It’s very possible we haven’t learned to recognize them. (although that fact also implies that the effects are subtle, doesn’t it?)

Thank you for the links. I didn’t have time to review them all in detail but I did take the time to find the study that Forbes was referring to ( because a sample size that big is very interesting, even if it was just a population study.

Their inclusion criteria were people who had Cannabis Use Disorder documented on their chart compared to statistically matched people who did not. They tried to control for socioeconomic factors.

In my opinion, it’s worth noting that people who end up with that chart diagnosis are going to be on the heavier end of users, as the majority of people who use pot don’t report it to their doctors nor end up in the EDs with cannabis related complaints.

In comparing the two populations, they found that the ABSOLUTE RISK (not relative risk) of adverse cardiovascular events was increased by 0.9%. Notable limitations to the study include that they don’t know exactly how much cannabis each person was using, they couldn’t fully control for tobacco use, and (imo) the exclusion of people with previous cardiovascular events was limited to a 2 year lookback, which may be a bit limiting.

So the conclusions we can draw from this is “within a population of the heaviest cannabis users with greater than average healthcare exposure, risk of CVD goes up by less than a percent.”

I’m totally willing to believe that it presents some risk- I just think it’s more likely to be even less of a factor (or at least in the same ballpark) in the development of CVD than things like diet and exercise.

Comparing this study to some established numbers on tobacco can be helpful here. A quick search on the medical database UpToDate showed me some data suggesting that in heavy smokers, the risk of CVD was 600% greater (relative risk), which is 10 times higher than the 60% relative risk increase that we saw in the cannabis study.

doi.org/10.1111/add.16337 cannabis study pubmed.ncbi.nlm.nih.gov/8565161/ tobacco study