Cannabis, heart disease and stroke


Cannabis has been legal for medicinal use in Canada since 2001. Since 2018, many cannabis products have been legal for recreational use, including dried cannabis, fresh cannabis, cannabis oil and cannabis seeds for cultivation. In 2019, cannabis edibles, topicals and extracts (including cannabis vape products) became legal.

There is currently little high-quality scientific evidence about the impact of recreational cannabis use on heart conditions and stroke.

  • Emerging evidence shows an increased risk for heart disease and stroke from the effects of cannabis on blood pressure, inflammation of the blood vessels and cardiac arrhythmias1,2,3,4
  • Other reports link cannabis use with cardiovascular emergencies, including heart attackarrhythmias, heart failure, stroke and cardiac arrest (cardiopulmonary arrest).5,6,7
  • Some research shows that long-term or excessive use of cannabis, increases the risk for heart disease and stroke.1,3,8
  • Respiratory illness and deaths in the United States have been linked to vape products, many of which are cannabis (THC) vaping products obtained through informal sources.9

Heart & Stroke recommends reviewing the Lower-Risk Cannabis User Guidelines to assess the safest modes of cannabis use. Consumers should follow guidance and advisories from Health Canada related to vape products and if vaping cannabis, always obtain THC extracts for vaping from authorized dealers.

Recreational use of cannabis

If you are considering using cannabis for recreational purposes, read the Lower-Risk Cannabis Use Guidelines. However, the guidelines have not been updated since early 2019 and predate the surge in vaping-related lung illness throughout 2019. Heart & Stroke recommends that people follow the advice of health agencies – including the Centre for Disease Control (CDC) and Health Canada – with regards to the use of vape products. We also recommend that you speak to your healthcare provider about the effects of cannabis on your personal health – especially if you have a higher risk for heart disease and stroke.

 
Vape products and cannabis

There have been over 2,600 cases of vaping related respiratory illness in the US, including over 60 related deaths.9 Several cases have emerged in Canada, without any deaths. The CDC has recently identified Vitamin E acetate (an additive in some THC vape products) as a chemical of concern in this outbreak and is warning e-cigarette users to avoid using THC products especially from informal sources. 9 The CDC has not yet ruled out other chemicals of concern. Heart & Stroke warns that vape devices of all kinds are not without harm.

Smoking cannabis is considered the most harmful for respiratory health and ingestion of cannabis is the least harmful. Vaping cannabis is somewhere in the middle in terms of level of harm. All modes of delivery have some level of overall health risk.

Heart & Stroke is working to ensure government regulations are in place to make sure young people are protected from vape products with nicotine or THC. These include:

  • warning labels
  • marketing restrictions
  • flavour ban
  • restricting sales to special vape shops
  • increasing the legal purchase age to 21 years of age
Cannabis for medical purposes for heart disease and stroke

Using cannabis products to help you with pain from heart disease and stroke is a personal decision. To get cannabis for medical purposes, you need a prescription from a healthcare provider.10 There are discussions taking place about allowing Canadians access to cannabis health products for minor ailments (muscle soreness, pain relief) without a prescription.11

Talk to your healthcare provider about the risks and benefits of using cannabis for medical purposes. While cannabis products are legal, Health Canada does not endorse, nor has it evaluated, the use of cannabis for medical purposes.12

Gaps in research

Further research is needed into the short-term and long-term effect of cannabis on heart disease and stroke. Heart & Stroke encourages more research on the impact of recreational cannabis use and the medicinal benefits of cannabis products on heart disease and stroke.

Related information

 
Heart & Stroke position statement on e-cigarettes and youth: Protecting youth from the vaping crisis

Heart & Stroke e-cigarette position statement: E-cigarettes in Canada

Know the risks of alcohol and recreational drug use

Learn about common heart conditions and stroke.

Vaping: What you need to know

 

References

1.     Desbois AC, Cacoub P. Cannabis-associated arterial disease. Ann Vasc Surg. 2013 Oct;27(7):996-1005. doi: 10.1016/j.avsg.2013.01.002. Epub 2013 Jul 10.
2.     Barber PA, Pridmore HM, Krishnamurthy V, Roberts S, Spriggs DA, Carter KN, Anderson NE. Cannabis, ischemic stroke, and transient ischemic attack: a case-control study. Stroke. 2013 Aug;44(8):2327-9.  Epub 2013 May 21.
3.     Westover AN, McBride S, Haley RW. Stroke in young adults who abuse amphetamines or cocaine: a population-based study of hospitalized patients. Arch Gen Psychiatry 2007;64:495-502.
4.     Kalla. American College of Cardiology. Marijuana use associated with increased risk of stroke, heart failure: As marijuana legalization spreads, better understanding of side effects is needed. 9 March 2017.
5.     Lindsay AC, Foale RA, Warren O, et al. Cannabis as a precipitant of cardiovascular emergencies. International Journal of Cardiology, 2005; 104: 230–232.
6.     Aryana A, Williams MA. Marijuana as a trigger of cardiovascular events: Speculation or scientific certainty? International Journal of Cardiology, 2007; 118: 141–144.
7.     Jones RT. Cardiovascular system effects of marijuana. Journal of Clinical Pharmacology, 2002; 42: 58S–63S
8.     Ravi D, Ghasemiesfe M, Korenstein D, Cascino T, Keyhani S. Associations Between Marijuana Use and Cardiovascular Risk Factors and Outcomes: A Systematic Review. Ann Intern Med. 2018 Feb 6;168(3):187-194.
9.     CDC website 
10..  Health Canada website 1
11..  Health Canada website 2
12.   Health Canada website3

 

 

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