20% increased stroke risk and 29% higher chance of acute coronary syndrome
June 18, 2025
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Major global review finds cannabis users face up to 100% higher risk of cardiovascular death.
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Study shows 20% increased stroke risk and 29% higher chance of acute coronary syndrome.
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Experts urge public health reforms and tobacco-style regulation of cannabis products.
A sweeping international review of nearly 200 million individuals has revealed that cannabis use may significantly elevate the risk of life-threatening cardiovascular issues, including a doubling of the risk of death from heart disease and a 20% increased risk of stroke. The findings, published in the journal Heart, represent one of the largest and most comprehensive syntheses of real-world data on the subject to date.
The research was led by a team from the University of Toulouse in France, who sought to clarify the scale of cannabis-related cardiovascular risks amid a sharp rise in global use and changing legal frameworks. Though earlier studies had raised alarms about potential heart-related side effects, the researchers said previous data lacked clarity on just how serious the consequences might be.
Data from 24 studies
To deepen the understanding of cannabis’s cardiovascular impact, the Toulouse team reviewed 24 large-scale observational studies published between 2016 and 2023. Together, these studies covered nearly 200 million participants, including 17 cross-sectional studies, six cohort studies, and one case-control study.
Most participants were aged 19 to 59, and where demographic data was recorded, cannabis users were found to be predominantly male and younger than non-users.
The pooled analysis found:
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A 29% increased risk of acute coronary syndrome (e.g., heart attacks).
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A 20% increased risk of stroke.
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A 100% (doubling) of the risk of death from cardiovascular disease.
Research limitations,calls for caution
Despite the alarming results, the study authors acknowledged notable limitations. Many of the included studies had a moderate to high risk of bias, often due to imprecise cannabis exposure measurement and missing data. Furthermore, as most of the data came from observational studies, the researchers stopped short of claiming a definitive causal link.
Still, they argued the findings were meaningful and urgent: “The findings outlined by this meta analysis should enhance the general awareness of the potential of cannabis to cause cardiovascular harm,” the authors said.
Experts: Treat cannabis like tobacco
In an accompanying editorial, Prof. Stanton Glantz and Dr. Lynn Silver of the University of California, San Francisco, warned that the assumptions of cannabiss cardiovascular safety are now deeply challenged.
They noted the modern cannabis market has shifted toward high-potency concentrates, synthetic cannabinoids, and diverse edibles, all of which may compound cardiovascular risks. The editorial urged public health authorities to adopt tobacco-style policies: warning labels, marketing restrictions, and limits on secondhand exposure.
“Effective product warnings and education on risks must be developed, required, and implemented,” Glantz and Silver wrote. “Cardiovascular and other health risks must be considered in the regulation of allowable product and marketing design.”
They concluded that cannabis should not be criminalised, but rather regulated with vigorous public health protections”not unlike tobacco.”
A wake-up call
With cannabis use now increasingly mainstream and legally sanctioned in many regions, researchers and public health experts say these findings demand immediate attention. As more people turn to cannabis for recreational or medicinal purposes, a clearer understanding of the long-term cardiovascular effects is vital.
The new study delivers a powerful warning: as cannabis products become more accessible and potent, so too may the unseen dangers to the heart.
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