How Different Drugs Affect the Heart: Cannabis Compared to Alcohol, Amphetamines, and Others | Research

The takeaway

A review found that cardiovascular problems from cannabis were less common than from opiates, amphetamines, or alcohol, though chronic use was associated with cognitive disorders.

Read this if you want to understand how cannabis heart risks compare to those of alcohol and other drugs.

Cannabis cardiovascular problems less common than opiates, amphetamines, or alcohol

What the researchers found

The review compared cardiovascular effects across five categories of substances. Cannabis posed fewer cardiovascular risks than opiates (which could cause arrhythmias and pulmonary edema), amphetamines (which shared cocaine's acute and chronic cardiovascular toxicities), and alcohol (associated with cardiomyopathy, hypertension, and arrhythmia). However, the review noted that major cognitive disorders could accompany chronic cannabis use.

Alcohol was unique among these substances in having possible protective effects against coronary artery disease and stroke when used in moderate amounts. Caffeine's role in hypertension and coronary disease remained controversial.

Why it matters

By placing cannabis cardiovascular risks in the context of other commonly used substances, this review provided perspective often missing from single-substance analyses. The finding that cannabis posed relatively lower cardiovascular risk compared to other drugs of abuse was informative for both clinical risk assessment and public health messaging.

The numbers in context

No specific quantitative data were presented in the cannabis section of the abstract.

How the study worked

This was a narrative review comparing the cardiovascular manifestations of alcohol, amphetamines, heroin, cannabis, and caffeine, serving as part 2 of a two-part series on substance abuse and cardiovascular disease.

What this study cannot tell us

The review covered five substance classes in a single paper, limiting depth on each. The cardiovascular effects of cannabis were not extensively detailed in the abstract. The cognitive effects mentioned were outside the cardiovascular focus.

How to read the evidence

This is a narrative review comparing cardiovascular effects across multiple substances, providing moderate-level evidence through comparative synthesis.

When this study was published

Published in 2003. The relative cardiovascular safety of cannabis compared to other substances has been generally supported by subsequent research.

The bigger picture

Subsequent research has refined the understanding of cannabis cardiovascular risks, identifying specific scenarios (acute use in older adults with heart disease, synthetic cannabinoid use) where risks are more significant. The relative safety compared to alcohol and amphetamines has been consistently supported.

Questions still open

Has the relative cardiovascular safety of cannabis compared to other substances been confirmed by more recent studies? Does the route of cannabis administration affect cardiovascular risk?

Common questions

Is cannabis safer for the heart than alcohol?

This review found that cannabis posed fewer cardiovascular risks than alcohol, which is associated with cardiomyopathy, hypertension, and arrhythmia. However, both substances carry health risks and direct comparisons depend on usage patterns.

Can cannabis cause heart problems?

While cardiovascular problems from cannabis were described as less common than from other substances, they are not absent. Increased heart rate and blood pressure changes can occur, and there are case reports of heart attacks associated with cannabis use, particularly in people with existing heart disease.

Read the original research

Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine.

Heart disease (Hagerstown, Md.), 5(4), 253-71

View on PubMed ↗

Citation

Frishman, William H; Del Vecchio, Alexander; Sanal, Shirin; Ismail, Anjum. (2003). Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine.. Heart disease (Hagerstown, Md.), 5(4), 253-71.