Cannabis Use Was Not Linked to Higher Heart Attack Odds in a National U.S. Survey
A 2023 analysis of national U.S. health data found no statistically significant association between a history of monthly cannabis use and physician-diagnosed heart attack among adults ages 35 to 59. The study, published in the American Journal of Cardiology, analyzed data from 9,769 participants in five cycles of the National Health and Nutrition Examination Survey conducted between 2009 and 2018. The original study is available through PubMed.
About one-quarter of participants reported having used cannabis at least monthly for more than a year. After the researchers adjusted for factors including age, sex, race and ethnicity, education, income, cigarette and alcohol use, physical activity, body mass index, and cardiovascular risk, a history of monthly cannabis use was not associated with higher odds of having had a myocardial infarction.
The analysis also found no significant association between heart attack history and the duration of monthly cannabis use. Participants who reported more than 10 years of monthly use did not have significantly different odds of myocardial infarction than people who had never used cannabis. However, the confidence intervals were wide, meaning the study could not rule out modest increases or decreases in risk.
One unexpected finding involved recency of use. Among participants with a history of monthly cannabis use, those who reported no use during the previous month had roughly three times the odds of reporting a prior heart attack in one analysis. The researchers did not interpret this as evidence that stopping cannabis causes heart attacks. They suggested that some people may have stopped using cannabis because of health concerns or other factors associated with cardiovascular disease. The result could also reflect limitations of the study data.
The study’s design is important. It was a cross-sectional analysis based largely on participants’ self-reported cannabis use and medical history, so it can identify associations but cannot establish whether cannabis use causes—or prevents—heart attacks. The survey also did not provide detailed information about cannabis dose, THC potency, product type, or route of administration, such as smoking, vaping, or consuming edibles.
The findings therefore offer limited reassurance about the specific association examined, rather than proof that cannabis is harmless to the cardiovascular system. Cannabis can temporarily increase heart rate and blood pressure, and the Centers for Disease Control and Prevention’s overview of cannabis and heart health notes that the long-term cardiovascular effects remain uncertain. Smoke exposure may also introduce cardiovascular and respiratory irritants similar to some of those found in tobacco smoke.
The broader evidence remains mixed. A 2020 scientific statement from the American Heart Association described potential cardiovascular risks, including effects on heart rate, blood pressure, oxygen demand, blood vessels, and platelets, while emphasizing that much of the available evidence is observational and limited. Other studies have reported associations between cannabis use and cardiovascular events, particularly among younger adults or people using cannabis frequently.
For now, the 2023 NHANES analysis is best understood as evidence that a history of monthly cannabis use was not independently associated with self-reported physician-diagnosed myocardial infarction in this middle-aged sample. It does not establish that cannabis lowers heart attack risk or that all cannabis products and patterns of use carry the same effects. Larger prospective studies that measure dose, potency, timing, and method of use are needed to clarify the relationship.
