A new analysis of global health data has found that cannabis use is associated with a significantly increased risk of cardiovascular disease, including double the risk of dying from related conditions. The findings, published in the journal Heart, raise fresh concerns over the long-term safety of cannabis as legalization and medicinal use continue to rise worldwide.
The study, a systematic review and meta-analysis led by an international research team, evaluated data from 24 major observational studies involving roughly 200 million people. Cannabis users, who were typically younger and predominantly male, showed a 29% increased risk of acute coronary syndrome, a 20% higher risk of stroke, and twice the risk of death from cardiovascular disease compared to non-users.
Researchers said their findings provide “the most exhaustive analysis to date” of the cardiovascular risks associated with cannabis use. Though most of the studies included were observational—and subject to moderate to high bias due to inconsistent exposure measurement and missing data—the overall trend points to a strong correlation between cannabis use and adverse heart outcomes.
“While causality cannot be definitively established, the association is concerning and warrants immediate attention from health professionals and policymakers,” the authors said.
In an accompanying editorial, public health experts called for a regulatory shift, likening cannabis to tobacco in terms of public health management. “Cannabis should not be criminalized,” they wrote, “but it should be actively discouraged—especially through public education and protections against secondhand exposure.”
The editorial, penned by Dr. Lynn Silver of the Public Health Institute and Professor Stanton Glantz of UCSF, highlighted how cannabis products today are more potent and available in varied forms—concentrates, edibles, and synthetics—raising new questions about their cardiovascular impact.
They argue that cardiovascular disease prevention must now be built into cannabis regulation, with stronger product warnings, marketing restrictions, and clearer public guidance. “Current regulations prioritize building legal markets while largely ignoring health risks,” they concluded.
As cannabis use becomes more normalized, experts say it’s vital for public health frameworks to keep pace with emerging evidence.
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