Cannabis Use Disorder Linked to Higher Cardiovascular Risk in Alberta Study
A population-based study from Alberta, Canada, found that adults with a documented diagnosis of cannabis use disorder (CUD) experienced cardiovascular disease events more often than comparable adults without such a diagnosis. The study, published in Addiction, identified an association—not proof that cannabis use directly causes heart disease.
Researchers analyzed five linked administrative health databases covering the period from January 1, 2012, through December 31, 2019. They compared 29,764 adults with CUD diagnosis codes with 29,764 matched adults who had no such codes, for a total of 59,528 participants. The groups were matched by sex, year of birth, and timing of their presentation to the health-care system.
During the study period, 2.4% of participants with CUD experienced at least one new adverse cardiovascular event, compared with 1.5% of those in the comparison group. That amounted to a relative risk of 1.57, or approximately 60% higher risk in the CUD group. The cardiovascular outcomes were identified through diagnostic codes and included serious events such as heart attack, stroke, heart failure, and other cardiovascular conditions.
The association was also observed among participants who appeared relatively healthy based on their medical records. In subgroup analyses, the estimated risk was higher among people without recorded medical comorbidities, those who were not taking prescription medications, and those with fewer recent health-care visits. These findings do not mean that otherwise healthy cannabis users face a 60% absolute risk of a cardiovascular event: the absolute difference in this study was 0.9 percentage points.
The analysis also found a stronger association among participants with multiple CUD diagnosis codes. However, the number of codes is not a direct measure of how much cannabis a person consumed, and the study did not establish that heavier consumption caused the increased risk.
CUD is a clinical diagnosis involving problematic cannabis use and difficulty controlling use despite negative consequences. It should not be treated as synonymous with any cannabis use. Because the study relied on administrative health records, it likely captured people whose condition had been recognized in the health-care system rather than everyone who met diagnostic criteria. The results therefore may not apply equally to people who use cannabis without a CUD diagnosis.
The researchers described the work as an observational, retrospective study and cautioned that it cannot establish cause and effect. The analysis was not preregistered, and the authors noted that unmeasured factors—including cigarette smoking—could potentially account for some or all of the observed association. The results also cannot determine whether the risk varies according to cannabis potency, frequency of use, route of administration, or use alongside tobacco and other substances.
The findings are consistent with broader public-health guidance that cannabis can temporarily increase heart rate and affect blood pressure, while the long-term cardiovascular effects remain incompletely understood. The U.S. Centers for Disease Control and Prevention’s overview of cannabis and heart health similarly emphasizes the need for more research. The American Heart Association’s scientific statement has also described possible cardiovascular risks while noting that much of the existing evidence is observational.
For clinicians, the Alberta study supports asking patients about cannabis use and CUD when assessing cardiovascular and overall health. It does not, by itself, justify routine cardiovascular screening for every person who uses cannabis. People with known heart or vascular disease, or those who develop symptoms such as chest pain, fainting, severe palpitations, or shortness of breath, should discuss cannabis use and potential medication interactions with a health-care professional. Health Canada’s guidance on cannabis health effects provides additional information about cardiovascular effects and other risks.
