Daily cannabis use linked to 25% higher heart attack risk and 42% higher stroke risk in large US survey | Research

The takeaway

Among over 434,000 US adults, daily cannabis use was associated with significantly higher odds of heart attack and stroke, even after accounting for tobacco use, with stronger effects in never-tobacco smokers.

Cardiologists, primary care physicians, cannabis users, and public health researchers

434,104 adults; stroke risk 42% higher with daily use

What the researchers found

Daily cannabis use was associated with 25% higher odds of heart attack (aOR 1.25), 42% higher odds of stroke (aOR 1.42), and 28% higher odds of any cardiovascular event (aOR 1.28) after adjusting for tobacco and other factors. Among never-tobacco smokers, the associations were even stronger: 49% higher heart attack odds and 116% higher stroke odds.

Why it matters

This is one of the largest studies to examine cannabis and cardiovascular risk. The finding that associations were stronger among never-tobacco smokers helps rule out tobacco as the primary driver.

The numbers in context

434,104 respondents; 4% daily users, 7.1% non-daily users; daily use aORs: coronary heart disease 1.16, heart attack 1.25, stroke 1.42, composite 1.28; never-tobacco smokers: heart attack aOR 1.49, stroke aOR 2.16, composite aOR 1.77; dose-response relationship with days of use

How the study worked

Population-based cross-sectional analysis of 2016-2020 Behavioral Risk Factor Surveillance Survey data from 27 US states and 2 territories (434,104 respondents aged 18-74). Multivariable regression models assessed associations between cannabis use days per month and self-reported cardiovascular outcomes.

What this study cannot tell us

Cross-sectional design cannot establish causation; self-reported cardiovascular outcomes and cannabis use; cannot determine method of cannabis consumption; no data on cannabis type or potency; people with cardiovascular conditions may use cannabis for symptom management (reverse causation)

How to read the evidence

Very large population-based study with appropriate adjustment for tobacco and demographics, but cross-sectional design with self-reported outcomes limits causal inference.

When this study was published

2024 study analyzing 2016-2020 survey data

The bigger picture

As cannabis use becomes more prevalent across the US, evidence of cardiovascular risk that persists independent of tobacco use has important implications for public health messaging and clinical screening.

Questions still open

Does the method of cannabis consumption (smoking vs. edibles) modify cardiovascular risk? Is there a safe frequency of cannabis use from a cardiovascular standpoint? What biological mechanisms drive these associations?

Common questions

How much did daily cannabis use increase cardiovascular risk?

After adjusting for tobacco use and other factors, daily cannabis users had 25% higher odds of heart attack and 42% higher odds of stroke compared to non-users. The risk increased proportionally with more days of use per month.

Could tobacco use explain the findings?

The researchers specifically analyzed never-tobacco smokers and found even stronger associations: 49% higher heart attack risk and more than double the stroke risk (116% higher) with daily cannabis use. This suggests the cardiovascular risk is not simply a tobacco effect.

Read the original research

Association of Cannabis Use With Cardiovascular Outcomes Among US Adults.

Journal of the American Heart Association, 13(5), e030178

View on PubMed ↗Publisher’s paper ↗

Citation

Jeffers, Abra M; Glantz, Stanton; Byers, Amy L; Keyhani, Salomeh. (2024). Association of Cannabis Use With Cardiovascular Outcomes Among US Adults.. Journal of the American Heart Association, 13(5), e030178. https://doi.org/10.1161/JAHA.123.030178