Comparison of Atherosclerotic Cardiovascular Risk Factors and Cardiometabolic Profiles Between Current and Never Users of Marijuana

Abstract

BACKGROUND: The relationship between marijuana use and cardiovascular health remains uncertain, with several observational studies suggesting a potential association with increased adverse atherosclerotic cardiovascular disease (ASCVD) outcomes. This study examined the relationship between marijuana use, ASCVD risk factors, and cardiometabolic risk profiles. METHODS: US adults (18–59 years) without cardiovascular disease were identified from the National Health And Nutrition Examination Survey (2005–2018) based on self-reported marijuana use. Current users (used within the past month) and never users were compared with assess the burden and control of traditional ASCVD risk factors and biomarkers, using inverse probability of treatment weighting to adjust for sociodemographic and lifestyle factors, including tobacco use. RESULTS: Of the 13 965 participants identified (mean age, 37.5; 51.2% female; 13% non-Hispanic Black), 26.6% were current users. Current users were predominantly male, low-income, and more likely to be concurrent tobacco users. Inverse probability of treatment weighting analysis showed no significant differences in the burden and control of hypertension (19.3% versus 18.8%, P =0.76; 79.8% versus 77.8%, P =0.75), dyslipidemia (24.0% versus 19.9%, P =0.13; 82% versus 75%, P =0.95), diabetes (4.8% versus 6.4%, P =0.19; 52.9% versus 50.6%, P =0.84), obesity (35.8% versus 41.3%, P =0.13), and physical activity levels (71.9% versus 69.3%, P =0.37) between current and never users. Likewise, mean 10-year ASCVD risk scores (2.8% versus 3.0%, P =0.49), 30-year Framingham risk scores (22.7% versus 24.2%, P =0.25), and cardiometabolic profiles including high-sensitivity C-reactive protein (3.5 mg/L versus 3.7 mg/L, P =0.65), neutrophil-lymphocyte ratio (2.1 versus 2.1, P =0.89), low-density lipoprotein (114.3 mg/dL versus 112.2 mg/dL, P =0.53), total cholesterol (191.2 mg/dL versus 181.7 mg/dL, P =0.58), and hemoglobin A1C (5.4% versus 5.5%, P =0.25) were similar between current and never users. CONCLUSIONS: This cross-sectional study found no association between self-reported marijuana use and increased burden of traditional ASCVD risk factors, estimated long-term ASCVD risk, or cardiometabolic profiles. Further studies are needed to explore potential pathways between adverse cardiovascular disease outcomes and marijuana use.