Cannabis use disorder linked to 60% higher cardiovascular disease risk in Canadian adults | Research

The takeaway

In a matched population-based study of nearly 60,000 Canadian adults, those with cannabis use disorder had approximately 60% higher risk of experiencing adverse cardiovascular events and shorter time to those events.

Cannabis users, cardiologists, primary care providers assessing cardiovascular risk

RR 1.57 for cardiovascular events

What the researchers found

Cannabis use disorder was associated with significantly higher cardiovascular disease events (RR 1.57, 95% CI 1.40-1.77). CUD was also associated with reduced time to incident CVD. The highest relative risks were in those without mental health comorbidity, without recent healthcare use, and without prescription medications.

Why it matters

Cardiovascular disease is a leading cause of death, and cannabis use disorder prevalence is rising. This population-level evidence of increased cardiovascular risk could influence clinical screening and counseling practices.

The numbers in context

59,528 total participants (29,764 matched pairs). CUD prevalence: 0.8%. CVD events: 2.4% in CUD group vs. 1.5% in unexposed. RR: 1.57 (95% CI 1.40-1.77).

How the study worked

Matched population-based retrospective cohort using five linked Alberta administrative health databases (2012-2019). 29,764 CUD-matched pairs (59,528 total). Poisson regression and Mantel-Haenszel risk ratios computed.

What this study cannot tell us

Administrative data cannot capture cannabis use severity or consumption method. CUD diagnosis codes likely capture only severe use. Cannot separate effects of cannabis from effects of smoking. Matched design controls for some but not all confounders.

How to read the evidence

Large matched population-based cohort with administrative data provides robust association evidence, but cannot establish causation or control for all confounders.

When this study was published

2024 analysis of Alberta health data from 2012-2019

The bigger picture

The finding that healthier individuals (no comorbidities, no medications, no recent healthcare) had the highest relative risk is notable. It suggests cannabis use disorder may be a more prominent cardiovascular risk factor when other traditional risk factors are absent.

Questions still open

Is the cardiovascular risk from cannabis smoking, THC effects, or both? Would the risk differ for non-smoked cannabis consumption? Does the risk reverse after cannabis cessation?

Common questions

How much does cannabis use disorder increase heart risk?

The study found approximately 60% higher risk (RR 1.57) of adverse cardiovascular events in people with cannabis use disorder compared to matched controls without CUD.

Were sicker people more at risk?

Counterintuitively, no. The highest relative risks were in people without mental health conditions, recent healthcare use, or prescription medications, suggesting CUD may be a more prominent risk factor when other risk factors are absent.

Read the original research

Cannabis use disorder and adverse cardiovascular outcomes: A population-based retrospective cohort analysis of adults from Alberta, Canada.

Addiction (Abingdon, England), 119(1), 137-148

View on PubMed ↗Publisher’s paper ↗

Citation

Bahji, Anees; Hathaway, Josh; Adams, Denise; Crockford, David; Edelman, E Jennifer; Stein, Michael D; Patten, Scott B. (2024). Cannabis use disorder and adverse cardiovascular outcomes: A population-based retrospective cohort analysis of adults from Alberta, Canada.. Addiction (Abingdon, England), 119(1), 137-148. https://doi.org/10.1111/add.16337