Daily Dose: Cannabis Use & Coronary Artery Disease

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On February 24, 2023, we reported on a study presented at the American College of Cardiology’s (ACC) 72nd Annual Scientific Session Together With the World Congress of Cardiology, being held March 4-6, 2023, in New Orleans.

The study

Researchers conducted one of the largest and most comprehensive to date to analyze the potential long-term cardiovascular effects of marijuana use. Using data from the All of Us Research Program of the National Institutes of Health, which includes detailed information about the health and habits of 175 000 people, investigators first analyzed the association between cannabis use frequency (assessed using surveys at the time of enrollment) and rates of coronary artery disease (CAD). Then, the research team performed a Mendelian randomization analysis using summary statistics from genome wide association studies of cannabis use disorder (CUD) and lifetime cannabis use.

After adjusting for age, sex, hypertension, hyperlipidemia, type 2 diabetes, body mass index, education, insurance status, and cigarette use, investigators observed that daily marijuana users (N=4736) had an increased odds of developing CAD (odds ratio [OR] 1.34, 95% CI, 1.13-1.58, P=.001) compared to those who never used marijuana.

Using 2-sample Mendelian randomization (MR), genetic liability to CUD was associated with an increased risk of CAD (OR 1.05, 95% CI, 1.02-1.09, P=.001). There was no evidence of pleiotropy, outliers, or violation of Mendelian randomization assumptions, authors added in the abstract. The association of CUD and CAD was independent of alcohol and tobacco use in multivariable Mendelian randomization analysis (OR 1.04, 95% CI, 1.01-1.07).

Note from authors

"In a large population-level cohort, frequent but not occasional cannabis use was associated with an increased risk of CAD. In MR analysis, CUD, but not occasional use was associated with CAD, independent of tobacco use."

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