Cannabis Use Linked to 29% Higher Heart Attack Risk and Double the Cardiovascular Death Risk | Research

The takeaway

A meta-analysis of 24 studies found cannabis use associated with a 29% increased risk of acute coronary syndrome, 20% increased stroke risk, and 110% increased cardiovascular death risk.

cardiologists, primary care clinicians, cannabis users with cardiovascular risk factors, public health officials

What the researchers found

Risk ratios for cannabis users: ACS 1.29 (95% CI 1.05-1.59), stroke 1.20 (1.13-1.26), cardiovascular death 2.10 (1.29-3.42). No significant association for composite ACS+stroke. Sensitivity analysis restricted to cohort studies yielded comparable results (RR 1.32, 1.01-1.73). 24 studies included: 17 cross-sectional, 6 cohort, 1 case-control.

Why it matters

This is one of the most comprehensive quantitative assessments of cannabis cardiovascular risk. The elevated cardiovascular death risk (2.1x) is particularly concerning given increasing cannabis use and the often-overlooked cardiac effects.

The numbers in context

24 studies from 3,012 screened. 17 cross-sectional, 6 cohort, 1 case-control. ACS RR: 1.29. Stroke RR: 1.20. CV death RR: 2.10. Cohort-only analysis: RR 1.32 for ACS.

How the study worked

Systematic review and meta-analysis (PROSPERO: CRD42023401401) of pharmacoepidemiological studies published January 2016-January 2023. Searched PubMed, Web of Science, Scopus. Quality assessed with ROBINS-E tool. DerSimonian-Laird random effects meta-analysis with inverse variance weighting.

What this study cannot tell us

Most included studies were cross-sectional, limiting causal inference. Exposure measurement varied across studies. Potential residual confounding from co-use of other substances. Heterogeneity in study populations and designs.

How to read the evidence

Systematic review and meta-analysis with registered protocol and sensitivity analyses, though predominantly cross-sectional source studies limit to moderate.

When this study was published

Studies published 2016-2023, search through September 2023.

The bigger picture

While most cannabis safety discussions focus on mental health or respiratory effects, this meta-analysis provides pooled evidence that cardiovascular risks are real and quantifiable. The magnitude of the cardiovascular death association is notable.

Questions still open

Does the cardiovascular risk vary by cannabis product type or consumption method?
Are certain populations (age groups, pre-existing conditions) at higher cardiovascular risk from cannabis?

Common questions

Does cannabis increase heart attack risk?

This meta-analysis found a 29% increased risk of acute coronary syndrome (which includes heart attacks) among cannabis users across 24 studies.

How serious is the cardiovascular risk from cannabis?

The most concerning finding was a 2.1-fold increased risk of cardiovascular death. Stroke risk was elevated by 20%. These associations persisted when analysis was restricted to higher-quality cohort studies.

Read the original research

Cardiovascular risk associated with the use of cannabis and cannabinoids: a systematic review and meta-analysis.

Heart (British Cardiac Society), 111(22), 1047-1056

View on PubMed ↗Publisher’s paper ↗

Citation

Storck, Wilhelm; Elbaz, Meyer; Vindis, Cécile; Déguilhem, Amélia; Lapeyre-Mestre, Maryse; Jouanjus, Emilie. (2025). Cardiovascular risk associated with the use of cannabis and cannabinoids: a systematic review and meta-analysis.. Heart (British Cardiac Society), 111(22), 1047-1056. https://doi.org/10.1136/heartjnl-2024-325429