“A growing body of evidence suggests that cannabis is not entirely without harm and may actually cause cardiovascular disease,” said lead study author Dr. Ishan Paranjpe, a resident physician at Stanford University. The study — which has not yet been published -— will be presented Sunday at the annual meeting of the American College of Cardiology.
“Thus, the decision to use cannabis must be carefully weighed against the potential for serious heart disease,” Paranjpe said.
Coronary artery disease is caused by plaque buildup in the walls of the arteries that supply blood to the heart. Also called atherosclerosis, CAD is the most common type of heart disease, according to the US Centers for Disease Control and Prevention.
Signs of the condition include having angina, or chest pain, feeling weak, dizzy or sick to your stomach, or experiencing shortness of breath. However, for “some people, the first sign of CAD is a heart attack,” the CDC says on its website.
Using once a month or less
The study pulled data on people participating in the All of Us Research Program. Administered by the National Institutes of Health, the program is designed to gather health information over time from 1 million or more people in the United States.
They found that daily cannabis users were 34% more likely to be diagnosed with coronary artery disease than those who had never used the drug.
People who used weed only once a month or less had no significant risk, the study found.
The results held true even after researchers factored out other potential causes of coronary heart disease, such as age, sex and major cardiovascular risk factors — high blood pressure, high cholesterol, type 2 diabetes, obesity, smoking and alcohol use.
The study used Mendelian randomization (MR) to determine risk, which other studies on the topic have not, Paranjpe said in an email. The MR method measures gene variations known to be related to a modifiable risk factor to determine the causal influence of the risk factor.
“While other work has also linked cannabis with CAD, there are several potential confounders that may explain this relationship. Our MR analysis suggests this relationship may be directly causal,” Paranjpe said.
Marijuana and the heart
Why does marijuana appear to damage the heart and blood vessels? First, it increases heart rate and blood pressure immediately after each use, according to the CDC.
“Marijuana smoke also delivers many of the same substances researchers have found in tobacco smoke — these substances are harmful to the lungs and cardiovascular system,” the agency says.
Smoking or vaping any substance, including cannabis, should be avoided due to the risk of harm to the heart, lungs and blood vessels, the American Heart Association warned in 2020.
The AHA’s guidance released then pointed to studies that found heart rhythm abnormalities, such as tachycardia and atrial fibrillation, could occur within an hour after weed containing delta-9-tetrahydrocannabinol, or THC, was smoked. (THC is the part of the marijuana plant that creates a high.)
Other research has shown smoking weed has triggered heart attacks and leads to a higher risk of strokes and heart failure in people with underlying heart disease.
Notably, the new study was not able to tease out whether different types of cannabis use — such as consuming edibles versus smoking weed, for example — made a difference in a person’s risk of developing CAD. However, since THC gets to the brain faster when smoked, the researchers argue future research should investigate various usage methods and their impact on the heart.
In terms of the public health message, it shows that there are probably certain harms of cannabis use that weren’t recognized before, and people should take that into account.”
Researchers analyzed data from a cohort of 175,000 people, comparing those who use cannabis regularly against those who don’t, to determine the connection between the frequency of use and rates of CAD. Their datasets were adjusted to account for other major cardiovascular risk factors, such as tobacco and alcohol use, but did not differentiate between modes of drug use, whether smoked or consumed in edibles.
They found that daily cannabis users were 34% more likely to develop CAD than those who have never used marijuana.
However, monthly marijuana use did not seem to have a link to CAD diagnoses.
Experts are now warning that marijuana use does not come without health risks and strongly recommend that those who partake inform their doctors so they may better monitor their heart health.
Researchers hypothesized that the interplay between the plant’s psychoactive ingredient, tetrahydrocannabinol, and receptors in the heart and blood vessels may promote inflammation and the buildup of plaque.
CAD is the most common type of heart disease in the United States, but the risk of developing the disease can be reduced with lifestyle changes, according to the Centers for Disease Control and Prevention.
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