A study conducted at the University of California, USA, finds that cannabis use can increase the risk of serious cardiovascular events and that heavier use is associated with higher cardiovascular risk.
The study is published in the Journal of the American Heart Association.
Study: Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. Image Credit: Bits And Splits / Shutterstock
Background
The prevalence of cannabis use has increased from 10% in 2002 to 18% in 2019 among US adults. The number of cases of cannabis disorder has also increased sharply over time in the US. This could be because of the decreasing perception of the harmfulness of cannabis use in the general population. National surveys find that the percentage of people believing in health risks associated with cannabis use has decreased from 50% in 2002 to 28% in 2019.
Cannabis use is known to be associated with atherosclerotic heart disease. Tetrahydrocannabinol is an active compound of cannabis, which has been found to increase the risk of syncope, stroke, and myocardial infarction. Cannabis is predominantly inhaled through smoking, which can exert an additional negative impact on the cardiovascular system.
In this study, scientists have analyzed 2016 – 2020 data from the Behavioral Risk Factor Surveillance Survey to determine the association between cannabis use and cardiovascular outcomes among US adults.
Study design
The Behavioral Risk Factor Surveillance Survey is a US Centers for Disease Control and Prevention (CDC)-conducted telephonic survey covering 27 American states and two territories. The data of a total of 434,104 survey participants aged 18 to 74 years was analyzed in this study.
The number of days of cannabis use in the past 30 days was analyzed to determine cannabis use frequency. Self-reported cardiovascular outcomes included coronary heart disease, myocardial infarction, stroke, and a composite measure of all three cardiovascular events.
Cardiovascular risk factors adjusted in the analysis included tobacco cigarette use, alcohol consumption, nicotine-based electronic cigarette use, body mass index, diabetes, and physical activity.
Important observations
The prevalence of daily, non-daily, and never cannabis use was estimated to be 4%, 7.1%, and 88.9%, respectively, in the entire study population. The majority (61%) of participants reported never using tobacco cigarettes. The prevalence of coronary heart disease, myocardial infarction, stroke, and the composite outcome was 3.5%, 3.6%, 2.8%, and 7.4% in the study population, respectively.
The prevalence of current tobacco use and daily alcohol intake was significantly higher among daily and non-daily cannabis users compared to that among never-cannabis users. Significant differences in the distribution of cardiovascular events were observed between daily, non-daily, and never-cannabis users, with non-daily users showing the lowest estimates.
The analysis conducted after adjusting for demographic characteristics and cardiovascular risk factors revealed a significant association of cannabis use with the risks of myocardial infarction, stroke, and the composite outcome of coronary heart disease, myocardial infarction, and stroke. The risk of cardiovascular events increased with the increasing days of cannabis use.
The strong association observed between cannabis use and cardiovascular outcomes in the entire study population remained similar among adults who had never smoked tobacco cigarettes. Among participants who had never used tobacco cigarettes and electronic cigarettes, cannabis use showed significant associations with stroke and the composite outcome but not with coronary heart disease and myocardial infarction.
A subgroup analysis involving men aged below 55 years and women aged below five years who were at risk of premature cardiovascular disease revealed that cannabis use is significantly associated with increased risk of all tested cardiovascular events. These associations remained similar for those who had never used tobacco cigarettes and electronic cigarettes.
Study significance
The study finds that cannabis use is associated with an increased risk of myocardial infarction and stroke and that the association becomes stronger for those with a higher frequency of cannabis use per month.
Notably, US adults who have never smoked tobacco cigarettes exhibit a similar association between cannabis use and adverse cardiovascular outcomes.
Overall, the findings highlight the need for screening patients for cannabis use and advising them to quit the habit in order to reduce the risk of premature cardiovascular disease and cardiac events.
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