In a new systematic review and meta-analysis, investigators found a positive association between cannabis use and major adverse cardiovascular events (MACE), raising awareness about the potential risks to cardiovascular health for cannabis users.1
Investigators of a study used a systematic review and meta-analysis to evaluate the risk of major adverse cardiac events related to cannabis by using real-world data. | Image Credit: svetazi – stock.adobe.com
In an editorial published in Heart, the authors write that there has been frequent cannabis use increasing in several countries as many believe it is a safe and effective way to relieve pain despite evidence of health risks. In the US, they stated that “daily cannabis use in adults aged 35–50 tripled between 2008 and 2023 from 2.5% to 7.5% and is approaching rates in young adults and nearly matching daily alcohol use (7.6%) and daily cigarette use in 35–50-year-olds (7.8%).”
Further, they added that the situation is even more concerning for younger adults aged 19 to 30 years, with 10.4% of this age group being affected by daily cannabis use compared with 3.6% for daily alcohol use and 3.6% for daily cigarette use. In the past 30 days, approximately 28.7% of younger adults used cannabis.2
“Cannabis needs to be incorporated into the framework for prevention of clinical cardiovascular disease,” the authors wrote.2 “Cannabis should be treated like tobacco: not criminalised but discouraged, with protection of bystanders from secondhand exposure.”
In the new analysis, also published in Heart, investigators evaluated the risk of MACE related to cannabis by using real-world pharmacoepidemiological data and quantifying the risk using a systemic review and meta-analysis. Data between January 1, 2026, and January 31, 2023, was used, with the population including the general public likely to be exposed to cannabis or cannabinoids compared with those who were not exposed to either. The outcomes included the occurrence of MACE defined by the 3-point composite outcomes of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.1
Investigators identified 3012 records, with 110 eligible for inclusion and 24 being included in the final analysis. Articles included cross-sectional studies (70.8%), cohort studies (25%), and case-control studies (4.2%). All studies assessed the potential association of recreational cannabis use and MACE, and 14 studies were from 3 databases, including the National Inpatient Sample, Behavioral Risk Factor Surveillance System, and National Health and Nutrition Examination Survey, which could cause overlap. In total, there were 432,245,972 patients included, with a mean age ranging from 19 years to 59 years. Approximately 83.3% of studies had a high rating for risk of bias and 16.7% raised some concerns.1
The investigators found that the odds ratio of acute coronary syndrome (ACS), stroke, and cardiovascular mortality was associated with cannabis use at 1.29, 1.20, and 2.10, respectively. Further, the composite ACS/stroke outcome was 1.04. Heterogeneity was substantial to considerable, with I2 values ranging from 79.2% to 89.3% across subgroup outcomes excluding cardiovascular mortality.1
“Our findings are consistent with those from previous reviews, which outlined a positive association between cannabis use and cardiovascular disorders,” the study authors concluded.1 “The increased awareness of this potential risk among cannabis users should encourage investigating such use in all patients presenting with serious cardiovascular disorders.”
READ MORE: Cardiology Resource Center
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REFERENCES
1. Storck W, Elbaz M, Vindis C, Déguilhem A, Lapeyre-Mestre M, Jouanjus E. Cardiovascular risk associated with the use of cannabis and cannabinoids: a systematic review and meta-analysis. Heart. Published online June 17, 2025. doi:10.1136/heartjnl-2024-325429
2. Glantz S, Silver L. It is time to treat cannabis as an important risk factor for cardiovascular disease. Heart. Published online June 17, 2025. doi:10.1136/heartjnl-2025-326169
Investigators of a study used a systematic review and meta-analysis to evaluate the risk of major adverse cardiac events related to cannabis by using real-world data. Read More
