Marijuana Use Tied to Death from Hypertension, Study Suggests — Physician’s First Watch

August 10, 2017

Marijuana Use Tied to Death from Hypertension, Study Suggests

By Amy Orciari Herman

Edited by Susan Sadoughi, MD

Patients may ask about a widely reported study suggesting that marijuana use is associated with increased risk for death from hypertension. The findings appear in the European Journal of Preventive Cardiology.

Researchers studied 1200 adults who completed the 2005 National Health and Nutrition Examination Survey. Over half reported having ever used marijuana.

During follow-up through 2011, the incidence of death from hypertension was 2.6 per 1000 among marijuana users versus 1.4 per 1000 among nonusers. After adjustment for confounders, including prior diagnosis of hypertension, the risk for hypertension mortality was significantly higher with marijuana use (hazard ratio, 3.4). Risks for heart disease and cerebrovascular mortality were not significantly increased in marijuana users.

The authors point to numerous study limitations but conclude that "recreational use of marijuana should be approached with caution."

Reader Comments (3)

Bryan Finlay Other Healthcare Professional, Orthopedics, Retired

With only 1200 individuals enrolled in the study, and with Death Stats of 1.4 and 2.6 per 1000, it appears there may have only been one-or-two deaths in each group, which would probably confound the value of any conclusions ?

SHELDON BALL Physician, Geriatrics, Humana

An increase in mortality from hypertension without an increase in cardiovascular mortality is puzzling.... and home blood pressure monitoring is a good idea regardless or whether or not you smoke ...

Harvey A. Pollack MD MS Physician, Radiology, Children's Hospital Los Angeles

Having read the complete paper, it seems fraught with potential errors, particularly by the assumption that "ever use" of cannabis is equivalent to "continuous use" thorough the study duration. In addition the lack of data collection regarding other illicit drug use, specifically cocaine and amphetamines, both sympathomimetic drugs that are well documented to cause cardiovascular problems renders this study of limited accuracy. In fairness to the authors they do mention these as limitations, but no attempt is made to estimate how strong their effect is. Finally, it is difficult to discern what is meant by death from hypertension, since the more common causes of proximal death, specifically heart disease and cerebrovascular disease were found to be unchanged between the defined user and nonuser cohorts and thus are apparently excluded. Hypertension is a cause of renal disease and other vascular diseases such as aortic aneurysms, which could be a proximal cause of death, but these are significantly less common causes of death compared to heart disease and stroke. The authors are correct that this sort of study is important given the changing legal status of cannabis. However, as it is written this study is at best incomplete, and somewhat unfortunately appears a piece of propaganda akin to the screeds of the cannabis users who proclaim marijuana as a panacea.

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