Cannabis use, including marijuana, appears to be linked with an increased risk of cardiovascular disease, especially stroke, according to new preliminary research presented at the American Heart Association's Scientific Sessions 2026. The findings, based on an analysis of nearly half a million U.S. adults, suggest that cannabis use should be considered when assessing cardiovascular risk and counseling patients about heart disease and stroke prevention.
The study, led by Aabha Divya, M.B.B.S., M.Ch., an assistant professor at Tulane University School of Medicine, analyzed pooled data from the Behavioral Risk Factor Surveillance System (BRFSS) for 2020-2024, covering 442,906 adults in states that included the optional cannabis module. Participants reported cannabis use frequency and whether they had been diagnosed with cardiovascular disease, including heart attack, stroke, or coronary heart disease. Compared with non-users, those who used cannabis 1-5 days per month had 23% higher odds of reporting a history of cardiovascular disease, while heavy users (16-30 days per month) had 21% higher odds. The strongest link was with stroke: low-frequency use was associated with 40% higher odds of stroke, and heavy use with 25% higher odds. No statistically significant association was found between cannabis frequency and heart attack.
"We were surprised to find that the link between cannabis use and cardiovascular disease was not straightforward," Divya said. "We expected that the chances of heart disease would gradually rise as people used cannabis more often, but that wasn't the case." She added that as cannabis use becomes more common, it is increasingly important for people and their healthcare professionals to include it in conversations about cardiovascular health, just as they discuss tobacco, alcohol and other commonly used substances.
The research comes amid a sharp rise in cannabis use. Divya noted that 1 in 6 adults in 2024 reported having used cannabis within the last month, up from 1 in 10 in 2020, a 51% increase. Previous studies have raised concerns about cardiovascular effects, but results have not been consistent. Robert L. Page II, Pharm.D., M.S.P.H., FAHA, chair of the writing group for the American Heart Association’s 2020 cannabis scientific statement, said the new findings add to the evidence. "Overall, cannabis is beginning to emerge as a major contributor to premature heart disease in young and older adults," Page said. "Clinicians should be addressing cannabis use with their patients as they would tobacco use when considering the risk of cardiovascular disease."
The study has limitations: it presents associations from a single point in time and cannot prove that cannabis use causes heart disease. It relied on self-reported data, lacked information on cannabis potency or amount consumed, and did not include all U.S. states. The findings are considered preliminary until published in a peer-reviewed journal. The research will be presented at the American Heart Association's Scientific Sessions 2026, a premier global exchange of cardiovascular science, and the abstract is available in the Scientific Sessions 2026 Online Program Planner. A Spanish news release is also available.
The implications are significant for public health. As cannabis legalization and commercial availability expand, more adults are using the substance, often without considering its potential cardiovascular consequences. The American Heart Association has previously highlighted links between cannabis and heart attack and stroke risk in releases such as Cannabis use linked to increase in heart attack and stroke risk and Marijuana use linked with increased risk of heart attack, heart failure. For readers, the takeaway is clear: if you use cannabis, discuss it with your healthcare provider as part of your cardiovascular risk assessment. For clinicians, the study underscores the need to routinely ask about cannabis use, much like tobacco and alcohol, to better identify and manage heart disease and stroke risk.
