Is cannabis use disorder linked to higher rates of heart rhythm problems in young adults? | Research

The takeaway

An analysis of over 68 million US hospital records found that cannabis use disorder was associated with 28-52% increased odds of arrhythmia hospitalization in people aged 15-34, with atrial fibrillation being the most common rhythm disturbance.

Young cannabis users, clinicians managing arrhythmias in younger patients, and anyone interested in the cardiovascular effects of cannabis.

1.52x arrhythmia odds in ages 25-34

What the researchers found

CUD was associated with 1.28 times higher odds of arrhythmia hospitalization in 15-24 year olds (95% CI: 1.229-1.346) and 1.52 times in 25-34 year olds (95% CI: 1.469-1.578). Among cannabis users with arrhythmia, 42% had atrial fibrillation, followed by other arrhythmias (24%) and atrial flutter (8%). Patients with CUD were more likely to be younger, male, and African American.

Why it matters

This is described as the first national study finding an association between CUD and arrhythmia hospitalization in young people. Atrial fibrillation in this age group is particularly concerning because it can lead to stroke and other embolic events.

The numbers in context

570,556 arrhythmia patients; 67.7 million comparison patients; CUD prevalence in arrhythmia patients: 2.6%; odds ratio 15-24 years: 1.28; 25-34 years: 1.52; 42% had atrial fibrillation; controlled for other substance use

How the study worked

Retrospective analysis of the Nationwide Inpatient Sample (2010-2014). Compared 570,556 patients aged 15-54 with primary arrhythmia diagnosis to 67.7 million non-arrhythmia inpatients. Logistic regression adjusted for demographics and comorbid risk factors.

What this study cannot tell us

Retrospective administrative data cannot establish causation. ICD coding may under-capture CUD diagnosis. Cannot distinguish cannabis use patterns (frequency, route, potency). Association controlled for confounders but unmeasured variables may exist.

How to read the evidence

Large national database with adjusted analyses, but retrospective administrative data with potential coding limitations.

When this study was published

Published in 2021 using 2010-2014 data; cannabis potency and use patterns have changed since.

The bigger picture

Young adults are not typically considered at high risk for arrhythmia. The finding that cannabis use disorder is independently associated with heart rhythm problems after controlling for other substances adds to growing evidence that cannabis may carry underappreciated cardiovascular risks.

Questions still open

Does the mechanism involve direct cardiac effects of THC, autonomic nervous system disruption, or something else? Do these arrhythmias resolve with cannabis cessation? Is there a dose-response relationship between cannabis use intensity and arrhythmia risk?

Common questions

Can cannabis cause heart rhythm problems?

This large national study found an association between cannabis use disorder and arrhythmia hospitalization in young adults, but cannot prove causation. The risk was 28-52% higher after controlling for other factors.

What type of arrhythmia was most common?

Atrial fibrillation accounted for 42% of arrhythmias in cannabis users, which is notable because atrial fibrillation can cause blood clots and stroke.

Who was most at risk?

The association was strongest in 25-34 year olds (52% higher odds). Cannabis-related arrhythmia patients were more likely to be younger, male, and African American.

Read the original research

Cannabis use disorder and increased risk of arrhythmia-related hospitalization in young adults.

The American journal on addictions, 30(6), 578-584

View on PubMed ↗Publisher’s paper ↗

Citation

Patel, Rikinkumar S; Gonzalez, Mario D; Ajibawo, Temitope; Baweja, Raman. (2021). Cannabis use disorder and increased risk of arrhythmia-related hospitalization in young adults.. The American journal on addictions, 30(6), 578-584. https://doi.org/10.1111/ajad.13215