Posted by RickJWagner 6 hours ago
Personally I'd wager a bet it's the tobacco and/or smoking that is the harmful part, but it kind of dumbfounds me they failed to account for "details" like "duration and amount of cannabis use", that feels like a very vital thing to control for. Nothing is good for you in too great amounts, even water, so not taking that into account seems to not really give reliable and trustworthy results.
Also, title needs a 2025.
> The findings are from a retrospective study of over 4.6 million people published in JACC Advances and a meta-analysis of 12 previously published studies being presented at the American College of Cardiology's Annual Scientific Session (ACC.25).
> Kamel and his team conducted the retrospective study using data from TriNetX, a global health research network that provides access to electronic medical records. Their findings indicate that over an average follow-up of over three years, cannabis users had more than a sixfold increased risk of heart attack, fourfold increased risk of ischemic stroke, twofold increased risk of heart failure and threefold increased risk of cardiovascular death, heart attack or stroke. All study participants were younger than age 50 and free of significant cardiovascular comorbidities at baseline, with blood pressure and low-density lipoprotein (LDL) cholesterol levels within a healthy range and no diabetes, tobacco use or prior coronary artery disease.
> This retrospective cohort study utilized the TriNetX health research network, which aggregates deidentified electronic medical records from health care organizations worldwide.
> 1) The cannabis-user group with cannabis use diagnoses (International Classification of Diseases, 10th Revision: F12.1, F12.9, F12.90).
You can't expect them to work miracles and come up with data they didn't have. They produced a valuable piece of research furthering our understanding of the cardiovascular risks of cannabis use based on a very large existing dataset that was available to them.
Of course they would love to be able to answer the question of whether smoking is worse for your heart than edibles and so on, and they stated they would like to do this in a future study. But that costs time and money to create an entirely new dataset, and you know what funding for science is like these days.
There's plenty of other evidence in the literature on the cardiovascular effects of THC if you want to see what our current understanding is there. TL;DR: smoking is worse than vaping or edibles; myocardial infarction risk spikes within the first few hours of using cannabis; but the risks are not limited to inhalation because THC itself has physiological effects that raise cardiovascular risk factors (increased heart rate, endothelial dysfunction, platelet activation raising clotting risk, inflammation and oxidative stress, etc.).
Still good data, but I don’t think it’s predictive for what cannabis use leads to (unless you assume that taking up cannabis makes you proportionately more likely to also take up whatever the confounding factors were).
Information like this get collected at a point in time and never goes away. People have EMR fatigue and click though the questions. Anecdotal point, several years ago I accidentally stated that I drank enough to be considered a severe alcoholic. Even after correcting it at my next visit, it never really goes away, I get asked lifestyle questions relating to alcoholism.
Similarly advocacy against drunk driving, a noble cause, juiced up the stats. If you run over and injure a guy on the sidewalk carrying a sealed bottle of liquor, it will be labeled “alcohol related” more often than not based on officer discretion. If it’s fatal, the autopsy will take that conclusion if any party has a 0.01 BAC.
After reading the study, should we update our posterior on the hypothesis that cannabis use causes cardiovascular disease to nudge it in the direction that it does? Yes - that's just Bayes' theorem. Does the probability go to 95%+? No, of course not; I'm not claiming otherwise. It's still useful research.
Also, worth noting that MI risk spikes several-fold within the first hour after cannabis use (and that's not caused by cocaine).
(Sadly speaking from experience)
Cannabis is a multi purpose drug, cocaine is party drug and/or a "I haven't slept, don't want the 8 hour+ commitment of speed, but need to stay awake" drug.
The overlap of pot users and cocaine users is rather small in my anecdotal experience.
Confounding migraines for weed prescriptions and very real stroke risk and a desire for low THC marijuana isn't going to be a happy show I want to go through watching that happen to friends.
It makes a mockery of real medical issues.
Doctors and health care should be involved in drug use and advising patients, maybe even clean supplies or other things.
But we got the ACA of public health options with medical marijuana. And I want to remember Obama and others for inspiring us, not hacks.
A lot of people won't be believed in time.
Everyone I knew who developed coke problems had drinking problems first. Bar none.
Were I to pick a gateway drug into cocaine, it would be alcohol. It becomes a way to infuse more energy in a later night, which is usually one of alcoholic revelry.
When cannabis is just in a store and it's the only thing there, many potheads just stay in the pothead bubble.
Myself I have been involved with weed a long time and never seen cocaine though my son did go into town one night and lock himself out of his car and have an experience we call "the night of the living baseheads."
The best drug dealer at my old school was a guy who would take chances nobody else would; I knew him somebody who dealt weed, psychedelic mushrooms and acid to my friends although I was persona-non-gratis with him because he was seriously criminally minded and led a gay bashing gang that mostly bashed straight people who were perceived as allies, although it took just one snarky comment (my case) or advising somebody being shot at with a paint pellet gun to see the police (the popular president of the paint pellet gun club.)
He eventually got caught bashing in an RA in the face with a rock shot with one of those rubber band catapults people use to shoot water balloons at the beach. He was banned from campus but I saw him once when he was dropping off a delivery for a friend. My friend later told me that he'd been caught on videotape dealing 3kg of cocaine to an undercover cop and he did time.
That's an unusual case. Except for that guy and the Vietnamese kid who took money and never delivered the weed to my wife when she was in high school, all the pot dealers I knew were basically responsible and law-abiding people who only dealt pot and other soft drugs. Funny somebody dropped a dime on the later.
But not all potheads are lazy, and many non-potheads are.
Media tropes sure are great at propagating myths and generating false stigma, which creates a chilling effect for ever correcting the former.
Having lived in a country where cannabis has been legal for about a decade now it's quaint seeing this kind of casual disrespect levelled by a stranger.
I wonder if this kind of mindset is still common here and people just don't vocalize it anymore, or if it's the kind of mentality that continued criminalization perpetuates.
It's actually not even just HN. I've noticed this with many people in real life (US).
It's especially strong with the subset of Boomers who never used it. They make it part of their personality to have not used it, while often fully embracing alcohol and ignoring all of the personal and societal risks it brings. Surely they pass this mentality onto their kids with a 50% success rate.
Maybe it's some kind of inferiority/superiority compensation mechanism for not being a hippy like their rival sibling was, etc.
There was a deliberate effort to demonize weed in the US as it's associated with mexicans, black people, and counterculture, and it's difficult to monetize if it's legal (anyone can just grow it).
https://www.youtube.com/watch?v=Uy_lCjA6poo
Also, there are alternatives to smoking it: use a dry herb vaporizer with no tobacco and you avoid the vast majority of the negative health effects.
The thing is we don't know without doing more research, which I genuinely appreciate the authors essentially calling out point blank. They're not saying cannabis is bad, they're saying that looking at the thin amount of valid data we have available thus far, there's definitely a correlation there worth investigating further.
> I've smoked cannabis daily for maybe 15 years [...] Visited a cardiologist like two months ago and have perfectly fine heart despite the smoking.
Mostly it's been smoking, though I've had access to edibles and was lately impressed by cannabis beverages that contain 10mg of THC and some CBD that give an experience competitive to drinking alcohol. I find it easy to not use it if is not around, but once I get into it I will keep using it and quitting is a few days of hell followed by almost forgetting it ever existed. But maybe I get depressed a bit a few months later and think "I will feel better if I use" and then I will use for a few weeks to months, start feeling strung out and quit. Never dabbed, I haven't found a vape I like the way I like smoking but for me it has always been green weed, not extracts. It is legal to grow in NY and I know enough amateur and pro growers who owe me a favor that I rarely have to pay for weed and don't expect to ever go into a dispensary.
I do know that I gain/lose several kg of wait depending on if I am using cannabis. Despite being rather athletic and having a lot of lean muscle mass I have many signs of "metabolic syndrome" including somewhat high blood sugar, blood pressure, etc. [2] I am off cannabis now and just started Zepbound which I am hoping will help with my metabolic syndrome.
[1] once i got into a biosignals hobby and started looking at EEG traces to evaluate heart rate variability where I often can't make out the P wave on a two or three lead ECG, how can you say 20 beats out a million were bad with any accuracy?
[2] with somewhat aggressive pharmacological treatment including high dose fish oil without which my triglycerides would have another 0 on the right; showed up my docs with a sheaf of pubmed abstracts, switched to Montelukast as my asthma controller because it may be cardioprotective whereas my academic advisor and galactic astronomer Edwin Salpeter and his daughter wrote a paper finding LABAs are probably the opposite; my pulmonologist switched me to using a LABA/Steroid inhaler for rescue because a recent study has shown that the holy grail of "just one inhaler" has been attained for a lot of people and the LABA isn't much slower to hit than Albuterol. Also added Nebivolol as a BP med which I think should be more popular than it is.
And that was a physical change. Heart attacks happen because of electrocardiac issues as well.
Trust doctors with a grain of salt. There are many bad doctors that market themselves as good doctors, but are in reality terrible providers.
I recently had a scare, where I was encouraged by two separate general practitioners to seek immediate care with an ophthalmologist. I visited the ophthalmologist who I was referred to and they said everything was great, then booked my next appointment for a year out. Four days later, I started losing vision in my right eye.
After visiting a competent ophthalmologist, they were flabbergasted by what the other did. Ten appointments within 2 weeks later with the new specialist and we're undoing the damage that was easily preventable.
In short, some doctors are borderline DANGEROUS, but it's difficult to distinguish them with the ample legal protections they receive.
Anyhow, hope your brother recovered well.
This is likely even more true in modern times with such high rates of anxiety and other similar disorders paired alongside the internet - there's going to be a lot of hypochondriacs suddenly thinking, and subsequently claiming, that they have every symptom of [something awful].
Doctors have very little in the way of legal protections, but malpractice has to actually be malpractice. A recent study on the topic found that in low risk occupations, 75% of doctors end up getting sued for malpractice over their career, and in high risk it bumps up to 99%. [1] When people don't like the outcome, they sue, but in most cases the outcome was largely unpreventable even with a high standard of care.
[1] - https://www.reuters.com/article/us-doctors-idUSTRE77G5YS2011...
A: Doctor
Bingo.
Some medical practitioners were the bottom of the class.
No different than mechanics.
Can’t hero-worship.
Eeesh...sorry about that. Been there my whole life. It too ten years to get an appointment with a Hematologist and was finally diagnosed with Erythrocytosis which I told them I had but always said my HCT levels were "not really that high". The Hematologist looked at my records and wondered why they did not send me in twenty years ago. I am on Medicare which makes it much more difficult.
> Anyhow, hope your brother recovered well.
My whole family disowned me for no other reason than me having a serious mental illness so I do not care. But thanks.
Yet I only see about .5-1% of the population in my area these days wearing any kind of mask/N95 respirator in public.
Anybody curious might consider scanning the sticky posts on /r/zerocovidcommunity for more information and links to external sources.
Growing up I definitely knew some people who had their demons who turned to drugs.
However we also had a lot of people who were in good situations who picked up drugs for purely recreational reasons. One of my friends at the time even boasted that drugs were actually more appropriate for people like him who were educated, in good situations, and rational (his description of himself) because they knew how to manage themselves and their usage better. He even had links to some subset of the rationality community who had become pro-recreational drugs with a lot of justifications.
His turn to drug use marked the end of his promising academic career. He started struggling with mental health in ways that were obviously related to the drugs. Holding a job had never been a problem until he starting smoking, which marked his turn toward job struggles. His friends and family relationships started declining and falling apart.
He’s not the only one I know like this. The first person I knew who had to go to rehab for drug addiction was a happy, successful guy who started using drugs as a way to party more and for longer. He thought his life was awesome and he was invincible.
I think there’s become a belief that drug use is purely a symptom, but I’ve seen enough people go from happy to falling apart as an obvious result of the drug use. Most of the people I know who started using drugs didn’t do it at their homes in private to cope, they started doing it at parties with friends.
This is even well known with alcohol: There is common belief that being a “social drinker” is a different risk profile than someone who does their drinking alone.
I think it’s a comforting idea that we tell ourselves that nobody chooses to use drugs, they are driven to do so by circumstances out their control. We like removing blame from people and hoisting it on to the world. I don’t think it’s always true, though. Many people use drugs because drugs are rewarding (at first) and they like the way the drugs make them feel. The negative consequences come later.
I can have fun without drugs.
Yes!!! I love this approach! nonironically
Going on an actual calorie restricted diet while consuming cannabis is basically impossible for me.
Then instead of walking 60 minutes I end up sitting and listening to music.
There is really not anything for me that correlates with healthy behavior when I smoke.
Set and Setting are also relevant too. If you do it a soecfic way with other soecific tools and activities while on it, that all gets packaged and reinforced.
Well, Id guess these are reasons for any case of substance missuse?
I have not met ANY regular drug user (regardless which drugs), who didnt had "frictions with parents" early in their life. (and some for which its still persisting into their 40ies)
I’m not sure what the first sentence is after, but this one reminded me of Michael Phelps.
^^ many of those are boring people.
You can never know for sure what’s to blame but the evidence that daily use causes vascular dysfunction seems pretty convincing to me. The studies i read saw similar numbers in edible users
If I was a weekly or monthly user, I’d probably wouldn’t have bothered quitting. The idea that daily use of any recreational drug is safe, seems funny from distance. I was more easily convinced as a user...
I’m less concerned about actue effects like raised heart rate. It’s the chronic cumulative impact on the arteries that was a concern. I’ve also made lots of other lifestyle changes so I’ll never know for sure how to weight the weed's contribution to my crappy arteries. it was of course a combinination of things
but sure, still lets make to account by other "legal" substances (alco, tobacco, cocaine, pharmaceutics and other "lifestyle choices" infecting cardiovascular system) and way they are consumed(smoked, ingested, pure or with say tobacco)
would love see data for a group who consumes cannabis by ingestion and especially not via smoking!
also- do they differ different thc/cbd grades used (high/low thc, "medical")?
im regards "research demonstrates something does this.." for many years alcohol was considered "healthier" over non consumption, just becauses non-drinkers were together with those of abstinent ex-alcholics.. thus average score was lower than for those who drunk minimal amounts and were considered "healthier".
Anecdotal of course, many could probably bring up counter-stories too, but I do think you bring up a good point, it seems to me a completely sedentary lifestyle seems to be way more destructive to your health than moderate usage of various drugs and/or eating habits. People who just walk a bit daily already seem way healthier and happier than peers in their same age.
Hemp, meaning very low THC, higher terpene and CBD content, is for you (and most!).
I would assume that cannabis use correlates with a few other important heart health variables and we would expect the odds ratio to be lower when accounting for those (alcohol doesn't have an OR more than 1.0, tobacco smoking ~1.5)
I'm sure that cannabis use is bad for cardio health but the reported odds ratio is very high. I personally do not use cannabis.
Now I stimulate the Vegas nerve in the morning and at night with breathing regiments
Its hard to quit as there is a lot it does for you neurologically like caffeine does but I finally realized it was giving me neuroinflammation and wrecking my sleep quality so I stopped. Likely other long term health problems but those are harder to see/feel.
Now my body does biphasic sleep and I journal at night and read books. Never liked to do either. Get crazy amounts of energy now and people constantly comment on the difference in me.
Goodluck, you can in fact regulate this shit out of your daily habits if you find a way to do a cellular reset. Its not easy.
I quit smoking cigarettes and checked drinking way way easier than cannabis