Cannabis Use Not Linked to Heart Rhythm Problems in People Living with HIV
Cannabis use showed no association with ECG abnormalities among 3,610 people with and without HIV in a decade-long cohort study.
Quick Facts
What This Study Found
Cannabis use was not significantly associated with ECG evidence of myocardial infarction (aOR 1.02) or other abnormalities (aOR 1.02) in adjusted analyses. HIV status and sex were more important determinants — female participants had more abnormal findings, and male PWH had higher odds of non-MI abnormalities compared to PWoH.
Key Numbers
3,610 participants (63% PWH). 28% reported cannabis use. 59% had normal ECG findings. Adjusted ORs for cannabis and MI evidence: 1.02 (95% CI: 0.82-1.26). For other abnormalities: 1.02 (95% CI: 0.80-1.32). Male PWH had higher odds of non-MI abnormalities vs PWoH (aOR 1.35).
How They Did This
Baseline logistic regression analysis of 3,610 participants from the MACS/WIHS Combined Cohort Study (2007-2017), comparing ECG findings between cannabis users (28%) and non-users, with adjustment for demographic and clinical covariates.
Why This Research Matters
People living with HIV already face elevated cardiovascular risk. Knowing that cannabis use doesn't appear to add ECG-detectable cardiac harm provides important reassurance for the many PWH who use cannabis for symptom management.
The Bigger Picture
As cannabis becomes more widely used for managing HIV-related symptoms like pain, nausea, and appetite loss, understanding its cardiovascular safety profile in this population is critical for informed clinical decision-making.
What This Study Doesn't Tell Us
Cross-sectional ECG analysis at baseline limits temporal conclusions. Self-reported cannabis use may be underreported. Cannot distinguish between different cannabis products, potencies, or consumption methods. Residual confounding possible.
Questions This Raises
- ?Would more sensitive cardiac imaging detect subclinical changes?
- ?Do specific cannabis metabolites or usage patterns affect cardiovascular risk differently?
- ?What role does antiretroviral therapy play in modifying any cannabis-heart interaction?
Trust & Context
- Key Stat:
- Evidence Grade:
- Large, well-characterized cohort with decade of follow-up provides moderate evidence, limited by cross-sectional ECG analysis and self-reported exposure.
- Study Age:
- Published 2026, analyzing 2007-2017 MACS/WIHS data.
- Original Title:
- The Association Between Cannabis Use and Electrocardiographic Abnormalities in People Living With HIV.
- Published In:
- Journal of acquired immune deficiency syndromes (1999), 101(2), 191-198 (2026)
- Authors:
- Larson, Michaela E, Pan, Yue(2), Lakhani, Fatima, Chavez, Jennifer V, Santana, Andrea, Nogueira, Nicholas Fonseca, Lieberman, Adam, Riley, Elise D, Wu, Katherine C, Tien, Phyllis, Kizer, Jorge, Floris-Moore, Michelle, Pyslar, Nataliya, Palella, Frank J, Witt, Mallory D, Magnani, Jared W, Plankey, Michael, Lazar, Jason, Sharma, Anjali, Moran, Caitlin, Topper, Elizabeth, Fox, Ervin, Kambrakos, Litsa, Fischl, Margaret, Jones, Deborah L, Alcaide, Maria L, Vidot, Denise, Martinez, Claudia
- Database ID:
- RTHC-08412
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Does cannabis affect heart health in people with HIV?
In this study of over 3,600 people, cannabis use showed no association with ECG abnormalities — the odds ratios were essentially 1.0 — suggesting cannabis doesn't add detectable cardiac risk on top of HIV.
What does affect heart risk in people with HIV?
HIV status itself and sex were more important factors. Male people living with HIV had 35% higher odds of non-MI ECG abnormalities, and female participants had more abnormal findings overall than males.
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Cite This Study
https://rethinkthc.com/research/RTHC-08412APA
Larson, Michaela E; Pan, Yue; Lakhani, Fatima; Chavez, Jennifer V; Santana, Andrea; Nogueira, Nicholas Fonseca; Lieberman, Adam; Riley, Elise D; Wu, Katherine C; Tien, Phyllis; Kizer, Jorge; Floris-Moore, Michelle; Pyslar, Nataliya; Palella, Frank J; Witt, Mallory D; Magnani, Jared W; Plankey, Michael; Lazar, Jason; Sharma, Anjali; Moran, Caitlin; Topper, Elizabeth; Fox, Ervin; Kambrakos, Litsa; Fischl, Margaret; Jones, Deborah L; Alcaide, Maria L; Vidot, Denise; Martinez, Claudia. (2026). The Association Between Cannabis Use and Electrocardiographic Abnormalities in People Living With HIV.. Journal of acquired immune deficiency syndromes (1999), 101(2), 191-198. https://doi.org/10.1097/QAI.0000000000003786
MLA
Larson, Michaela E, et al. "The Association Between Cannabis Use and Electrocardiographic Abnormalities in People Living With HIV.." Journal of acquired immune deficiency syndromes (1999), 2026. https://doi.org/10.1097/QAI.0000000000003786
RethinkTHC
RethinkTHC Research Database. "The Association Between Cannabis Use and Electrocardiographi..." RTHC-08412. Retrieved from https://rethinkthc.com/research/larson-2026-the-association-between-cannabis
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.