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Cannabis use predicts risks of heart failure and cerebrovascular accidents: results from the National Inpatient Sample

Kalla, Aditia,*; Krishnamoorthy, Parasuram M.a,*; Gopalakrishnan, Akshayab; Figueredo, Vincent M.a,c

Journal of Cardiovascular Medicine: September 2018 - Volume 19 - Issue 9 - p 480–484
doi: 10.2459/JCM.0000000000000681
Research articles: Prevention

Background Cannabis for medicinal and/or recreational purposes has been decriminalized in 28 states as of the 2016 election. In the remaining states, cannabis remains the most commonly used illicit drug. Cardiovascular effects of cannabis use are not well established due to a limited number of studies. We therefore utilized a large national database to examine the prevalence of cardiovascular risk factors and events amongst patients with cannabis use.

Methods Patients aged 18–55 years with cannabis use were identified in the National Inpatient Sample 2009–2010 database using the Ninth Revision of International Classification of Disease code 304.3. Demographics, risk factors, and cardiovascular event rates were collected on these patients and compared with general population data.

Results Prevalence of heart failure, cerebrovascular accident (CVA), coronary artery disease, sudden cardiac death, and hypertension were significantly higher in patients with cannabis use. After multivariate regression adjusting for age, sex, hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, tobacco use, and alcohol use, cannabis use remained an independent predictor of both heart failure (odds ratio = 1.1, 1.03–1.18, P < 0.01) and CVA (odds ratio = 1.24, 1.14–1.34, P < 0.001).

Conclusion Cannabis use independently predicted the risks of heart failure and CVA in individuals 18–55 years old. With continued legalization of cannabis, potential cardiovascular effects and their underlying mechanisms need to be further investigated.

aInstitute for Heart and Vascular Health, Einstein Medical Center, Philadelphia, Pennsylvania

bIcahn School of Medicine at Mount Sinai, New York, New York

cSidney Kimmel College of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania, USA

Correspondence to Vincent M. Figueredo, MD, Institute for Heart and Vascular Health, Einstein Medical Center, 5501 Old York Road, Levy 3232, Philadelphia, PA 19141, USA Tel: +1 215 456 8991; fax: +1 215 456 3533; e-mail:

Received 6 July, 2017

Revised 9 May, 2018

Accepted 14 May, 2018

© 2018 Italian Federation of Cardiology. All rights reserved.