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Older adults who don’t smoke tobacco but use marijuana are at higher risk of both heart attack and stroke upon hospitalization, while daily marijuana users are 34 percent more likely to develop heart failure, according to two new unpublished studies presented Monday at the American Heart Association’s Scientific Sessions in Philadelphia.
“Observational data strongly suggest that cannabis use at any time, whether recreational or medical, can lead to the development of cardiovascular disease,” Robert Page II, chair of the volunteer writing group for the 2020 American Heart Association scientific statement, “Medical Marijuana, Recreational Cannabis, and Cardiovascular Health,” said in a statement, who was not involved in either new study.
The AHA’s recommendations advise against smoking or vaping any substance, including cannabis products, due to the potential harm to the heart, lungs and blood vessels.
“The latest research on cannabis use shows that smoking or inhaling cannabis increases levels of carboxyhemoglobin (the poisonous gas carbon monoxide) and tar (partially burned combustible substances) in the blood, producing effects similar to those caused by inhaling tobacco, both of which are associated with myocardial disease, chest pain, heart rhythm disorders, heart attacks and other serious symptoms,” said Page, a professor in the departments of clinical pharmacy and physical medicine/rehabilitation at the University of Colorado Skaggs School of Pharmacy in Aurora, Colorado.
“You need to treat this like any other risk factor — for heart disease or stroke — and be honest about understanding the risk you’re taking,” he said.
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Marijuana use among older adults is on the rise, but experts say many are unaware of the cardiovascular risks.
Marijuana use is on the rise among older adults. A 2020 survey found that the number of older Americans age 65 and older who currently smoke marijuana or use edible marijuana doubled between 2015 and 2018. A 2023 survey found that binge drinking and marijuana use in the past month among people age 65 and older increased by 450% between 2015 and 2019.
Nearly three in 10 marijuana users develop a dependence on marijuana, known as cannabis use disorder. According to the National Institute on Drug Abuse, someone is considered dependent on marijuana if they experience food cravings, loss of appetite, irritability, restlessness, or mood or sleep difficulties after quitting marijuana.
Marijuana can become addictive when a person is unable to stop using it despite it interfering with many aspects of their life.
Chronic Disease and Weeds
One study that looked at hospital records of non-tobacco smokers aged 65 and older with cannabis use disorder found that by age 65, older adults are more likely to have developed a number of chronic conditions that exacerbate the effects of marijuana.
“What’s unique about our study is that we excluded patients who also used tobacco, because cannabis and tobacco are sometimes used together, so we were able to look specifically at cannabis use and cardiovascular disease outcomes,” said lead study author Dr. Abhilash Mondal., A medical resident at Nazareth Hospital in Philadelphia said in a statement.
Researchers found that 8,535 adults who abuse marijuana had a 20 percent higher risk of developing serious heart or brain disease during hospitalization compared with more than 10 million older adults who did not use marijuana.
Both marijuana abusers and non-users had previously been diagnosed with hypertension, type 2 diabetes, and high cholesterol. The study found that hypertension above 130/80 mm Hg and high cholesterol were significant predictors of serious adverse heart and brain events in marijuana users.
“Acute use has been shown to lead to a drop in blood pressure, particularly if it’s vaped, smoked or combusted. So, … “To understand the potential risk for stroke, we need to look at individuals who are long-term, daily cannabis users,” Page said, “but what’s interesting is that cannabis is associated with elevated blood pressure, which is also a risk factor for many other cardiovascular diseases.”
The second study, published Monday, followed about 160,000 adults, with an average age of 54, for about four years to see if cannabis use affects the risk of developing heart failure. Heart failure doesn’t mean the heart has stopped working, it just means the heart is no longer pumping oxygen-rich blood normally, according to the AHA.
At the end of the study, the researchers found that those who reported daily marijuana use had a 34% higher risk of developing heart failure compared to those who reported never using marijuana.
A study published earlier this year also found that daily marijuana users increased their risk of coronary artery disease by one-third compared to non-users. Coronary artery disease is caused by a buildup of plaque in the walls of the arteries that supply blood to the heart. CAD, also known as atherosclerosis, is the most common type of heart disease, according to the Centers for Disease Control and Prevention.
“Previous studies have shown an association between marijuana use and cardiovascular disease, including coronary artery disease, heart failure and atrial fibrillation, which are known to cause heart failure,” Dr. Yaqub Bene Alhassan, a medical resident at MedStar Health in Baltimore and lead author of the heart failure study, said in a statement.
“Our findings should inspire more researchers to study marijuana use to better understand its health effects, particularly on cardiovascular risk,” said Bene Alhassan.
Update: This story has been updated to remove an internal editorial note that was published in error.
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