#85 Strong Clinical Relevance
High-quality evidence with meaningful patient or clinical significance.
Clinicians need this evidence to counsel patients about cardiovascular risks associated with cannabis use, particularly regarding heart failure and stroke, which are serious complications that may not be widely recognized by users. This data enables informed shared decision-making and helps identify high-risk patients who require closer cardiovascular monitoring or lifestyle modification. The findings support screening for cannabis use during cardiovascular risk assessments and inform treatment discussions with patients who use or are considering cannabis products.
This retrospective cohort study using the National Inpatient Sample examined associations between cannabis use and cardiovascular outcomes, finding that patients with documented cannabis use had significantly elevated risks of both heart failure and cerebrovascular accidents compared to non-users. The findings remained significant even after adjustment for traditional cardiovascular risk factors such as hypertension, diabetes, and smoking, suggesting cannabis may independently contribute to these adverse cardiac and cerebral events. Given the increasing prevalence of cannabis use across all age groups and the growing normalization following legalization in many jurisdictions, clinicians should recognize that cannabis use represents a previously underappreciated cardiovascular risk factor that warrants clinical attention. These results have particular relevance for patients with existing cardiac disease or stroke risk factors, where cannabis use could substantially amplify morbidity and mortality. Clinicians should incorporate cannabis use history into cardiovascular risk assessments and counsel patients about potential cardiac and cerebrovascular hazards, particularly those in high-risk populations. Patients using cannabis should be informed of these cardiovascular risks and monitored closely for signs of heart failure or stroke symptoms.
“What we’re seeing in the data is that cannabis use, particularly at higher frequencies, carries real cardiovascular risk that we can no longer dismiss as theoretical, and this means I need to screen my patients for cannabis use with the same rigor I apply to smoking and alcohol, then counsel accordingly based on their individual risk profile.”
💔 This observational study from the National Inpatient Sample identifies associations between cannabis use and increased hospitalization rates for heart failure and stroke, findings that warrant clinical attention given the rising prevalence of cannabis use in primary care populations. However, the cross-sectional design precludes causal inference, and the study cannot exclude confounding from unmeasured variables such as smoking of other substances, underlying cardiovascular disease severity, or socioeconomic factors that may independently drive both cannabis use and adverse cardiac outcomes. The magnitude of risk elevation, frequency and route of cannabis consumption, and temporal relationships remain unclear from the available data, limiting ability to counsel individual patients on absolute risk. Despite these limitations, the association is biologically plausible given cannabis’s known effects on heart rate, blood pressure, and inflammation, and clinicians should include cannabis use in cardiovascular risk assessment, particularly for patients with existing cardiac or cerebrovascular disease or significant risk factors. Prospective
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