Introduction to the Study
A comprehensive meta-analysis of 24 significant studies has revealed a concerning link between cannabis use and a doubled risk of major adverse cardiovascular events (MACE), including a twofold increase in the likelihood of death related to these events. This analysis, one of the most extensive and detailed to date, highlights the urgent need for systematic investigation into cannabis use among patients with severe cardiovascular disorders.
Details of the Meta-Analysis
The study, led by Wilhelm Storck, a doctoral candidate at the University of Toulouse, was published online on June 17 in the journal Heart. The findings come at a time when cannabis use is on the rise, partly due to legalization and its increasing use for medical purposes. These changes may have contributed to a more permissive public attitude towards cannabis, despite growing evidence of its health risks, particularly concerning heart health.
Previous Research and Current Findings
While previous studies have identified cardiovascular risks associated with cannabis, gaps remained regarding the extent of these risks, especially in recent years with the availability of more potent and diverse forms of cannabis. These include highly concentrated inhaled forms, “space cakes,” and synthetic cannabinoids. Storck and his colleagues aimed to quantify the real cardiovascular risks of cannabis use in light of these evolving trends.
Methodology and Scope
The researchers systematically reviewed 24 pharmaco-epidemiological studies (17 cross-sectional, 6 cohort, and one case-control study) published between January 2016 and January 2023. Collectively, these studies involved approximately 200 million individuals across several countries. The final analysis focused on cannabis-related MACEs, including cardiovascular death, non-fatal acute coronary syndrome (ACS) such as myocardial infarction, and non-fatal stroke.
Key Findings
The pooled results showed positive associations between cannabis use and MACEs, with a 20% higher risk for strokes (risk ratio [RR], 1.20), a 29% higher risk for ACS (RR, 1.29), and more than double the risk for cardiovascular mortality (RR, 2.10) compared to non-users. Notably, the only study on medical cannabis included in the meta-analysis also highlighted a positive association.
Robustness of the Results
The findings were confirmed by sensitivity analyses limited to cohort studies, suggesting a strong association despite some methodological limitations. Additionally, four other articles published outside the study’s timeframe yielded comparable results.
Challenges in Measuring Cannabis Exposure
The authors noted that cannabis exposure was often poorly measured in the studies. Only four studies collected data on dosage and assessed the dose-response relationship. Many studies also had a moderate to high risk of bias, with most being cross-sectional and not designed to prove causality.
Implications and Editorial Insights
Despite these caveats, this “comprehensive analysis of published data on the potential association between cannabis use and the occurrence of MACEs provides new insights from real-world data,” the authors stated. An accompanying editorial emphasized that the study raises “serious questions about the assumption that cannabis poses only a low cardiovascular risk.”
Recommendations for Policy and Regulation
The editorial authors, Stanton Glantz and Dr. Lynn Silver from the University of California, San Francisco, argued that cannabis should be integrated into the framework of clinical cardiovascular disease prevention. Similarly, cardiovascular disease prevention should be incorporated into cannabis market regulations. As evidence accumulates, they assert that cardiovascular and other health risks must be considered in the regulation of authorized products and marketing design.
Conclusion
“Currently, regulation focuses on establishing a legal market while neglecting health risks. Specifically, cannabis should be treated like tobacco: not criminalized but discouraged, with protection against secondhand smoke,” they concluded. The study received no specific funding, and the authors and editorialists declared no conflicts of interest.
**Source:** [Medscape](https://francais.medscape.com/voirarticle/3613037)