Cannabis use is associated with prevalent coronary artery disease

Am J Med Sci. 2022 Sep;364(3):304-308. doi: 10.1016/j.amjms.2022.04.005. Epub 2022 Apr 12.


Background: Cannabis is associated with risk of acute coronary syndrome in observational studies. However, its association with prevalent coronary artery disease (CAD) remains unclear. We hypothesized that cannabis use is associated with prevalent CAD.

Methods: This analysis included 12,543 participants (age 39.3 ± 11.6 years, 48.8% male, 35.3% Caucasians) from The National Health and Nutrition Examination Survey (NHANES). Cannabis use was self-reported. Prevalent CAD was defined by physician diagnosis. The association between cannabis use and CAD was tested for using multivariable logistic regression.

Results: About 53.1% (n = 6,650) of participants were ever cannabis users and 1.1% (n = 137) had prevalent CAD. Ever (versus never) cannabis users had 90% increased odds of CAD [OR (95% CI): 1.90 (1.24 - 2.93), p = 0.003]. Those who had used cannabis at least once per month for at least one year had 68% increased odds of CAD [OR (95% CI): 1.68 (1.02-2.77), p = 0.04]. Current cannabis users had near 98% increased odds of CAD [OR (95% CI): 1.98 (1.11 - 3.54), p = 0.02]. Similar results were seen with heavy cannabis users [OR (95% CI): 1.99 (1.02 - 3.89), p = 0.045]. These results were consistent in subgroups stratified by race, gender, hypertension, obesity, COPD, hyperlipidemia, tobacco smoking status, and diabetes.

Conclusions: Cannabis use is associated with prevalent CAD. This finding emphasizes the potential harmful effects of cannabis use on cardiovascular health and highlights the need for further research as it becomes more accepted at both a national and global level.

Keywords: Cannabis use; Cardiovascular disease; Coronary artery disease; Marijuana use.

MeSH terms

  • Adult
  • Cannabis* / adverse effects
  • Coronary Artery Disease* / epidemiology
  • Coronary Artery Disease* / etiology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Risk Factors