A new study published in JAMA Cardiology on May 28 has shed light on the impact of cannabis consumption—both through smoking and edibles—on vascular function, suggesting potential risks to heart health comparable to tobacco use. While previous research has primarily focused on the dangers of smoking THC-containing cannabis, the findings highlight that ingesting edibles may not be a benign alternative, challenging the perception that non-combustible forms of cannabis are safe.
Study Links Cannabis Use to Endothelial Dysfunction
Led by researchers at the University of California, San Francisco (UCSF), the study compared vascular health markers in three groups: chronic cannabis smokers, chronic THC edibles users, and non-users. The 55 participants, all healthy adults aged 31 on average with no tobacco exposure, were evaluated on three key measures
- low-mediated dilation (FMD): A gauge of blood vessel flexibility, where lower FMD indicates impaired function.
- Nitric oxide (NO) production: A molecule critical for blood vessel relaxation, measured in vitro using participants’ blood serum.
- Pulse wave velocity (PWV): A marker of arterial stiffness.
Both cannabis-using groups showed significantly reduced FMD—approximately half the level of non-users—mirroring declines seen in tobacco smokers in prior studies. Notably, NO production dropped sharply when endothelial cells were exposed to serum from smokers, but not edibles users, suggesting combustion byproducts may exacerbate vascular injury in smokers.
Dose Response: Heavy Use Worsens Vascular Dysfunction
The study also observed a dose-response relationship: The more participants smoked or consumed edibles, the worse their endothelial function became. Chronic smokers, with an average of 10 years of use, and edibles users (five years average) both exhibited signs of endothelial dysfunction, a precursor to cardiovascular disease that impairs blood vessel dilation.
Experts Warn: Cannabis Is Not a ‘Safe’ Alternative to Tobacco
“Smoking marijuana does not avoid the harmful vascular effects of tobacco, and frequent THC edibles use is not harmless,” said Matthew L. Springer, PhD, a UCSF professor and senior study author. Nicholas Leeper, MD, a Stanford Medicine vascular surgery professor, noted that while the study cannot prove causation, it adds to evidence that cannabis use—regardless of method—“may be associated with risk for heart disease.”
Keith C. Ferdinand, MD, of Tulane University, emphasized that endothelial dysfunction, while not an immediate heart attack or stroke, signals increased long-term vascular disease risk. “Phrases like ‘natural’ or ‘safer than tobacco’ don’t mean ‘harmless,’” Leeper cautioned, advocating for moderation or cessation to reduce cardiovascular risks.
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