A question was asked to The Drs. Wolfson recently on Facebook. It was regarding the safety of marijuana and cannabis use, particularly related to heart disease. I thought it best to respond with a blog post, since cannabis use is so prevalent around the world and even legal in some states in with a prescription.

We know of the extreme dangers of smoking, secondhand smoke, and even third-hand smoke. But is marijuana an innocent habit when it comes to heart health? A review of the literature indicates it could be a problem. Let the toker beware.

The risk is there.
A major medical journal found that marijuana smoking led to a heart attack in about 1% of all heart attack victims. The authors surveyed heart attack victims to find out precipitating events prior to the heart attack. Again, only one in a hundred heart attacks were linked to marijuana. The most common preceding events were traffic exposure, physical exertion, alcohol, coffee, a heavy meal, negative emotions, and sexual activity. But marijuana was on the list. A heart attack is more commonly due to cocaine than cannabis. (1) There is risk with marijuana use, not only heart attack, but also stroke. (2).

Medicinal use only.
The problem is that cannabis is the most used illicit substance worldwide. It is clearly abused socially, but increasingly used for medicinal purposes. It is an option for patients with pain, nausea, and anorexia. There may be a promising application for use in vaccine-injured children with seizures.  I am okay with marijuana use for medicinal purposes and believe alcoholism is a lot more dangerous than marijuana use.

Risk increases with frequency.
It is likely the more often you smoke, the more dangerous marijuana is. If you use tobacco as well, cardiovascular risk goes up dramatically. Case reports regarding marijuana use include the aforementioned heart attack and strokes, but also chest pain, shortness of breath, palpitations, tachycardia, lightheadedness, and syncope (fainting). There is even a case report of atrial fibrillation related to cannabis use. (3) The worst case scenario is a report of three people who suffered from a cardiac arrest related to marijuana use. (4)

It’s not heart-smart.
Patients with known coronary artery disease should be cautioned against marijuana use or at least informed of the increased risk of heart attack and stroke. It is unclear why marijuana use could be problematic to the heart, autonomic dysfunction could be a reason. This is the part of the brain and neurologic system that controls so many of body functions. (5)

It’s best to stay away.
Hey, I went to college. I must say that most people who smoke marijuana on a regular basis are trying to escape from something and should seek appropriate help to find a better solution to their problems. I like to be in control of my body, my thoughts, and my behaviors. We should enjoy life while not under the influence of anything besides our natural state of being.

The risks of marijuana/cannabis must be explained and made public. Hence this blog post. At the end of the day, I would never encourage my child to smoke and would actively preach why not to use this or any drug. The only exception is monitored medicinal use in specific situations.



  • 2011 Feb 26;377(9767):732-40
  • Arch Gen Psychiatry. 2007;64:495-502
  • Med Sci Monit.2000 Mar-Apr;6(2):386-9.
  • Acta Cardiol. 2014 Apr; 69(2):131-6.
  • Br J Pharmacol.2001;134:1319–27.

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