Legal Cannabis and Heart Attacks: What the Study Shows

What the researchers did

The team led by Slavin SD analyzed hospital discharge records from 2012 to 2018, about 50 million in total. The data come from the National Inpatient Sample, which covers roughly 97 percent of the US population.

They compared the 13 states of the West region with regions that had not legalized. In the West, including Colorado, Washington, Oregon and California, legal recreational sales began in January 2014, about five years before most other regions. The researchers then looked at how hospital admissions in the West changed compared with the rest, using 2012 and 2013 as the starting point before sales began.

The results

For each year of legal sales, adjusted admissions in the West rose significantly:

• Heart failure: just under 4 percent more per year
• Heart attack: just over 3 percent more per year
• Atrial fibrillation and flutter: just over 2 percent more per year

Ischemic stroke, venous clots and ventricular tachycardia also went up, but not by a statistically reliable amount. Patients in the West were younger on average (51 versus 55 years) and more often came from higher-income ZIP codes.

Note the unit: these percentages are per year of legal sales, not a total increase.

What the study cannot prove

The authors say themselves that this is an observational study. It shows an association, not a cause. There are several gaps:

• Individual states could not be separated.
• The way people used cannabis is unknown: smoking, vaping or edibles.
• Illegal use was not accounted for.
• The study did not measure whether the patients themselves used cannabis.

So the claim that legalization causes heart attacks cannot be drawn from this data. The authors recommend a cautious approach and call for better data on cardiovascular effects.

What this means for you

If you use cannabis regularly, this is not a headline to wave away. The study cannot tell you what happened in your own body. It is one more sign that your body does not simply absorb regular use without a cost.

If you notice a racing heart, chest pressure or skipped beats, get it checked and tell the doctor that you use cannabis. This matters most for young adults who have always thought of themselves as healthy.

The study is also limited to the US West, so it does not describe every place or every product. Still, the question of whether your heart is already under strain is a fair one to ask.

Quitting is the one thing you control. It takes a load off your body, no matter how the statistics are read in the end.

Source

Slavin SD et al.: “Cannabis legalisation and cardiovascular hospitalisations in the United States: nationwide difference-in-differences analysis, 2012 to 2018,” BMJ Open, October 22, 2026, DOI 10.1136/bmjopen-2025-111050. We could not access the original paper, so the figures were checked against the journal’s press release and two consistent news reports.