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Does marijuana cause heart attack or stroke?

A recent article published in the Journal of the American heart Association on February 28, 2024 stated that “cannabis use is associated with adverse cardiovascular outcomes, with heavier use (more days per month) associated with higher odds of adverse outcomes”.  This means that there is an association between using cannabis and heart attack and stroke. 

After reviewing this article and doing some research I have concluded that the study is more about smoking rather than cannabis itself causing increased risk of heart attack and stroke.  The fact is this study was about smoking cannabis as 74% of the patients who used cannabis smoked it.  This means that there is no evidence that taking cannabis by vaporization or oral routes is associated with increased risk of heart attack or stroke.

It is well-known that stroke and heart attack are partly caused by inhaling chemicals and matter which is from burning material such as smoking cigarettes or inhaling pollution.

This study also did not address the reason why people were using cannabis. As the study authors say, the main reasons for using cannabis are anxiety, insomnia, and pain.  All of these are independently associated with an increased risk of heart attack and stroke.  Therefore, the people who use cannabis may have had underlying conditions which were associated with increased risk of heart attack and stroke that were not accounted for in the study.

The study was also cross-sectional design which meant that the questions asked reflected a one-time answer to the questions as to whether the patient smoked marijuana or had heart attack or stroke.  It is not known whether the patient started smoking marijuana after the events or before.

In conclusion this was a scientific study that was done by questionnaire and represents observational data which does not mean that there is cause-and-effect, it only means there is an association.  This association is confounded by the fact that marijuana users frequently have associated conditions such as anxiety and chronic pain which would increase the risk of heart attack and stroke.

However, assuming that there is cause-and-effect, the worst-case scenario is that smoking marijuana increases of the risk of stroke and heart disease.  In this study 74% were of marijuana users were smokers.  The other routes of using cannabis are by oral ingestion or vaporization, neither of which were significantly represented in this study.  This study only shows an association between smoking cannabis and heart disease and stroke.  It does not show an association between other forms such as vaporization or oral use causing any harm.

Based on this information, I advised against smoking cannabis at this time until further studies are done.  Taking cannabis by vaporization or oral routes have not been associated with heart attacks or strokes. The conclusion of the study was based upon the majority of cannabis users being smokers.

This does not mean the cannabis is safe, just that this article has not proven that non smokable cannabis causes heart attack or stroke.  Further studies need to be done to determine whether vaping or oral use of cannabis causes heart attack or stroke.

By Walter E Brodis MD

     Internal Medicine and cannabis therapy specialist

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