Young adults with cannabis use disorder had higher rates of hypertensive crisis hospitalizations | Research

The takeaway

Young adults with cannabis use disorder were more likely to be hospitalized for hypertensive crisis and had higher odds of death, arrhythmia, and stroke during those hospitalizations.

Young adults, clinicians, and researchers interested in cardiovascular risks of cannabis use.

5.7x higher odds of death during hypertensive crisis hospitalization

What the researchers found

Young adults (18-44) with cannabis use disorder had 15% higher odds of hypertensive crisis hospitalization compared to those without (aOR 1.15). During those hospitalizations, they had 5.7 times higher odds of death, 73% higher odds of arrhythmia, and 46% higher odds of stroke.

Why it matters

As recreational cannabis use grows, understanding its cardiovascular risks in young adults is important for clinical awareness and screening.

The numbers in context

Propensity-matched cohort: 4,440 patients, median age 36, 64.2% male, 64.4% Black. All-cause mortality OR 5.74, arrhythmia OR 1.73, stroke OR 1.46.

How the study worked

Retrospective analysis of the National Inpatient Sample (October 2015-December 2017) with propensity-score matching to compare outcomes between young adults with and without cannabis use disorder admitted for hypertensive crisis.

What this study cannot tell us

Retrospective database study cannot establish causation. Cannabis use disorder does not capture frequency, potency, or route of use. ICD coding may misclassify patients.

How to read the evidence

Large national database with propensity matching, but retrospective design and inability to control for unmeasured confounders limit causal inference.

When this study was published

Published in 2022 using 2015-2017 hospital data.

The bigger picture

The association between cannabis use disorder and hypertensive crisis was partially explained by concurrent cocaine and stimulant use, highlighting the importance of polysubstance patterns.

Questions still open

Does cannabis directly contribute to hypertensive crisis, or is this driven by associated substance use patterns? Would these cardiovascular risks apply to occasional cannabis users?

Common questions

Was cannabis the direct cause of the hypertensive crises?

The study found an association, not causation. The link between cannabis use disorder and hypertensive crisis was partially explained by concurrent cocaine and stimulant use.

How severe were the outcomes?

Young adults with cannabis use disorder who had hypertensive crisis hospitalizations had 5.7 times higher odds of dying, 73% higher odds of arrhythmia, and 46% higher odds of stroke compared to matched patients without cannabis use disorder.

Read the original research

Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis.

Medicina (Kaunas, Lithuania), 58(10)

View on PubMed ↗Publisher’s paper ↗

Citation

Desai, Rupak; Jain, Akhil; Sultan, Waleed; Gandhi, Zainab; Raju, Athul Raj; Varughese, Vivek Joseph; Jnaneswaran, Geethu; Agarwal, Charu; Rizvi, Bisharah; Mansuri, Zeeshan; Gupta, Puneet; Kumar, Gautam; Sachdeva, Rajesh. (2022). Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis.. Medicina (Kaunas, Lithuania), 58(10). https://doi.org/10.3390/medicina58101465