The association between cannabis use and cardiovascular outcomes among U.S. Adults, 2020-2023

The effect of cannabis use on cardiovascular disease is mixed in the literature. This study assessed the association between cannabis use and multiple cardiovascular outcomes using recent national data from the U.S. Potential heterogenous effects by age and sex were also examined.

Using a national sample of 436,949 adults who were interviewed between 2020 and 2023 in BRFSS, we employed multivariable logistic regressions to determine the association between cannabis use and cardiovascular health outcomes, adjusting for sociodemographics, health status, other substance use behaviors, and state-level cannabis laws. State and year fixed effects were also included to adjust for time-invariant state characters and trends in cardiovascular outcomes.

The weighted prevalence was 4.4 % for coronary heart disease, 4.5 % for myocardial infarction, 3.6 % for stroke, and 9.3 % for the composite measure of any cardiovascular outcome. Non-daily cannabis use, compared to no cannabis use in the past 30 days, was associated with increased odds of stroke (aOR = 1.28, 95 % CI, 1.06-1.54) and the composite measure (aOR = 1.16, 95 % CI, 1.03-1.29). Daily cannabis use was also associated with increased odds of stroke and the composite measure, with aORs at 1.29 (95 % CI, 1.07-1.54) and 1.20 (95 % CI, 1.06-1.36), respectively. Subgroup analyses revealed that cannabis use was associated with more cardiovascular outcomes among middle-aged adults and females.

We found cannabis use to be associated with increased odds of several cardiovascular outcomes. Some population groups who use cannabis, such as middle-aged adults and females, may be at higher cardiovascular risk.