risk for heart disease. They also factored in the number of days per month that people used cannabis.
The analyses of found:
- Any cannabis use (smoked, eaten or vaporized) was independently associated with a higher number of adverse cardiovascular outcomes (coronary heart disease, myocardial infarction and stroke) and with more frequent use (more days per month), the odds of adverse outcomes were even higher. The results were similar after controlling for other cardiovascular risk factors, including tobacco and/or e-cigarette use, alcohol consumption, body mass index, Type 2 diabetes and physical activity.
- Both daily and non-daily cannabis users had an increased risk of heart attack compared to non-users; daily cannabis users had 25% higher odds of heart attack compared to non-users.
- The odds of stroke for daily cannabis users were 42% higher compared to non-users, with lower risk among those who used cannabis less than daily.
- Among younger adults at risk for premature cardiovascular disease (defined as men younger than 55 years old and women younger than 65 years old) cannabis use was significantly associated with 36% higher combined odds of coronary heart disease, heart attack and stroke, regardless of whether or not they also used traditional tobacco products. A separate analysis of a smaller subgroup of these adults who had never smoked tobacco cigarettes or used nicotine e-cigarettes also found a significant association between cannabis use and an increase in the combined odds of coronary heart disease, heart attack and stroke.
“Our sample was large enough that we could investigate the association of cannabis use with cardiovascular outcomes among adults who had never used tobacco cigarettes or e-cigarettes,” Jeffers said. “Cannabis smoke is not all that different from tobacco smoke, except for the psychoactive drug: THC vs. nicotine. Our study shows that smoking cannabis has significant cardiovascular risk risks, just like smoking tobacco. This is particularly important because cannabis use is increasing, and conventional tobacco use is decreasing.”
Study background and details:
- Survey participants were ages 18-74, with an average age of 45 years.
- About half of the participants self-identified as female. 60.2% self-identified as white adults, 11.6 self-identified as Black adults, 19.3 self-identified as Hispanic adults and 8.9% self-identified as other.
- Nearly 90% of adults did not use cannabis at all; 7% used it less than daily; and 4% were daily users. Among current cannabis users, 73.8% reported smoking as the most common form of cannabis consumption. More than 60% of total respondents had never used tobacco cigarettes; 28.6% of daily cannabis users had never used tobacco cigarettes; 44.6% of non-daily cannabis users had never used tobacco cigarettes and 63.9% of participants who did not use cannabis had never used tobacco cigarettes.
The study had several limitations, including that cardiovascular conditions and cannabis use were self-reported, making them potentially subject to recall bias (potential errors in memory); that the authors did not have health data measuring participants’ baseline lipid profile or blood pressure; and the study captured data for only a single point in time for the participants. The authors note that there is a need for prospective cohort studies – studies that follow groups of individuals over time – to examine the association of cannabis use and cardiovascular outcomes while accounting for frequency of cannabis use.
“The findings of this study have very important implications for population health and should be a call to action for all practitioners, as this study adds to the growing literature that cannabis use and cardiovascular disease may be a potentially hazardous combination,” said Robert L. Page II, Pharm.D., M.S.P.H., FAHA, chair of the volunteer writing group for the 2020 American Heart Association Scientific Statement: Medical Marijuana, Recreational Cannabis, and Cardiovascular Health. Page is professor of clinical pharmacy, medicine and physical medicine at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of Colorado School of Medicine in Aurora, Colorado. Page was not involved in this study.
“In the overall population, the study findings are consistent with other studies indicating that daily cannabis use was associated with an increase in heart attack, stroke and the combined endpoint of coronary heart disease, heart attack and stroke,” he said. “As cannabis use continues to grow in legality and access across the U.S., practitioners and clinicians need to remember to assess cannabis use at each patient encounter in order to have a non-judgmental, shared decision conversation about potential cardiovascular risks and ways to reduce those risks.”
Reference: “Association of Cannabis Use With Cardiovascular Outcomes Among US Adults” by Abra M. Jeffers, Stanton Glantz, Amy L. Byers and Salomeh Keyhani, 28 February 2024, Journal of the American Heart Association.
DOI: 10.1161/JAHA.123.030178
pretty damning and pretty much obliterates the argument of people who think that it’s like Tylenol and should be used as like a painkiller for children and replace SSRIs for young adults.
in some cases sure that might be more important , for ex in the case of a child that has cancer or some other mortal illness then yeah you’d use whatever you need to use to make them comfortable (I know kids on fentanyl) , or in super severe nerve disorders where the current medication is essentially not helpful like Parkinson’s and stuff like that
This is somewhat concerning to cannabis regular users, BUT it does have numerous weaknesses in the methodology and a glaring lack of actual measured health data as it is all self-reported with no professional medical diagnoses involved. It merits further and closer follow up study to see if the actual medical outcomes match up with the predictions this study would suggest.
What no comparison with the overwhelming research of alcohol abuse that starts abuse.
If smoked, yes!
My colleagues use oil and edibles and they’re fine. The smoking ones are in rough shape.
Smoking is bad kiddos, mmkay?
Now how about another article on the jab toxicity, eh?
When you look at HOW they statistically analyzed the data, they seem to combine smoking, vaping, and eating in one group, then pull statistics from there.
Furthermore, this study does not look at QUANTITIES consumed, only regularity.
Furthermore, this study does not differentiate between various WAYS of smoking. Rolling it into a “joint” like a cigarette, or smoking through a short hand-held pipe, are the most common ways I see recreational users consuming the herb. This is NOT the way one should smoke anything. It should be vaporized, or burned and the smoke filtered through water to remove the tar and microscopic burning particles. Note the “hookah” is common in countries where the herb use comes from the Vedic teachings that this herb is the embodiment of the highest God Shiva and the “lower” path to enlightenment, but no one there rolls it. Best is to use a “one-hitter” size bowl, avoid touching the flame from the petrol-lighter to the product (just use the heat to ignite it), burn it slow and INCOMPLETELY, leaving a ball of carbon that would become carbon-monoxide if burned – a product not good for you or your heart. Still, even then, I would be curious as to the cardiovascular risks.
Furthermore, this study does not look at the DIET of the individuals in the study. Diet is everything, in my opinion, from my personal experience and watching others. Are these herb-users in the study just common fools looking for the next “high” or “cool thing” who BOTH smoke it “rolled” AND eat a poor diet? Tobacco use is declining, alcohol use is declining, but herb use rates are increasing? Human nature is relatively fixed across the species. There will always be those folks who are the “next fool who is born every minute”; folks who just want to relax with a good movie, a bag of non-organic deep-fried chips, and a beer, cig, or joint, or …whatever comes next in popular social use. Is this MINDSET the distinguishing factor in this study, folks who just don’t care for their body in general? Even when they “exercise” as this study supposedly accounts for, is this just an excuse to feel good? I see plenty of folks at the gym with less-than-sculpted bodies. I eat correct, don’t work out daily except for an evening walk, smoke the herb PROPERLY daily, and have a sculpted body without trying. I can hike 20 miles at over 8000 feet elevation, up to over 11,000 feet, with 6400 feet of elevation gain/loss in one day, and my heart and lungs and muscles are not stressed (my knees may be!).
You can make statistics say anything you want, if you “analyze” the data the right way.
Will >>I<< die early of heart disease and stroke? This study says nothing to me.
I forgot to mention:
the use of OTHER drugs is not said to be considered in this study. How many of those recreational “party users” are also consuming meth and/or smoking “ice”, snorting cocaine, taking dexadrine (not sure how to spell that one), etc., etc., etc…
Are they the ones bumping up the “statistics”?
Who is it that said “statistics” are damn lies?
You can make “statistics” say anything you want, if you “analyze” the data the right way.
Will >>I<< die early of heart disease and/or stroke? Or suffer through them? This study says nothing to me, but I sure would LIKE to se REAL science published on this website that clarifies all this nonsense.
I am middle aged. I have smoked herbs daily, and nothing else, since my teen years. I am fine.
I have two dead friends. They both smoked herb, and did meth. They died of a heart attack. I have two other friends that had a heart attack. They both smoked herb and did meth. They quit the meth, at least for a while.
Unfortunately, I am the only one of my friends that didn’t go down the rabbit hole. I only smoke the herb. They are no where near as health as me, but they are not vegan, either.
The “rebel party mindset” exists, whether you like it or not. Placing the magic green herb in the “rebel” category with the other, truly harmful and dangerous drugs out there, that you will NEVER get rid of, no matter how much WE want them gone, only confuses the young folks. “Oh, the herb ain’t so bad like they say it is…” And they are right. Then they go on to try meth, Xanax, opiates, etc. And down the hole they go. I lost too many friends that way. “I had NO idea what I was getting into!” they told me. By then it was too late.
THIS ARTICLE ONLY ENFORCES THAT MINDSET AND LEADS THESE KIDS TO THEIR DEATH.
Perhaps it should not be left as regardless to point out that the white blood cells count(specifically the T-cell(transformer)) has been reported to increase an average of 10,000 times the normal count of non-partakers. Studies might appropriate whether this is a consistent factor during continued use. And whether or not moderation of use to once or twice per month verses daily use might offset the possible challenges having that many more T-Cells adrift in the circulatory system may play a roll in the increased health risks associated with frequent uses outlined in the associated article this statement is in response to as moderate boosting of transformer cell counts may have overall health benefits such as promoting heightened activity of M-RNA Transcriptase pivotal to cellular upkeep and genetic integrity. However; as this article suggests to my interpretive nature; excessive use may convollute, and complicated regulatory conditioning resulting in the overall detriment to healthy physical functioning. As the old add age goes: moderation is key.
Bad science. No consideration of diet or exercise. Two of the best ways to prevent heart disease!
And marijuana grows hair on your knuckles. This was all disproved 60 years ago, Get up to speed.
As a 50 year heavy user with a healthy heart, I have to say hmmm.
Thank you for sharing this insightful study. It’s concerning to learn about the potential risks associated with cannabis use, particularly concerning heart health. This research underscores the importance of ongoing conversations between healthcare providers and patients to ensure informed decision-making and prioritize overall well-being.
“The study had several limitations, including that cardiovascular conditions and cannabis use were self-reported, making them potentially subject to recall bias (potential errors in memory); that the authors did not have health data measuring participants’ baseline lipid profile or blood pressure; and the study captured data for only a single point in time for the participants. The authors note that there is a need for prospective cohort studies – studies that follow groups of individuals over time – to examine the association of cannabis use and cardiovascular outcomes while accounting for frequency of cannabis use.”
Another completely useless self reported ‘study’ publicized to hype the dangers of using Marijuana – no mention of amounts used, other drugs used, lifestyle and exercise or diet…which makes the conclusions invalid.