Marijuana use may not elevate stroke risk among young adults
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Marijuana use was not associated with risk for ischemic stroke among young adults compared with never users, according to research published in Stroke.
Researchers reported a trend toward greater stroke risk among those who reported smoking marijuana once per week, but the association was not significant.
“Marijuana use has been implicated in numerous cardiovascular pathologies, particularly in healthy young males without other known vascular risk factors and is the subject of a recent scientific statement focused on cardiovascular health issued by the American Heart Association,” Tara Dutta, MD, assistant professor of neurology at the University of Maryland School of Medicine, and colleagues wrote. “We, therefore, sought to evaluate whether self-reported marijuana use was associated with early-onset ischemic stroke using a large population-based case-control study of ischemic stroke in young adults, controlling for several common stroke risk factors, including quantity of current tobacco use, and evaluating for dose-response and the temporal relationship between marijuana use and stroke.”
For this population-based case-control study, researchers included individuals with first-ever ischemic stroke aged 15 to 49 years in the Baltimore-Washington, D.C., region. Participants in the control arm were obtained by random digit dialing from the same geographic region and were frequency-matched to patients with first-ever stroke based on age, sex, region of residence and race (751 ischemic stroke cases; 813 controls).
Participants interviewed to ascertain stroke risk factors and marijuana use.
Those who reported a history of cocaine or amphetamine use were excluded from the analysis. Individuals who reported use of substances without known association with stroke, such as heroin, were not excluded from the analysis.
Patients in the first-ever stroke group were more often older, had a history of hypertension and/or diabetes and were more likely to report current tobacco use (P for all < .001).
Rates of ever marijuana use between the first ever-stroke arm and the control arm were similar (36.1% vs. 38.4%, respectively).
Compared with never use, researchers reported that ever marijuana use was not associated with stroke, regardless of the timing of use in relationship to the stroke (adjusted OR = 0.86; 95% CI, 0.68-1.08; P = .19).
Moreover, the odds for stroke use within 24 hours of marijuana use was not significant compared with never use (aOR = 0.98, 95% CI, 0.29-3.27; P = .97).
According to the study, there was a trend toward increased risk for stroke among individuals who smoked marijuana at least once per week, but it too was not significant compared with never use (aOR = 1.9; 95% CI, 0.8-4.9; P = .17).
“Although we did not demonstrate an association between marijuana use and an increased risk of early-onset ischemic stroke, our statistical power was limited for assessing the association among very heavy users,” the researchers wrote. “The issue of whether high frequency or high dose of use is associated with stroke risk is increasingly important as marijuana use becomes more widespread. At present, the epidemiological literature, including our study, does not provide evidence that marijuana use is causally associated with stroke.”
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