Cannabis use disorder in women linked to 48% higher cardiovascular risk, especially stroke

In a cohort of over 1.2 million pregnant women followed for up to 30 years, cannabis use disorder was associated with 48% higher risk of cardiovascular hospitalization, with a particularly strong link to hemorrhagic stroke.

Auger, Nathalie et al.·BMC medicine·2020·Moderate EvidenceLongitudinal Cohort
RTHC-02400Longitudinal CohortModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=1,247,035

What This Study Found

Women with cannabis use disorders had 1.48 times the risk of cardiovascular hospitalization (95% CI 1.27-1.72). Cannabis with other substances had stronger association (HR 1.84) than cannabis alone (HR 1.30, borderline significant). Cannabis use disorder was strongly associated with hemorrhagic stroke even after adjusting for other substance use (HR 2.08, CI 1.07-4.05). Cardiovascular hospitalization incidence was 58.4 vs 33.6 per 10,000 person-years.

Key Numbers

1,247,035 women. 18,998,986 person-years. Overall CVD: HR 1.48 (95% CI 1.27-1.72). Cannabis alone: HR 1.30. Cannabis + other substances: HR 1.84. Hemorrhagic stroke: HR 2.08 (95% CI 1.07-4.05).

How They Did This

Longitudinal cohort of 1,247,035 pregnant women in Quebec, Canada (1989-2019). 18,998,986 person-years of follow-up. Cox regression adjusted for patient characteristics.

Why This Research Matters

This is one of the largest and longest studies examining cannabis and cardiovascular risk in women, providing evidence that cannabis use disorder may have lasting cardiovascular consequences.

The Bigger Picture

The hemorrhagic stroke finding is particularly concerning for young women, as stroke in this population is relatively rare but has devastating consequences.

What This Study Doesn't Tell Us

Cannabis use disorder identified by diagnostic codes (may miss non-disordered use). Confounding by other substance use partially addressed but not eliminated. Healthy user bias possible.

Questions This Raises

  • ?Is the cardiovascular risk from cannabis itself or from lifestyle factors associated with cannabis use disorder?
  • ?Does the hemorrhagic stroke risk apply to recreational users without a diagnosed disorder?

Trust & Context

Key Stat:
2.08x hemorrhagic stroke risk with cannabis use disorder
Evidence Grade:
Very large longitudinal cohort with long follow-up, though subject to diagnostic code limitations and residual confounding.
Study Age:
2020 study using 1989-2019 data.
Original Title:
Cannabis use disorder and the future risk of cardiovascular disease in parous women: a longitudinal cohort study.
Published In:
BMC medicine, 18(1), 328 (2020)
Database ID:
RTHC-02400

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does cannabis increase heart disease risk in women?

In this study of 1.2 million women, cannabis use disorder was associated with 48% higher cardiovascular hospitalization risk over up to 30 years, with hemorrhagic stroke risk roughly doubled.

Is the cannabis cardiovascular risk independent of other drug use?

Cannabis alone showed a borderline significant 30% increase in risk, while cannabis with other substances showed 84% higher risk. Hemorrhagic stroke remained significant even after adjusting for other substances.

Read More on RethinkTHC

Cite This Study

RTHC-02400·https://rethinkthc.com/research/RTHC-02400

APA

Auger, Nathalie; Paradis, Gilles; Low, Nancy; Ayoub, Aimina; He, Siyi; Potter, Brian J. (2020). Cannabis use disorder and the future risk of cardiovascular disease in parous women: a longitudinal cohort study.. BMC medicine, 18(1), 328. https://doi.org/10.1186/s12916-020-01804-6

MLA

Auger, Nathalie, et al. "Cannabis use disorder and the future risk of cardiovascular disease in parous women: a longitudinal cohort study.." BMC medicine, 2020. https://doi.org/10.1186/s12916-020-01804-6

RethinkTHC

RethinkTHC Research Database. "Cannabis use disorder and the future risk of cardiovascular ..." RTHC-02400. Retrieved from https://rethinkthc.com/research/auger-2020-cannabis-use-disorder-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.