Cannabis use independently predicted higher risks of heart failure and stroke in adults under 55

An analysis of the National Inpatient Sample database found that cannabis use was an independent predictor of heart failure (OR 1.1) and cerebrovascular accident (OR 1.24) in adults aged 18-55 after adjusting for traditional cardiovascular risk factors.

Kalla, Aditi et al.·Journal of cardiovascular medicine (Hagerstown·2018·Moderate EvidenceRetrospective Cohort
RTHC-01709Retrospective CohortModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=2,009

What This Study Found

Researchers identified cannabis users aged 18-55 in the National Inpatient Sample 2009-2010 database and compared their cardiovascular outcomes to the general population.

Prevalence of heart failure, stroke, coronary artery disease, sudden cardiac death, and hypertension were all significantly higher in cannabis users.

After multivariate regression adjusting for age, sex, hypertension, diabetes, hyperlipidemia, coronary artery disease, tobacco use, and alcohol use, cannabis use remained an independent predictor of heart failure (OR 1.1, 95% CI 1.03-1.18) and stroke (OR 1.24, 95% CI 1.14-1.34).

The stroke association was notably stronger than the heart failure association.

Key Numbers

Cannabis use independently predicted heart failure (OR 1.1, 95% CI 1.03-1.18, p < 0.01) and stroke (OR 1.24, 95% CI 1.14-1.34, p < 0.001) after adjusting for age, sex, hypertension, diabetes, hyperlipidemia, coronary artery disease, tobacco, and alcohol use.

How They Did This

Retrospective analysis of the National Inpatient Sample 2009-2010. Cannabis use identified by ICD-9 code 304.3 (cannabis dependence). Multivariate logistic regression adjusting for traditional cardiovascular risk factors.

Why This Research Matters

As cannabis use becomes more widespread, understanding cardiovascular risks matters for public health. This large database study suggests cannabis may carry independent cardiovascular risk even in younger adults, a population typically considered low-risk for heart failure and stroke.

The Bigger Picture

This adds to a growing body of evidence suggesting cannabis use may carry cardiovascular risks that are not fully explained by concurrent tobacco or alcohol use. However, database studies using diagnostic codes have inherent limitations in capturing the full picture of cannabis exposure.

What This Study Doesn't Tell Us

Retrospective database study relying on ICD-9 codes, which likely undercount cannabis use and only capture those with documented cannabis dependence. Cannot determine dose, frequency, or method of cannabis use. Cannot establish causation. Hospitalized patients may not represent all cannabis users.

Questions This Raises

  • ?Is there a dose-response relationship between cannabis use and cardiovascular events?
  • ?Does the method of consumption (smoking vs. edibles) affect cardiovascular risk?
  • ?Are younger cannabis users at different risk than older users?

Trust & Context

Key Stat:
Cannabis independently predicted stroke (OR 1.24) and heart failure (OR 1.1) in adults under 55
Evidence Grade:
Moderate. Large national database with appropriate statistical adjustments, but retrospective design and reliance on diagnostic codes limit causal conclusions.
Study Age:
Published in 2018 using 2009-2010 data. Cannabis cardiovascular research has continued to expand as legalization spreads.
Original Title:
Cannabis use predicts risks of heart failure and cerebrovascular accidents: results from the National Inpatient Sample.
Published In:
Journal of cardiovascular medicine (Hagerstown, Md.), 19(9), 480-484 (2018)
Database ID:
RTHC-01709

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

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Does this prove cannabis causes heart failure and stroke?

No. This is an observational study showing an association, not causation. Cannabis users identified by hospital diagnostic codes may differ from the general population in ways not captured by the study. However, the association persisted after adjusting for known cardiovascular risk factors.

What is an odds ratio of 1.24?

An odds ratio of 1.24 means cannabis users had 24% higher odds of stroke compared to non-users after adjusting for other risk factors. This is a modest but statistically significant increase, particularly meaningful in a younger population where stroke is relatively uncommon.

Read More on RethinkTHC

Cite This Study

RTHC-01709·https://rethinkthc.com/research/RTHC-01709

APA

Kalla, Aditi; Krishnamoorthy, Parasuram M; Gopalakrishnan, Akshaya; Figueredo, Vincent M. (2018). Cannabis use predicts risks of heart failure and cerebrovascular accidents: results from the National Inpatient Sample.. Journal of cardiovascular medicine (Hagerstown, Md.), 19(9), 480-484. https://doi.org/10.2459/JCM.0000000000000681

MLA

Kalla, Aditi, et al. "Cannabis use predicts risks of heart failure and cerebrovascular accidents: results from the National Inpatient Sample.." Journal of cardiovascular medicine (Hagerstown, 2018. https://doi.org/10.2459/JCM.0000000000000681

RethinkTHC

RethinkTHC Research Database. "Cannabis use predicts risks of heart failure and cerebrovasc..." RTHC-01709. Retrieved from https://rethinkthc.com/research/kalla-2018-cannabis-use-predicts-risks

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.