Most Americans now live in a state where marijuana is legal, raising all kinds of questions about whether cannabis is something you should look into. But research into the potential impact of weed on your health is ongoing, making it tricky to know exactly how to navigate all of this.

Now, a new scientific analysis suggests that it’s best to take a pass on regularly using cannabis if you’re concerned about your heart health. Of course, the findings are more nuanced than saying you should never have the odd weed gummy or use CBD oil for aches and pains. But it’s also not great news for people who consistently like to smoke or vape weed.

We tapped two of the study’s authors, along with cardiologists and a toxicologist to break this down.

What did the research find?

The scientific review, which was published in Nature Reviews Cardiology, looked at existing research around cannabis use and found it’s just not great for your heart. In fact, the researchers clearly state that cannabinoids (the active compounds in cannabis) impact the cardiovascular system in a negative way, raising the risk of heart attack, stroke, heart rhythm issues, and heart failure.

The researchers cited several studies, including one published last year that polled 430,000 people on their cannabis use and compared that to their heart health. That study found that the 4 percent of survey respondents who said they used cannabis on a daily basis had a nearly 50 percent higher risk of heart attack and a two-fold higher risk of stroke than never users. The researchers also found that the impact on the heart of regularly using cannabis was the same whether people also smoked tobacco or never used the stuff.

“Cannabis is something that’s been around for quite some time but it’s only recently that scientists have been able to study it,” says lead study author Mark J. K. Chandy, MD, PhD, Heart & Stroke Chair at Western University. “Recent literature suggests that it’s associated with heart disease, whether heart attacks and strokes or heart failure. That data has become more robust with time.”

This is not the first study to suggest cannabis isn’t great for your heart.

Just last week, a meta-analysis of 12 previously published studies was presented at the American College of Cardiology’s Annual Scientific Session that concluded that cannabis users younger than age 50 were more than six times more likely to have a heart attack compared to people who don’t use the stuff. Over three years, cannabis users also had a fourfold increased risk of ischemic stroke, a twofold increased risk of heart failure, and a threefold increased risk of cardiovascular death, heart attack, or stroke.

A 2022 study published in the journal Cell looked at the impact of cannabis and delta-tetrahydrocannabinol (THC), the main psychoactive compound in cannabis, in cell culture and mouse models. It linked THC with inflammation and cardiovascular disease. “We also found that cannabis use was linked to premature heart disease,” says Joseph C. Wu, MD, PhD, co-author of that study and the latest scientific review, and director of the Stanford Cardiovascular Institute at the Stanford University School of Medicine.

And a 2024 study published in the European Heart Journal discovered that using oral cannabis for chronic pain is also linked with a higher risk of heart rhythm issues.

Smoking cannabis seems to be especially dangerous.

As you probably know, there are a bunch of different ways to consume cannabis. But smoking or vaping it seems to be the most concerning.

“Smoking or vaping cannabis provides a larger dose of cannabinoids than oral formulations,” Wu says. When you take cannabis orally, your liver can break it down slightly, lowering the amount that makes it to your bloodstream, he explains.

“In addition, traditional cigarettes and vapes are heated to high temperatures, and cardiotoxic substances—including nicotine, heavy metals, and other compounds—might combine with cannabinoids and cause adverse effects,” Wu says. Plus, smoking or vaping anything means you’re sucking in small particulate matter like PM2.5, which can be in absorbed into your lungs and cause cardiovascular issues, he adds.

Chandy says this tends to be “dose-dependent,” though. “Just like cigarette smoking, if someone smokes [cannabis] occasionally, it’s hard to make an association between that and cardiovascular disease,” he says. “But if you do it daily, that’s concerning.”

Smoking cannabis delivers high levels of THC quickly into the bloodstream, which can trigger sudden increases in heart rate and blood pressure, raise oxygen demand, and promote inflammation, says Ragavendra Baliga, MBBS, a cardiologist and professor of internal medicine at The Ohio State University Wexner Medical Center. “It also exposes users to harmful combustion byproducts—similar to tobacco—that can damage blood vessels and worsen cardiovascular risk,” he adds.

So, how should you approach cannabis use?

“Harm reduction is always a good practice,” says Jamie Alan, PhD, an associate professor of pharmacology and toxicology at Michigan State University. “If you do smoke cannabis, deep inhalation—like using a bong—is likely the most risky. Switching to edible cannabis is probably less risky. The rest is likely in between.”

If you’re interested in trying cannabis, Wu says it’s “reasonable” to talk to a healthcare provider before diving in. Chandy agrees, but says that many doctors may not know what is and isn’t OK when it comes to things like dosing and type of cannabis to use. “It is reasonable to use cannabis in certain situations,” he says, listing off chronic pain as a big one. But that doesn’t mean you need to be in constant pain to consider using cannabis. “Recreational use of cannabis is also reasonable to discuss with your physician,” Chandy says.

Just know that no matter why you’re using it, cannabis probably isn’t doing your heart health any favors.

Korin Miller

Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more. She has a master’s degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.