Affiliation:
1. Center for Tobacco Control Research & Education University of California San Francisco CA USA
2. Mongan Institute Health Policy Research Center, Massachusetts General Hospital Boston MA USA
3. Division of General Academic Pediatrics Boston MA USA
4. Tobacco Research and Treatment Center, Massachusetts General Hospital Massachusetts General Hospital for Children Boston MA USA
5. Retired San Francisco CA USA
6. Department of Psychiatry & Behavioral Sciences University of California San Francisco CA USA
7. Department of Medicine, Division of Geriatrics University of California San Francisco CA USA
8. Section of Mental Health Services, San Francisco Veterans Affairs Medical Center San Francisco CA USA
9. Department of Medicine, Division of Internal Medicine University of California San Francisco CA USA
10. Medical Service San Francisco Veterans Affairs Medical Center San Francisco CA USA
Abstract
Background
We examined the association between cannabis use and cardiovascular outcomes among the general population, among never‐tobacco smokers, and among younger individuals.
Methods and Results
This is a population‐based, cross‐sectional study of 2016 to 2020 data from the Behavioral Risk Factor Surveillance Survey from 27 American states and 2 territories. We assessed the association of cannabis use (number of days of cannabis use in the past 30 days) with self‐reported cardiovascular outcomes (coronary heart disease, myocardial infarction, stroke, and a composite measure of all 3) in multivariable regression models, adjusting for tobacco use and other characteristics in adults 18 to 74 years old. We repeated this analysis among nontobacco smokers, and among men <55 years old and women <65 years old who are at risk of premature cardiovascular disease. Among the 434 104 respondents, the prevalence of daily and nondaily cannabis use was 4% and 7.1%, respectively. The adjusted odds ratio (aOR) for the association of daily cannabis use and coronary heart disease, myocardial infarction, stroke, and the composite outcome (coronary heart disease, myocardial infarction, and stroke) was 1.16 (95% CI, 0.98–1.38), 1.25 (95% CI, 1.07–1.46), 1.42 (95% CI, 1.20–1.68), and 1.28 (95% CI, 1.13–1.44), respectively, with proportionally lower log odds for days of use between 0 and 30 days per month. Among never‐tobacco smokers, daily cannabis use was also associated with myocardial infarction (aOR, 1.49 [95% CI, 1.03–2.15]), stroke (aOR, 2.16 [95% CI, 1.43–3.25]), and the composite of coronary heart disease, myocardial infarction, and stroke (aOR, 1.77 [95% CI, 1.31–2.40]). Relationships between cannabis use and cardiovascular outcomes were similar for men <55 years old and women <65 years old.
Conclusions
Cannabis use is associated with adverse cardiovascular outcomes, with heavier use (more days per month) associated with higher odds of adverse outcomes.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference44 articles.
1. Cannabis use, attitudes, and legal status in the U.S.: A review
2. Trends in Cannabis Use Among Older Adults in the United States, 2015-2018
3. Time trends in US cannabis use and cannabis use disorders overall and by sociodemographic subgroups: a narrative review and new findings
4. Center for Behavioral Health Statistics and Quality . Results from the 2019 National Survey on Drug Use and Health: Detailed tables. Rockville (MD): Substance Abuse and Mental Health Services Administration; 2020. https://www.samhsa.gov/data/
5. Deaths and mortality . Centers for Disease Control and Prevention. 2020. Accessed October 2 2023. https://www.cdc.gov/nchs/fastats/deaths.htm.