A recent meta-analysis has highlighted a concerning link between cannabis use and a significant increase in the risk of major adverse cardiovascular events (MACEs). This comprehensive study, which reviewed a total of 24 relevant research articles, indicates that individuals who consume cannabis are facing a twofold greater likelihood of experiencing serious cardiovascular issues, including a stark increase in mortality rates associated with these events.

The research was led by Dr. Wilhelm Storck from the University of Toulouse in France and was published on June 17 in the prestigious journal Heart. This study is considered one of the most comprehensive investigations to date, specifically focusing on the relationship between cannabis consumption and cardiovascular health in real-world scenarios.

As attitudes toward cannabis use shift, especially with the trend towards legalization and the acceptance of cannabis for medicinal purposes, public perception has become increasingly permissive. However, as the study suggests, this growing acceptance may overlook substantial health risks associated with cannabis use, particularly its impact on heart health.

While previous research has hinted at potential cardiovascular risks associated with cannabis, a significant knowledge gap existed regarding the extent of these risks, especially during the last few years when stronger and more diverse cannabis products have flooded the market. This includes everything from high-potency inhaled concentrates to various forms of edibles and synthetic cannabinoids.

In their analysis, Storck and his team scrutinized 24 pharmacoepidemiologic studies — comprising 17 cross-sectional, six cohort, and one case-control study — published between January 2016 and January 2023. These studies collectively surveyed approximately 200 million individuals from various countries, lending substantial weight to their findings.

The results of the meta-analysis were stark: cannabis users were found to have a 20% higher risk of stroke, a 29% increased risk of acute coronary syndrome (ACS), which includes conditions like myocardial infarction, and an alarming more than twofold risk of dying from cardiovascular-related causes compared to non-users. Specifically, the risk ratio for cardiovascular mortality was calculated at 2.10.

Interestingly, the sole study on medical cannabis included in the analysis also displayed a similar positive correlation. Despite some methodological issues, including the potential for bias in many studies and the predominance of cross-sectional studies, the findings remained consistent even when sensitivity analyses focused solely on cohort studies.

The authors of the study acknowledged that measuring cannabis exposure was often inadequate across the reviewed studies. Only a minority had collected detailed data on dosage and assessed dose-response relationships. These gaps highlight the need for more rigorous research methodologies in future studies on cannabis and cardiovascular health.

In a related editorial, experts Stanton Glantz and Lynn Silver from the University of California, San Francisco, emphasized the pressing need for cannabis to be considered within the framework of cardiovascular disease prevention. They raised critical questions about the prevailing assumptions that cannabis use carries minimal cardiovascular risk, advocating for a regulatory approach that parallels tobacco regulation.

According to Glantz and Silver, current regulations are primarily focused on establishing a legal market for cannabis, often neglecting the associated health risks. They argue that cannabis should be treated similarly to tobacco products: not criminalized, but actively discouraged, with measures in place to protect bystanders from secondhand exposure. This comprehensive analysis serves as a call to action for further exploration of the intersection between cannabis use and cardiovascular health.

Importantly, the study did not receive specific funding, and the authors have disclosed no conflicts of interest.