Heart Attacks in Young Cannabis Users Tripled Over a Decade, With the Sharpest Rise Among Black Americans | Research

The takeaway

In a nationwide US database of 819,175 hospitalizations for heart attack in patients 18-49, the incidence among cannabis users nearly tripled from 2.36% in 2007 to 6.55% in 2018, with the largest increase among Black Americans (5.69% to 12.25%).

Cardiologists, emergency physicians, public health officials, cannabis users concerned about heart health.

Heart attacks in young cannabis users rose from 2.36% to 6.55% over a decade

What the researchers found

Of 819,175 AMI hospitalizations among 18-49 year olds, 28% reported cannabis use. AMI incidence among cannabis users increased from 2.36% (2007) to 6.55% (2018). The increase was largest among Black Americans (5.69% to 12.25%). Cannabis-using AMI patients were more likely to be male (78% vs. 72%) and Black (32% vs. 14%). Rates increased across both sexes: males 2.63% to 7.17%, females 1.62% to 5.12%.

Why it matters

The steep increase in heart attacks among young cannabis users, combined with racial disparities, raises urgent questions about cardiovascular safety and health equity. Whether cannabis contributes to heart attacks or is a marker for other risk factors remains critical to determine.

The numbers in context

N=819,175 AMI hospitalizations ages 18-49. Cannabis use: 28%. AMI in cannabis users: 2.36% (2007) to 6.55% (2018). Black Americans: 5.69% to 12.25%. Males: 2.63% to 7.17%. Females: 1.62% to 5.12%.

How the study worked

Retrospective nationwide analysis using the Nationwide Inpatient Sample (NIS) database, 2007-2018. ICD-9 and ICD-10 codes identified AMI hospitalizations among cannabis users aged 18-49. Gender and race stratified trend analysis.

What this study cannot tell us

Administrative database cannot establish causation. Cannabis use identified by ICD codes likely underestimates prevalence. Cannot distinguish cannabis as risk factor vs. correlated behavior. Increasing coding awareness may inflate apparent trends. No dose-response data.

How to read the evidence

Large nationwide database study spanning 10 years, but administrative data cannot establish causation and cannabis use is likely underreported.

When this study was published

Published in 2023 using NIS data from 2007-2018.

The bigger picture

This trend parallels both increasing cannabis use and increasing cannabis potency. The racial disparity (Black Americans showing both higher baseline rates and steeper increases) may reflect intersecting factors including disparities in cardiovascular health, cannabis use patterns, and healthcare access.

Questions still open

Is cannabis directly causing more heart attacks in young people, or does cannabis use correlate with other cardiovascular risk factors?
Why is the increase steepest among Black Americans?

Common questions

Can cannabis cause a heart attack?

This study found heart attacks among young cannabis users nearly tripled over a decade, but cannot prove cannabis caused them. Cannabis use may co-occur with other cardiovascular risk factors.

Who is most at risk?

Males and Black Americans had the highest rates and steepest increases. Among Black cannabis users aged 18-49, the AMI rate rose from 5.69% to 12.25% between 2007 and 2018.

Read the original research

Rising trend of acute myocardial infarction among young cannabis users: A 10-year nationwide gender and race stratified analysis.

International journal of cardiology. Cardiovascular risk and prevention, 16, 200167

View on PubMed ↗Publisher’s paper ↗

Citation

Sandhyavenu, Harigopal; Patel, Harsh P; Patel, Riddhiben H; Desai, Rohan; Patel, Achint A; Patel, Bhavin A; Patel, Jaimin; Zahid, Salman; Khan, Safi U; Deshmukh, Abhishek; Nasir, Khurram; DeSimone, Christopher V; Dani, Sourbha S; Thakkar, Samarthkumar. (2023). Rising trend of acute myocardial infarction among young cannabis users: A 10-year nationwide gender and race stratified analysis.. International journal of cardiology. Cardiovascular risk and prevention, 16, 200167. https://doi.org/10.1016/j.ijcrp.2022.200167