Cannabis tied to heart disease, even with light use

Clinical takeaway: Ask patients about cannabis use—including occasional use—at the same visits you ask about tobacco and alcohol. 

Cannabis use is climbing in the US, and clinicians have had little firm evidence to offer patients who ask what it does to the heart. In 2024, one in six adults reported using cannabis in the past month, up from one in 10 in 2020. 

Earlier studies raised cardiovascular concerns, though investigators describe the results as inconsistent. Hospital discharge data add a population-level view, with cardiac admissions rising faster in the Western US after recreational sales began. Whether more frequent use is associated with more cardiovascular disease among individual users has been difficult to establish. A cross-sectional analysis presented at the AHA Scientific Sessions 2026 now puts numbers on that question, comparing how often adults use cannabis with their self-reported cardiovascular history. 

Adults who reported using cannabis on one to five days per month had 23% higher odds of reporting a history of cardiovascular disease than adults who reported no use. Heavy users, defined as use on 16 to 30 days per month, had 21% higher odds, with no clear dose-response increase beyond the light-use group.

Stroke showed the strongest association: 40% higher odds of reporting one at low frequency, 25% at heavy use. Myocardial infarction was the exception, with no statistically significant association with reported frequency of cannabis use. 

The analysis pooled 2020 to 2024 responses from 442,906 adults in the Behavioral Risk Factor Surveillance System, a CDC telephone survey, and compared cannabis users with nonusers after adjusting for tobacco smoking and other risk factors. Both cannabis use and cardiovascular history were self-reported at a single time point, and the nonuser group could include former users. 

“Unfortunately, many patients who use cannabis may also smoke tobacco, which completely clouds the issue when addressing atherosclerotic cardiovascular disease risk. In patients who use both, cannabis has always been considered an innocent bystander; however, this is not the case,” said Robert Page II, Pharm.D., a professor of clinical pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. He chaired the writing group for the American Heart Association 2020 cannabis scientific statement and was not part of the study. 

“This is the second observational study to suggest that cannabis exposure (without tobacco smoking) may be a potential risk factor for developing cardiovascular disease,” he continued. “Overall, cannabis is beginning to emerge as a major contributor to premature heart disease in young and older adults, which can lead to serious cardiovascular events. To this end, clinicians should be addressing cannabis use with their patients as they would tobacco use when considering the risk of cardiovascular disease.” 

Source: Divya A, et al. (2026 Nov 9) American Heart Association Scientific Sessions 2026. Abstract Mo3041. Cannabis Use and Atherosclerotic Cardiovascular Disease Among US Adults