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Regular marijuana use may increase the risk for heart failure, stroke or heart attack even after accounting for other cardiovascular risk factors such as type 2 diabetes, high blood pressure and obesity.
Two preliminary studies, presented at the American Heart Association’s Scientific Sessions 2023, suggest its regular intake may damage heart and brain health.
In one study, daily use of marijuana raised the risk of developing heart failure by about one-third, even after considering other factors, compared to people who reported never using marijuana.
More than 150,000 adults in the US participated in the All of Us Research Program, a National Institutes of Health-sponsored programme. Researchers focused on the relationship between lifestyle, biology and environment in diverse populations and analysed the association between daily marijuana use and heart failure.
Lead study author Yakubu Bene-Alhasan, a resident physician at Medstar Health in Baltimore, said: “Prior research shows links between marijuana use and cardiovascular disease like coronary artery disease, heart failure and atrial fibrillation, which is known to cause heart failure. Marijuana use isn’t without its health concerns, and our study provides more data linking its use to cardiovascular conditions.”
Daily marijuana use had a 34% increased risk of developing heart failure
Bene-Alhasan and colleagues followed 156,999 individuals who were free from heart failure at the time they enrolled in the research programme. Study participants completed a survey about the frequency of their marijuana use and were followed for nearly four years (45 months). The analysis was adjusted to account for individual demographic and economic factors, alcohol use, smoking and other cardiovascular risk factors linked with heart failure, such as type 2 diabetes, high blood pressure, high cholesterol and obesity.
The analysis found:
- During the study period, 2,958 people (almost 2%) developed heart failure.
- People who reported daily marijuana use had a 34% increased risk of developing heart failure, compared to those who reported never using marijuana. This risk was the same regardless of age, sex at birth or smoking history.
- In a secondary analysis, when coronary artery disease was added to the investigation, the risk of heart failure dropped from 34% to 27%, suggesting that coronary artery disease is a pathway through which daily marijuana use may lead to heart failure.
“Our results should encourage more researchers to study the use of marijuana to better understand its health implications, especially on cardiovascular risk,” Bene-Alhasan said. “We want to provide the population with high-quality information on marijuana use and to help inform policy decisions at the state level, to educate patients and to guide health care professionals.”
Increased risk of major adverse cardiac and cerebrovascular events in older non-smokers
In a second study, different researchers evaluated data from the 2019 National Inpatient Sample, the largest nationwide database of hospitalisations, to investigate whether hospital stays were complicated by a cardiovascular event, including heart attack, stroke, cardiac arrest or arrhythmia in patients who used marijuana.
Researchers extracted records on adults older than age 65 years with cardiovascular risk factors who reported no tobacco use (cigarettes or other tobacco products). This group of patient records were then divided into two groups: marijuana users and non-marijuana users. The marijuana user’s hospital records were coded for cannabis use disorder which can vary from hospital to hospital.
The study found of the 28,535 cannabis users with existing cardiovascular risk factors (high blood pressure, type 2 diabetes or high cholesterol):
- 20% had an increased chance of having a major heart or brain event while hospitalised, compared to the group who did not use cannabis.
- 13.9% of cannabis users with cardiovascular risk factors had a major adverse heart and brain event while hospitalised compared to non-cannabis users.
- Additionally, the cannabis users in comparison to non-cannabis users had a higher rate of heart attacks (7.6% versus 6%, respectively) and were more likely to be transferred to other facilities (28.9% vs. 19%).
- High blood pressure (defined as greater than 130/80mmHg) and high cholesterol were predictors of major adverse heart and brain events in marijuana users.
Robert L. Page, Departments of Clinical Pharmacy and Physical Medicine, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, said: “The latest research about cannabis use indicates that smoking and inhaling cannabis increases concentrations of blood carboxyhemoglobin (carbon monoxide, a poisonous gas), tar (partly burned combustible matter) similar to the effects of inhaling a tobacco cigarette, both of which have been linked to heart muscle disease, chest pain, heart rhythm disturbances, heart attacks and other serious conditions.
“Together with the results of these two research studies, the cardiovascular risks of cannabis use are becoming clearer and should be carefully considered and monitored by health care professionals and the public.”