Cannabis for medicinal and/or recreational purposes has been decriminalized in 28 states as of the 2016 election. In the remaining states, cannabis remains the most commonly used illicit drug. Cardiovascular effects of cannabis use are not well established due to a limited number of studies. We therefore utilized a large national database to examine the prevalence of cardiovascular risk factors and events amongst patients with cannabis use.
Prevalence of heart failure, cerebrovascular accident (CVA), coronary artery disease, sudden cardiac death, and hypertension were significantly higher in patients with cannabis use. After multivariate regression adjusting for age, sex, hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, tobacco use, and alcohol use, cannabis use remained an independent predictor of both heart failure (odds ratio = 1.1, 1.03-1.18, P < 0.01) and CVA (odds ratio = 1.24, 1.14-1.34, P < 0.001).
Cannabis use independently predicted the risks of heart failure and CVA in individuals 18-55 years old. With continued legalization of cannabis, potential cardiovascular effects and their underlying mechanisms need to be further investigated.