Cannabis Use Linked to Higher Cardiovascular Disease and Stroke Risk

New research presented at the American Heart Association’s Scientific Sessions 2026 links cannabis use to increased odds of cardiovascular disease, with a particularly strong association for stroke. The analysis of nearly half a million U.S. adults found that both occasional and heavy cannabis users had significantly higher odds of reporting a history of cardiovascular disease compared to non-users.

Study Reveals Cannabis Use Raises Stroke Risk

The analysis was limited to jurisdictions with available cannabis-use information during that period and included 442,906 adults who responded to telephone surveys. The study revealed that low-frequency cannabis users (1-5 days per month) had 23% higher odds of cardiovascular disease, while heavy users (16-30 days per month) had 21% higher odds. The strongest link was observed with stroke, where low-frequency use was associated with 40% higher odds and heavy use with 25% higher odds.

Contrary to expectations, the data showed no clear dose-response pattern—occasional users actually faced a higher stroke risk than heavy users. Notably, the research did not find a statistically significant association between cannabis use frequency and heart attacks. The study adjusted for factors like tobacco use, alcohol, obesity, and diabetes, suggesting the link may persist even after accounting for other lifestyle variables.

Cannabis Use Linked to Higher Cardiovascular Disease and Stroke Risk — Photo: news-medical.net

Unexpected Results and Shift from Earlier Data

The findings surprised researchers, who had anticipated that cardiovascular risk would increase steadily with more frequent cannabis use. We were surprised to find that the link between cannabis use and cardiovascular disease was not straightforward, said study author Aabha Divya. We expected that the chances of heart disease would gradually rise as people used cannabis more often, but that wasn't the case. Both low-use and heavy-use groups had higher odds of developing heart disease.

This contrasts with earlier BRFSS data from 2016-2020, which did show a dose-response relationship where heavier use correlated with higher cardiovascular risks. The current study’s authors noted that cannabis use has become more common since then, with past-month use rising from 1 in 10 adults in 2020 to 1 in 6 in 2024, a 51% increase potentially driven by expanding legalization. Previous research has indicated that cannabis use is rapidly increasing in the United States, with 1 in 6 adults in 2024 reporting having used it within the last month, up from 1 in 10 in 2020 – a 51% increase, Divya said.

Doctors Should Discuss Cannabis with Patients

Presented as preliminary research at the AHA conference in Chicago (Nov. 6-9), the study underscores the need for healthcare providers to discuss cannabis use with patients as part of cardiovascular risk assessments. “As cannabis use becomes more common, it is increasingly important that people and their healthcare professionals include it in conversations about cardiovascular health, just as they discuss tobacco, alcohol and other commonly used substances,” Divya stated.

To this end, clinicians should be addressing cannabis use with their patients as they would tobacco use when considering the risk of cardiovascular disease.
Robert L. Page II, Pharm.D., M.S.P.H., FAHA, chair of the writing group for the American Heart Association’s 2020 cannabis scientific statement

Robert L. Page II, an expert on cannabis and cardiovascular health who was not involved in the study, emphasized that cannabis should no longer be viewed as an innocent bystander in heart disease risk. He noted that this is the second observational study suggesting cannabis exposure without tobacco smoking may be a risk factor, potentially contributing to premature heart disease across age groups. Unfortunately, many patients who use cannabis may also smoke tobacco, which completely clouds the issue when addressing atherosclerotic cardiovascular disease risk. In patients who use both, cannabis has always been considered an innocent bystander; however, this is not the case, Page II said.

The researchers cautioned that the cross-sectional design cannot prove causation, and both cannabis use and disease diagnoses were self-reported. The data did not include product potency or amount consumed, and not all U.S. states participated in the optional BRFSS cannabis module. Full peer review of the findings is pending publication. Individuals concerned about their cardiovascular health should consult with qualified healthcare professionals for personalized guidance.