Blood pressure increased significantly when daily cannabis users stopped | Research

The takeaway

When 13 daily cannabis users stopped for supervised abstinence periods, a subset showed blood pressure increases up to 22.8 mmHg systolic, a potentially clinically significant cardiovascular withdrawal effect.

Read this if you use cannabis daily and are thinking about quitting, especially if you have high blood pressure.

Up to 22.8 mmHg systolic BP increase during cannabis abstinence

What the researchers found

Thirteen daily cannabis users participated in an inpatient study alternating between ad libitum cannabis smoking and supervised abstinence. Vital signs were measured three times daily over 11 inpatient days.

Blood pressure increased significantly during abstinence compared to cannabis-use periods. In a subset of 6 participants, the increases were substantial: up to 22.8 mmHg systolic and 12.3 mmHg diastolic. Heart rate was not significantly affected overall, though morning resting heart rate showed a slight increase during abstinence.

The authors noted that abrupt cessation of heavy cannabis use may cause clinically significant blood pressure increases, particularly concerning for users with preexisting hypertension.

Why it matters

Cannabis withdrawal is typically described in terms of mood, sleep, and appetite changes. This study identified a cardiovascular component that could be dangerous for people with existing high blood pressure who suddenly stop heavy cannabis use.

The numbers in context

13 daily cannabis users. Subset of 6 showed mean increases up to 22.8 mmHg systolic and 12.3 mmHg diastolic. 11 inpatient days. Vital signs measured 3 times daily.

How the study worked

Within-subjects ABAC crossover design with inpatient monitoring. 13 daily cannabis users (11 men, 8 African American) alternated between ad libitum cannabis smoking (A) and abstinence (B/C). Vital signs taken 3 times daily over 11 days.

What this study cannot tell us

Small sample size (13 participants). The clinically significant increases were seen in only a subset of 6. Short observation period means the time course of blood pressure normalization is unknown. All-male sample limits generalizability.

How to read the evidence

Small observational inpatient study with controlled conditions. The within-subjects design strengthens internal validity but the sample is too small for broad conclusions.

When this study was published

Published in 2011. Cannabis withdrawal cardiovascular effects have received limited additional study since.

The bigger picture

As cannabis use became more common and potent, understanding all aspects of withdrawal became important. The cardiovascular effects of stopping were not widely recognized, and this study suggested blood pressure monitoring should be part of cessation programs.

Questions still open

How long do blood pressure increases persist after cannabis cessation? Are certain individuals at higher risk for cardiovascular withdrawal effects? Should blood pressure monitoring be standard in cannabis cessation programs?

Common questions

Can quitting cannabis raise your blood pressure?

This study found that daily cannabis users experienced significant blood pressure increases during supervised abstinence. In a subset of participants, systolic pressure rose by as much as 22.8 mmHg, which is clinically meaningful and potentially concerning for those with existing hypertension.

Should you monitor blood pressure when quitting cannabis?

Based on this study, the authors recommended blood pressure monitoring for people attempting to reduce or quit frequent cannabis use, particularly those with preexisting hypertension. The time course of this effect is not yet known.

Read the original research

Increased blood pressure after abrupt cessation of daily cannabis use.

Journal of addiction medicine, 5(1), 16-20

View on PubMed ↗Publisher’s paper ↗

Citation

Vandrey, Ryan; Umbricht, Annie; Strain, Eric C. (2011). Increased blood pressure after abrupt cessation of daily cannabis use.. Journal of addiction medicine, 5(1), 16-20. https://doi.org/10.1097/ADM.0b013e3181d2b309