Tulane University Study Finds Cannabis Use Linked to Higher Cardiovascular Disease Risk

Cannabis use, encompassing both marijuana and other THC-containing products regardless of whether they are smoked or eaten, is linked to a higher risk of cardiovascular disease and specifically strokes, according to preliminary research presented at the American Heart Association’s Scientific Sessions. The findings arrive as national usage rates climb steeply across the United States, prompting public health researchers to urge clinicians to screen for cannabis use much like they already do for tobacco and alcohol.

Expanding Usage Meets Rising Medical Concerns

Recent survey data shows a sharp rise in American consumption habits. According to figures cited by Aabha Divya, an assistant professor in the division of cardiothoracic surgery at the Tulane University School of Medicine in New Orleans, 1 in 6 adults reported using cannabis within the past month in 2024. That figure marks a 51% jump from 2020, when only 1 in 10 adults reported usage. Medical Xpress reported that researchers used 2016-2020 data to examine the association between cannabis use and adverse cardiovascular outcomes.

To investigate further, researchers analyzed pooled data from nearly half a million U.S. adults who completed telephone interviews through the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS) between 2020 and 2024. Participants self-reported their monthly cannabis use alongside any professional diagnoses of heart attacks, strokes, or coronary heart disease. The study evaluated 442,906 adults with an average age of 49, drawing from 16 to 24 participating states each year.

Weighing Low-Frequency Versus Heavy Consumption Patterns

The study uncovered an unexpected twist regarding dosage frequency. While investigators anticipated that heart disease risks would climb in a linear fashion alongside heavier use, the actual data revealed elevated risks across multiple consumption levels. Respondents who used cannabis on 1 to 5 days per month showed 23% higher odds of reporting a history of cardiovascular disease compared to non-users.

Stroke emerged as the most prominent cardiovascular complication tied to the drug. Low-frequency cannabis users demonstrated 40% higher odds of stroke, while heavy users experienced 25% higher odds. Researchers found no statistically significant association between the reported frequency of cannabis use and heart attacks. We were surprised to find that the link between cannabis use and cardiovascular disease was not straightforward, Divya stated. 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.

These findings run parallel to earlier observations published in the Journal of the American Heart Association and supported by the National Institutes of Health. That earlier research, utilizing 2016–2020 BRFSS data analyzed by Massachusetts General Hospital data analyst Abra Jeffers and her team, found that daily cannabis smoking was tied to a 25% increased likelihood of heart attack and a 42% increased likelihood of stroke. Jeffers noted at the time that We know that toxins are released when cannabis is burned, similar to those found in tobacco smoke, pointing out that smoking poses added risks because users inhale particulate matter.

Isolating Cannabis from Tobacco Confounds Historical Data

A major hurdle in past cardiovascular research has been untangling cannabis consumption from tobacco use. Robert L. Page II, a professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and chair of the writing group for the American Heart Association’s 2020 cannabis scientific statement, explained the historical blind spot. Unfortunately, many patients who use cannabis may also smoke tobacco, which completely clouds the issue when addressing atherosclerotic cardiovascular disease risk, Page observed. In patients who use both, cannabis has always been considered an innocent bystander; however, this is not the case. This is the second observational study to suggest that cannabis exposure (without tobacco smoking) may be a potential risk factor for developing cardiovascular disease.

To account for confounding variables, the Tulane researchers adjusted their calculations for multiple heart disease risk factors, including demographics, tobacco and alcohol use, obesity, diabetes, chronic kidney disease, physical inactivity, education level, and income. Despite these adjustments, inherent study limitations remain. Because the research relies on a single point in time, it establishes associations rather than direct causality. The reliance on self-reported telephone surveys introduces potential memory errors, and the dataset lacked specific details regarding product potency or exact consumption amounts.

As state-level legalization expands across the country—with recreational cannabis currently legal in 24 states and Washington, D.C., and medicinal use permitted in 38 states—experts maintain that medical counseling must evolve. As cannabis use becomes more common, it is increasingly important that people and their health care professionals include it in conversations about cardiovascular health, just as they discuss tobacco, alcohol and other commonly used substances, Divya emphasized.

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