More frequent use of cannabis has been linked to an increase in heart attack and stroke risk, a new study published Wednesday in the Journal of the American Heart Association suggested.

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According to the study, a survey of data from 430,000 adults in the U.S. found that using cannabis has a significant association with an increased risk of heart attack and stroke independent of tobacco use, with higher odds among the adults with more frequent use.

Among the adults studied, the most common method of cannabis use was smoking, followed by eating or vaping it, the American Heart Association said.

“Despite common use, little is known about the risks of cannabis use and, in particular, the cardiovascular disease risks,” said lead study author Abra Jeffers, a data analyst at Massachusetts General Hospital in Boston.

“The perceptions of the harmfulness of smoking cannabis are decreasing, and people have not considered cannabis use dangerous to their health. However, previous research suggested that cannabis could be associated with cardiovascular disease. In addition, smoking cannabis—the predominant method of use—may pose additional risks because particulate matter is inhaled.”

The study does not provide conclusive evidence that regular marijuana use causes heart disease, but is an observation of the outcomes of study participants.

Researchers said the study showed:

• Any cannabis use was associated with more cases of heart disease, heart attack and stroke. With more frequent use, the odds of adverse outcomes were higher. The results were similar after researchers took out other cardiovascular risk factors, including tobacco and/or e-cigarette use, alcohol consumption, body mass index, Type 2 diabetes and physical activity.
• Both daily and non-daily cannabis users had an increased risk of heart attack compared to those who do not use cannabis. Daily cannabis users had 25% higher odds of having a heart attack compared to non-users.
• The odds of stroke for daily cannabis users were 42% higher compared to non-users, with lower risk among those who used cannabis less than daily.
• Among younger adults at risk for premature cardiovascular disease — defined as men younger than 55 years old and women younger than 65 years old — cannabis use was associated with a 36% higher combined risk of coronary heart disease, heart attack and stroke, regardless of whether or not the person also used traditional tobacco products.

The study was peer-reviewed and relied on cardiovascular conditions and cannabis use to be self-reported by the participants.

Researchers did not have health data measuring participants’ baseline lipid profile or blood pressure, and the study captured data for only a single point in time for the participants.

About 4% of the respondents reported daily marijuana use. Among those who never smoked tobacco, daily use of cannabis was tied to a 49% higher risk of heart attack and a more than doubled risk of stroke, the study indicated.

Thirty-eight states have legalized medical use of marijuana, and 24 have begun allowing recreational use.

The Food and Drug Administration has approved one cannabis-derived drug product: Epidiolex (cannabidiol); and three synthetic cannabis-related drug products: Marinol (dronabinol), Syndros (dronabinol) and Cesamet (nabilone). They are only available with a prescription from a licensed healthcare provider.

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