Cannabis Use and Heart Health

A recent study published in the Journal of the American Heart Association delves into the potential cardiovascular risks associated with cannabis use among adults in the United States. The research, conducted between 2016 and 2020, analyzed data from 430,000 individuals, shedding light on the prevalence and consequences of cannabis use on heart health.

The study highlights the increasing prevalence of cannabis use in the U.S., with 24 states and Washington, D.C., legalizing recreational cannabis. The shift in public perception regarding the harmfulness of smoking cannabis is noted, raising concerns about the potential health risks associated with this widely used substance. While federal illegality persists, cannabis consumption has surged over the past decades, as indicated by the Substance Abuse and Mental Health Service Administration’s 2019 National Survey on Drug Use and Health.

Lead author, Abra Jeffers, Ph.D., emphasizes the lack of comprehensive understanding regarding the cardiovascular risks of cannabis use. The study aims to deal with this knowledge gap. It investigates whether cannabis use, mainly through smoking, eating, or vaporizing, is independently associated with adverse cardiovascular outcomes.

The research employed survey data collected from the Behavioral Risk Factor Surveillance System, the annual national cross-sectional survey conducted by the U.S. Center for Disease Control and Prevention. The sample size encompassed 430,000 adults aged 18 to 74, with an average age of 45. Demographic details revealed a diverse participant pool.

The researchers focused on exploring associations between cannabis use and cardiovascular outcomes, including coronary heart disease, myocardial infarction (heart attack), and stroke. The analysis considered various factors, such as tobacco use, e-cigarette use, alcohol consumption, body mass index, Type 2 diabetes, and physical activity. Additionally, the study investigated subgroups, including individuals who had never smoked tobacco or used e-cigarettes and younger adults at risk for heart disease.

Cannabis Use and Heart Health

The study identified several noteworthy findings:

1. Independent Association with Cardiovascular Outcomes:

   – Any cannabis use (smoked, eaten, or vaporized) was independently associated with an increased number of adverse cardiovascular outcomes, even after controlling other risk factors.

   – More frequent cannabis use (measured in days per month) further increased the odds of adverse cardiovascular outcomes.

2. Increased Risk for Heart Attack:

   – Both daily and non-daily cannabis users exhibited an increased chance of heart attack compared to non-users.

   – Daily cannabis users had a 25% higher odds of experiencing a heart attack.

3. Elevated Odds of Stroke:

   – Daily cannabis users faced a 42% higher odds of stroke compared to non-users.

   – The risk of stroke was comparatively lower among those who used cannabis less than daily.

4. Younger Adults at Risk:

   – Among younger adults at risk for premature cardiovascular disease, cannabis use was significantly associated with a 36% higher combined odds of coronary heart disease, heart attack, and stroke.

   – This association persisted regardless of whether individuals also used traditional tobacco products.

Population Health Implications:

The study’s large sample size allowed for an investigation into the association of cannabis use with cardiovascular outcomes among adults who had never used tobacco or e-cigarettes. Notably, the study underscores that smoking cannabis poses significant cardiovascular risks akin to smoking tobacco. With the increase in cannabis use and the decrease in conventional tobacco use, the findings hold crucial implications for population health.

Limitations and Future Research:

The study acknowledges certain limitations, including self-reported cardiovascular conditions and cannabis use, potentially subject to recall bias. The absence of baseline lipid profiles or blood pressure data and the reliance on a single data point for participants are also recognized limitations. The authors advocate for prospective cohort studies to provide a more nuanced understanding of the relationship between cannabis use and cardiovascular outcomes over time.

Expert Commentary:

Robert L. Page II, Pharm.D., M.S.P.H., FAHA, chair of the volunteer writing group for the 2020 American Heart Association Scientific Statement on Medical Marijuana, Recreational Cannabis, and Cardiovascular Health, emphasizes the study’s implications for population health. He notes that as cannabis use continues to grow in legality and accessibility, healthcare practitioners need to be vigilant in assessing cannabis use during patient encounters. A non-judgmental, shared decision conversation is essential to discuss potential cardiovascular risks and strategies for risk reduction.

In conclusion, the study provides significant insights into the potential cardiovascular risks linked with cannabis use. With a focus on a large and diverse sample, the findings underscore the independent association between cannabis use and adverse cardiovascular outcomes, even after accounting for other risk factors. As cannabis use becomes more prevalent, this research serves as a call to action for healthcare practitioners to consider and discuss the potential cardiovascular risks with their patients, contributing to informed decision-making in the context of evolving cannabis legislation and usage patterns.