What cardiovascular risks are associated with cannabis use? | Research

The takeaway

A review of emerging evidence suggests cannabis use may pose serious cardiovascular risks, including associations with ischemic stroke and up to a fivefold increase in myocardial infarction risk, particularly in younger men.

Cannabis users concerned about heart health, and clinicians evaluating cardiovascular risk in patients who use cannabis.

~5x myocardial infarction risk increase

What the researchers found

Cannabis consumption was associated with increased ischemic stroke risk and an almost fivefold increase in myocardial infarction, primarily in the period immediately following consumption. Males in their 30s appeared to bear the greatest burden. Edible preparations were linked to more cardiovascular-related emergency department visits than combustible forms.

Why it matters

Cannabis is now the most popular inhaled substance in the US, surpassing tobacco. The cardiovascular risks may be placing a younger, traditionally low-risk population in danger of major cardiac events.

The numbers in context

Almost 5-fold increase in myocardial infarction risk; males in their 30s most affected; cannabis smoke contains PAHs, aromatic amines, and nitric oxide, some at higher concentrations than tobacco

How the study worked

Narrative review synthesizing existing evidence on cardiovascular effects of cannabis, including data on combustible and edible forms, chemical components (aromatic amines, PAHs), and vascular complications.

What this study cannot tell us

Narrative review without systematic methodology. Much of the evidence is observational and cannot establish causation. Research is described as "nascent" by the authors themselves.

How to read the evidence

Narrative review synthesizing observational evidence. Specific risk estimates should be interpreted cautiously pending larger prospective studies.

When this study was published

Published in 2021; cardiovascular research on cannabis has been expanding rapidly.

The bigger picture

The cardiovascular risk profile of cannabis complicates its perception as a safer alternative to tobacco. The finding that edibles may cause more cardiac ER visits than smoking challenges assumptions about the relative safety of different consumption methods.

Questions still open

Does the cardiovascular risk differ between occasional and chronic users? Are CBD-dominant products associated with the same cardiac risks as THC-dominant ones? Why do edibles appear to cause more cardiac ER visits?

Common questions

Can cannabis cause a heart attack?

Observational evidence links cannabis use to an almost fivefold increase in myocardial infarction risk, particularly in the moments immediately following consumption. However, this is based on observational data and cannot confirm causation.

Are edibles safer for the heart than smoking?

Not necessarily. This review notes that edible preparations have been linked to more cardiovascular-related emergency department visits than combustible forms, though the reasons are not fully understood.

Who is most at risk?

Based on current evidence, males in their 30s appear to bear the greatest burden of cannabis-related cardiovascular events, a group traditionally considered low risk for heart problems.

Read the original research

Reevaluating America's Latest Pharmaceutical Trend: The Cardiovascular Risk of Cannabis.

Current opinion in psychology, 38, 31-37

View on PubMed ↗Publisher’s paper ↗

Citation

O'Keefe, Evan L; Peterson, Tyler M; Lavie, Carl J. (2021). Reevaluating America's Latest Pharmaceutical Trend: The Cardiovascular Risk of Cannabis.. Current opinion in psychology, 38, 31-37. https://doi.org/10.1016/j.copsyc.2020.07.002