People who use cannabis are at a significantly greater risk for developing cardiovascular diseases, a new retrospective study shows. These data were reported by Ibrahim Kamel, MD, MHA, of the Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, and colleagues, in a manuscript published Tuesday online in JACC: Advances. “Asking about cannabis use should be part of clinicians’ workup to understand patients’ overall cardiovascular risk, similar to asking about smoking cigarettes,” said Dr. Kamel in a press release on Tuesday. “At a policy level, a fair warning should be made so that the people who are consuming cannabis know that there are risks.” Legalization of cannabis has expanded greatly. The drug has also become more popular and accepted socially. While some therapeutic benefits of cannabis have been noted, consumption has also been linked to adverse cardiovascular outcomes. The investigators in this study examined the long-term impacts of cannabis consumption in relative healthy people. This retrospective study utilized data from the TriNetX health research network — utilizing de-identified data from medical records around the world — to perform this analysis between 2010 and 2018. The Research network was the specific network used from TriNetX and contained data from 53 healthcare organizations (HCO) throughout the US. The primary outcome of this study was myocardial infarction (MI) defined using ICD-10 codes. Secondary outcomes were major adverse cardiovascular events (MACE), all-cause mortality, heart failure (HF) and ischemic stroke. A total of 4,636,628 relatively healthy adults between 18 and 50 years were evaluated for the study and split into two groups: cannabis users (2.01%, mean age=26 years) and non-users (97.99%, mean age=21 years). At baseline, both groups were free of significant comorbidities (hypertension, hyperlipidemia, coronary artery disease, diabetes mellitus and tobacco use). After propensity-score matching, each group had 89,776 patients with similar demographics and baseline health profiles. Across 5 years, the mean follow-up for cannabis users was 35.7 months and 44.2 months for non-users. Absolute risk (AR) for MI was 0.558% in cannabis users and 0.09% in non-users. The risk difference (RD) was 0.468% (95% confidence interval [CI]=0.415%-0.52%), risk ratio (RR) was 6.185 (95% CI=4.892-7.82) and an odds ratio (OR) of 6.214 (95% CI=4.913-7.86). Additionally, cannabis users (99.119%) had a lower survival probability than non-users (99.867) (p<0.0001; hazard ratio [HR]=7.568; 95% CI=5.982-9.575). Cannabis users had a greater AR for ischemic stroke (0.405%) versus non-users (0.094%), MACE (cannabis users=1.187%, non-users=0.366%), HF (cannabis users=0.861%, non-users=0.424%) and all-cause mortality (cannabis users=1.262%, non-users=0.841%). Overall, cannabis use is linked to a higher risk of several cardiovascular events, including MI, ischemic stroke, HF and mortality. The investigators concluded that cannabis is an underrecognized risk factor for cardiovascular diseases. Source: Kamel I, Mahmoud AK, Twayana AR, et al. Myocardial Infarction and Cardiovascular Risks Associated with Cannabis Use: A Multicenter Retrospective Study. JACC: Adv. 2025 March (Article in Press). Image Credit: HENADZY – stock.adobe.com