Cannabis use disorder may be linked to increased risk of cardiovascular disease

A new study has found that Canadian adults with cannabis use disorder appear to have an approximately 60% higher risk of experiencing their first heart attack, stroke, or other major cardiovascular event than those without cannabis use disorder.

The study, published in Addiction, measured the association between problematic marijuana use and the first-time occurrence of adverse cardiovascular disease events such as heart attack, stroke, cardiac dysrhythmias, and peripheral vascular disease.

Researchers used five Canadian health databases to create a cohort of nearly 60,000 participants, half with a cannabis use disorder diagnosis and half without, matched by gender, year of birth, and time of presentation to the health system. People with prior adverse cardiovascular disease events were excluded. The participants were tracked from January 2012 to December 2019. Among people with cannabis use disorder, 2.4% (721) experienced a first-time cardiovascular disease event, compared with 1.5% (458) in the unexposed group.

Within the group of people with cannabis use disorder, people with no co-occurring medical illness, no prescriptions, and fewer than five visits to health services in the last six months had an even higher risk of a first-time cardiovascular disease event – approximately 1.4 times higher than for the rest of the cannabis-use-disorder group. This may be because those people considered themselves healthy and may not have acted on or even noticed the warning signs of an imminent heart attack, stroke, or other major cardiovascular event.

Dr. Anees Bahji, lead author of the study, emphasized the significance of these findings for public health and clinical practice. "Our study doesn’t provide enough information to say that cannabis use disorder causes adverse cardiovascular disease events, but we can go so far as to say that Canadians with cannabis use disorder appear to have a much higher risk of cardiovascular disease than people without the disorder.”

The study contributes to the ongoing dialogue surrounding the health implications of cannabis use disorder and its potential links to cardiovascular health.

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For editors:

This paper is available to read online after the embargo has lifted ( https://onlinelibrary.wiley.com/doi/10.1111/add.16337), or you may request a copy from Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org.

To speak with lead author Dr. Anees Bahji, please contact him at the University of Calgary's Cumming School of Medicine by email (anees.bahji1@ucalgary.ca).

Full citation for article: Bahji A, Hathaway J, Adams D, Crockford D, Edelman J, Stein MD, and Patten SB (2023) Cannabis use disorder and adverse cardiovascular outcomes: a population-based retrospective cohort analysis of adults from Alberta, Canada. Addiction. DOI: 10.1111/add.16337

Funding: Dr. Bahji has been awarded doctoral studies research funding from the Canadian Institutes of Health Research (CIHR) Fellowship and the Alberta Innovates Foundations from the University of Calgary and has received research funding through the Calgary Health Trust. Dr. Patten is supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. Funding and support for the joint position, held by J. Hathaway, was provided through a partnership between the Canadian Research Initiative in Substance Misuse (CRISM) Prairies Node and the CRISM-Alberta Health Services (AHS) Advancement in Analytics in Addiction Partnership.

Declaration of interests: Dr. Bahji receives a small honorarium for teaching in the Cumming School of Medicine at the University of Calgary. Dr. Bahji is an unpaid member of the Canadian Network for Mood and Anxiety Treatments editorial committee, the International Society of Addiction Journal Editors, the Canadian Society of Addiction Medicine policy committee, and the Addiction Psychiatry section of the Canadian Psychiatric Association. Dr. Bahji is an unpaid associate editor of the Canadian Journal of Addiction and a mental health educator for TED-Ed, where he receives a small honorarium. The other authors have no conflicts of interest to disclose.

Data support: Administrative data analytical support was provided by the Canadian Research Initiative in Substance Misuse (CRISM) Prairies Node via the CRISM-Alberta Health Services (AHS) Advancement in Analytics in Addiction Partnership.

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, gambling, editorials, and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884.