A new study has found that cannabis use is linked to a doubling in the risk of dying from cardiovascular disease, with significantly heightened risks of having a stroke or acute coronary syndrome
Cannabis usage has grown in the past decade, with the rise of cannabis legalisation across the world and the expansion of its use for medical reasons, society’s view of the drug may have shifted the perception of risk. For example, in France, medical cannabis has been experimented with since 2021, while recreational cannabis is illegal and strictly regulated; nevertheless, its use is the most prevalent in Europe, especially among the young. Contrastingly, recreational cannabis was legalised in Germany in April 2024.
Previous studies have linked cannabis use to cardiovascular problems, but the magnitude of the risk is unclear, leading scientists to eliminate this research gap.
The findings are detailed in the journal Heart.
Exploring cannabis use and serious cardiovascular outcomes
The researchers analysed large observational databases published between January 2016 and December 2023 to explore a link between cannabis use and serious cardiovascular outcomes, such as death, heart attacks and strokes.
The researchers analysed 17 cross-sectional studies, six cohort studies, and one case-control study, examining data from adults aged between 19 and 59. In studies where sex was reported, cannabis users tended to be primarily male and younger than non-users.
Doubled risk of dying from cardiovascular disease
The researchers found heightened risks for cannabis use: 29% higher for acute coronary syndrome, 20% higher for stroke, and a doubling in the risk of dying from cardiovascular disease.
The researchers acknowledge that there was a moderate to high risk of bias in most of the included studies, mainly because of a lack of information on missing data and imprecise measures of cannabis exposure. Most of the included studies were observational, precluding the ability to draw causal inferences from the data. Several used the same data.
Furthermore, the researchers stress that the study is a comprehensive analysis of published data on the potential association between cannabis use and significant cardiovascular disease, providing new insights from real-world data.
Emeritus Professor Stanton Glantz, a renowned expert in public health from the University of California, San Francisco, and Dr Lynn Silver, a distinguished researcher from the Public Health Institute, Oakland, California, and the Department of Epidemiology and Biostatistics, University of California, San Francisco, say the study “raises serious questions about the assumption that cannabis imposes little cardiovascular risk.”
“How these changes affect cardiovascular risk requires clarification, as does the proportion of risk attributable to cannabinoids themselves versus particulate matter, terpenes or other components of the exposure,” the researchers added.
They concluded: “Cannabis needs to be incorporated into the framework for prevention of clinical cardiovascular disease. So, too, must cardiovascular disease prevention be incorporated into the regulation of cannabis markets. Adequate product warnings and education on risks must be developed, required, and implemented.
“Cardiovascular and other health risks must be considered in the regulation of allowable product and marketing design as the evidence base grows. Today, that regulation is focused on establishing the legal market with woeful neglect of minimising health risks.
“Specifically, cannabis should be treated like tobacco: not criminalised, but discouraged, with the protection of bystanders from secondhand exposure.”
