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Cannabis use not associated with stroke risk in young adults
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Cannabis use in young adulthood was not associated with incidence of stroke in adults younger than 60 years, according to new data.
However, tobacco smoking had a significant dose-response relationship with stroke risk.
“Recently, a growing body of research has linked cannabis use to stroke, particularly to those occurring before 45 years of age,” Daniel Falkstedt, PhD, of the department of public health sciences at the Karolinska Institutet, and colleagues wrote. “It seems cannabis-associated strokes usually occur in chronic or current cannabis users who also smoke tobacco, either in combination with or immediately after cannabis use.”
Falkstedt and colleagues studied Swedish men (n = 49,321) who were conscripted into military services in 1969-1970 at age 18 to 20 years. Cannabis, tobacco and alcohol use were assessed at baseline. Stroke incidence was obtained from national databases until age 59 years.
During the follow-up period, 1,037 strokes occurred, 192 of which happened at age 45 years or younger.
Factors that were significantly more common in men with stroke before age 60 years included: parental history of CVD, being overweight, low cardiorespiratory fitness, low socioeconomic position in childhood, short schooling, heavy smoking and high alcohol consumption.
According to data, heavy cannabis use (> 50 times) in young adulthood showed no association with stroke incidence at age 45 years or younger (HR = 0.93; 95% CI, 0.34-2.57) or up to age 60 years (HR = 0.95; 95% CI, 0.59-1.53) in multivariable models.
In crude models, the risk for ischemic stroke during the follow-up period for participants with heavy cannabis use was almost two times higher compared with nonusers. However, a dose-response shaped association with ischemic stroke was seen only with tobacco use and not alcohol or cannabis use, and the risk for ischemic stroke with heavy cannabis use was attenuated after adjustment for tobacco use (HR = 1.47; 95% CI, 0.83-2.56).
Smoking 20 or more cigarettes per day was associated with stroke at age 45 years or younger (HR = 5.04; 95% CI, 2.8-9.06) and with stroke up to age 60 years (HR = 2.15; 95% CI, 1.61-2.88), according to the researchers.
“We have expanded current knowledge by examining cannabis use in young adulthood in relation to the subsequent risk of stroke in a large population-based cohort,” Falkstedt and colleagues wrote. “We found no evident association between cannabis use and stroke, including stroke before 45 years of age. Tobacco smoking, however, showed a clear, dose-response shaped association with stroke across multivariable models.” – by Cassie Homer
Disclosure: The researchers report no relevant financial disclosures.
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