No increase in hypertension risk with lifetime cannabis use

Cumulative lifetime use of cannabis does not appear to raise the risk of developing hypertension, as shown in the study.

Researchers used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study and identified participants free of cardiovascular disease at baseline. Self-reported cannabis use was determined at each in-person examination (baseline and at 2, 5, 7, 10, 15, 20, 25, 30, and 35 years). 

The primary outcome of incident hypertension was defined using the updated American College of Cardiology/American Heart Association threshold (systolic blood pressure ≥130 mm Hg, diastolic blood pressure ≥80 mm Hg, or use of antihypertensive medication).

The analysis included 4,328 participants at baseline (median age 25 years, 58.2 percent, 49 percent White), with retention rates of 72.1 percent (n=3,121) at year 15 and 64.9 percent (n=2,810) at year 35.

Median cannabis-years increased minimally and remained low across visits, from 0.0 (Q1–Q3, 0.0–0.3) at baseline and 0.2 (Q1–Q3, 0.0–0.7) by year 35. A total of 2,478 incident cases of hypertension over 88,292 person-years of follow-up (28.1 cases per 1,000 person-years) were recorded.

Cannabis-years showed no significant association with incident hypertension (adjusted hazard ratio, 0.99, 95 percent confidence interval, 0.97–1.00; p=0.18). Results were consistent in sensitivity analyses.

The finding suggests that long-term cannabis use may not meaningfully contribute to long-term hypertension risk, challenging “the assumption that repeated activation of cannabinoid receptor type 1 receptors leads to deleterious long-term changes in vascular health vis-à-vis blood pressure,” the researchers said.

Overall, the present research may inform clinical risk assessment and public health guidance, given that cannabis use is becoming widespread.