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New research indicates a concerning link between cannabis use and increased cardiovascular risks, prompting calls for clinicians to warn patients about potential dangers. Studies suggest that even moderate cannabis consumption may elevate the risk of heart attack and stroke, with daily users facing significantly higher risks.
A recent large-scale US study, involving over 430,000 participants, revealed that daily cannabis users had a 49% increased risk of myocardial infarction (heart attack) and a twofold increased risk of stroke, compared to non-users. This heightened risk was observed regardless of tobacco use. Weekly users also showed increased risks, with a 3% higher likelihood of heart attack and a 5% higher risk of stroke.
These findings are supported by other studies, including a 2022 analysis of UK Biobank data, which found a significantly higher rate of heart attacks among cannabis smokers. Additionally, research published in the European Heart Journal linked cannabis use to an increased risk of arrhythmia, particularly atrial fibrillation.
Researchers attribute these risks to the effects of tetrahydrocannabinol (THC), the psychoactive component of cannabis. THC binds to CB1 receptors found in the heart and blood vessels, potentially leading to inflammation, oxidative stress, and atherosclerotic changes. Studies in mouse models have shown that cannabis can increase atherosclerotic plaques and may have a prothrombotic effect, increasing the risk of blood clots.
“The CB1 receptor promotes atherosclerotic changes,” explained Dr. Mark Chandy, a cardiologist scientist at Western University. “Mouse models have found that cannabis increases atherosclerotic plaques. Scientists also theorize that cannabis might have a prothrombotic effect increasing the risk for heart attacks and strokes.”
Experts also highlight the potential for cannabis to disrupt the heart’s electrical conduction system, leading to arrhythmias. “Vasospasm and constriction of blood vessels combined with high platelet aggregation” is the most probable mechanism explaining the association between cannabis and cardiovascular disease, said Dr. Chip Lavie, medical director at the John Ochsner Heart and Vascular Institute.
Clinicians are now being advised to discuss these risks with patients. “I would advise them not to use cannabis. At least, they should be able to make an informed decision about it and know the potential consequences of it,” said Dr. Chandy.
While randomized controlled trials are challenging, the growing body of observational evidence raises serious concerns. “We know that people who use cannabis are at an elevated risk, so maybe they should be getting a more vigilant approach,” suggested Dr. Anders Holt, a cardiologist at Copenhagen University Hospital.
Experts also suggest that if cannabis use cannot be avoided, patients consider consuming edibles or oils rather than smoking, and to reduce the amount used. There is also increased concern about synthetic cannabinoids, which may pose even greater risks due to their stronger binding to CB1 receptors.
As cannabis use becomes more prevalent, particularly among young people, researchers emphasize the importance of understanding the long-term cardiovascular effects.
Disclaimer: It is important to note that observational studies, while informative, cannot definitively establish causation. Other factors, such as lifestyle choices, may contribute to the observed risks. More research is needed to fully understand the relationship between cannabis use and cardiovascular health. This article is for informational purposes only and does not constitute medical advice. Consult with a healthcare professional before1 making any decisions related to your health or treatment.
