Cannabis Users Had 48% Higher Risk of Cardiovascular Events in Large Meta-Analysis
A meta-analysis of 17 studies involving nearly 1.9 million people found cannabis use was significantly associated with a 48% higher risk of composite adverse cardiovascular events, though individual associations with heart attack and stroke did not reach statistical significance.
Quick Facts
What This Study Found
Ever use of cannabis was associated with a statistically significant 48% higher risk of any adverse cardiovascular event (RR: 1.48, 95% CI: 1.16-1.90, p=0.002). The association with myocardial infarction alone (RR: 1.25, 95% CI: 0.91-1.71) and stroke alone (RR: 1.38, 95% CI: 0.88-2.16) did not reach statistical significance.
Key Numbers
17 studies, 1,902,481 individuals. Mean follow-up: 8.5 years. Any adverse CV event: RR 1.48 (95% CI: 1.16-1.90, p=0.002). MI: RR 1.25 (95% CI: 0.91-1.71, p=0.17). Stroke: RR 1.38 (95% CI: 0.88-2.16, p=0.16). Age range: 18-74 years.
How They Did This
Systematic review and meta-analysis of 17 observational studies (PubMed, Scopus, ScienceDirect, Cochrane) from inception to April 2024. Random effects models analyzed 1,902,481 individuals aged 18-74 with mean follow-up of 8.5 years. Registered with PROSPERO (CRD42024530366).
Why This Research Matters
Whether cannabis causes cardiovascular disease has been debated for years. This meta-analysis of nearly 1.9 million people provides the strongest pooled estimate to date, showing a significant association with composite cardiovascular events even if individual endpoints fall short of significance.
The Bigger Picture
The non-significant individual associations for heart attack and stroke combined with a significant composite endpoint suggest that cannabis may increase overall cardiovascular risk through multiple pathways rather than one dominant mechanism. This pattern is consistent with cannabis's known effects on blood pressure, heart rate, and vascular inflammation.
What This Study Doesn't Tell Us
All included studies were observational, limiting causal inference. Cannabis exposure was typically 'ever use,' which does not capture dose, frequency, or potency. Confounders like tobacco co-use may not be fully controlled. Publication bias possible. Heterogeneity across study designs and populations.
Questions This Raises
- ?Whether dose-response relationships exist between cannabis frequency and cardiovascular risk
- ?How much of the observed risk is attributable to smoked versus non-smoked cannabis
Trust & Context
- Key Stat:
- Evidence Grade:
- Large pooled analysis with PROSPERO registration and appropriate methodology, but observational data with crude exposure measures and potential residual confounding.
- Study Age:
- Published 2025, searching literature through April 2024.
- Original Title:
- Cannabis use and atherosclerotic cardiovascular disease outcomes: A meta-analysis of multinational cohort data.
- Published In:
- Disease-a-month : DM, 71(3), 101849 (2025)
- Database ID:
- RTHC-07608
Evidence Hierarchy
Combines results from multiple studies to find an overall pattern.
What do these levels mean? →Frequently Asked Questions
Does cannabis cause heart attacks?
This meta-analysis found an association but cannot prove causation. The 25% higher heart attack risk for cannabis users was not statistically significant on its own. However, the significant 48% increase in overall cardiovascular events suggests cannabis may affect heart health through multiple mechanisms.
How does this compare to tobacco's cardiovascular risk?
Tobacco smoking roughly doubles cardiovascular risk. The 48% increase associated with cannabis is smaller but still clinically meaningful, especially since many cannabis users also smoke tobacco, potentially compounding the risk.
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Cite This Study
https://rethinkthc.com/research/RTHC-07608APA
Sebastian, Sneha Annie; Shah, Yash; Arsene, Camelia; Krishnamoorthy, Geetha. (2025). Cannabis use and atherosclerotic cardiovascular disease outcomes: A meta-analysis of multinational cohort data.. Disease-a-month : DM, 71(3), 101849. https://doi.org/10.1016/j.disamonth.2024.101849
MLA
Sebastian, Sneha Annie, et al. "Cannabis use and atherosclerotic cardiovascular disease outcomes: A meta-analysis of multinational cohort data.." Disease-a-month : DM, 2025. https://doi.org/10.1016/j.disamonth.2024.101849
RethinkTHC
RethinkTHC Research Database. "Cannabis use and atherosclerotic cardiovascular disease outc..." RTHC-07608. Retrieved from https://rethinkthc.com/research/sebastian-2025-cannabis-use-and-atherosclerotic
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.