Health Advice



'California sober' may be bad for your heart

Lisa Jarvis, Bloomberg Opinion on

Published in Health & Fitness

The evidence is mounting that your daily toke can be bad for your heart. A large new study in the Journal of the American Heart Association found that the more often someone partakes in cannabis, the higher their risk of heart disease, heart attack or stroke. Daily users had a 25% higher chance of having a heart attack and 42% higher odds of a stroke than non-users.

It’s the latest in a string of studies showing a connection between marijuana and heart health. An important caveat: All of the research is observational, meaning the findings rely on surveys that ask people to recall their habits and health conditions rather than following participants in real time. Our memories are fallible. People can also massage the truth. For example, the self-reported rate of cannabis use in the new study was below what has been seen in other surveys, suggesting some might not have owned up to their habits.

But even with those limitations, the trendline is clear enough to put the cardiovascular risk on the radars of regular pot users. That’s especially true at a moment when recreational cannabis is on the rise, and is being framed as the “healthy” alternative to drinking. CDC data suggest Gen Z is embracing the “California Sober” lifestyle, eschewing alcohol for pot.

Cannabis companies are leaning into the aura of health. During Dry January, a public health initiative to encourage people to re-evaluate their relationship with alcohol, I was flooded with pitches from cannabis companies hoping to fill the void (a strategy that, based on data from Morning Consult, seems to be working). One firm said their THC-infused drinks were “healthier and more mindful” than alcohol, offering “relaxation and enjoyment without the potential drawbacks.”

Healthier? Maybe — the answer depends on how often and how much of either substance you’re using, as well as in what format. But healthy? That’s a bold claim. We just don’t have as much good data on marijuana as we do with alcohol — but that absence of evidence shouldn’t be confused with proof that it’s harmless.

Conceptually, the idea that weed could increase the risk of cardiovascular events for some users shouldn’t be a surprise. Delta-9 THC “very reliably and dose dependently” increases heart rate and cardiovascular stress, says Ryan Vandrey, who helps run the Cannabis Science Laboratory at Johns Hopkins University. Meanwhile, some users can experience a significant drop in blood pressure when suddenly sitting up or standing—causing light-headedness or dizziness.


This latest study, which analyzed data from the more than 400,000 Americans interviewed each year for the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, starts to untangle one of the knottiest questions surrounding cannabis and heart health. Given that many marijuana users in earlier studies also smoked cigarettes, which have long been associated with heart disease, the data were always left open to interpretation.

People wondered, “Is cannabis an innocent bystander, or does it contribute to coronary heart disease?” says Robert L. Page, a professor at the University of Colorado School of Medicine’s Skaggs School of Pharmacy and Pharmaceutical Sciences.

These results drop the façade. An increased risk of heart disease, heart attacks and stroke persisted for the survey participants who had never smoked tobacco or used e-cigarettes.

“That is a big answer,” Page says. He often talks to patients who think smoking pot is healthier, “and that is a complete misconception.” That’s particularly true, he says, for people who already have underlying risk factors or underlying heart disease.


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