5 ms·

> researchers were unable to account for several potential confounding factors including the duration and amount of cannabis use or the use of tobacco or other

> researchers were unable to account for several potential confounding factors including the duration and amount of cannabis use or the use of tobacco or other drugs. Personally I'd wager a bet it's the tobacco and/or smoking that is the harmful part, but it kind of dumbfounds me they failed to account for "details" like "duration and amount of cannabis use", that feels like a very vital thing to control for. Nothing is good for you in too great amounts, even water, so not taking that into account seems to not really give reliable and trustworthy results.

xattt 4mo ago
I tried to look up the source article, but there doesn’t seem to be any mention of consumption of edibles versus smoking.
honeycrispy 4mo ago
Do you smoke?
- embedding-shape 4mo ago
  Literally just wrote about that: https://news.ycombinator.com/item?id=48794178 https://news.ycombinator.com/item?id=48794178 > I've smoked cannabis daily for maybe 15 years [...] Visited a cardiologist like two months ago and have perfectly fine heart despite the smoking.
  - Noaidi 4mo ago
    Many people have had cardiologists say they have perfectly fine hearts go on to have heart attacks months later. My brother was one of these people. He was going in for spinal surgery, cardio said his heart was fine. Two weeks after surgery he was short of breath. Turns out he needed a triple bypass. And that was a physical change. Heart attacks happen because of electrocardiac issues as well.
    - yehosef 4mo ago
      [flagged]
    - pipes 4mo ago
      Did you brother have a Coronary Artery Calcium score scan?
      - Noaidi 4mo ago
        No. This was about ten years ago. But not much has changed as I cannot get CAC score on Medicare even though they wanted to put me on statins. Cardiologist says I am fine. :/
        ses1984 4mo ago
        They only cost about $100.
        Noaidi 4mo ago
        Can I have $100?
    - embedding-shape 4mo ago
      Yeah, but I mean what can you do really? Many people have CAT scans then it turns out the technician/whoever missed something, or a surgeon forgets an instrument inside of the patients body, shit happens.
    - tyjen 4mo ago
      Information asymmetries are a bane in the medical doctor market. Trust doctors with a grain of salt. There are many bad doctors that market themselves as good doctors, but are in reality terrible providers. I recently had a scare, where I was encouraged by two separate general practitioners to seek immediate care with an ophthalmologist. I visited the ophthalmologist who I was referred to and they said everything was great, then booked my next appointment for a year out. Four days later, I started losing vision in my right eye. After visiting a competent ophthalmologist, they were flabbergasted by what the other did. Ten appointments within 2 weeks later with the new specialist and we're undoing the damage that was easily preventable. In short, some doctors are borderline DANGEROUS, but it's difficult to distinguish them with the ample legal protections they receive. Anyhow, hope your brother recovered well.
  - PaulHoule 4mo ago
    I have been a heavy cannabis user (like that guy in the Bob Marley song who "smokes two joints in the morning, smokes two joints at night") on and off from my mid 20's onward. I've also been a heavy exerciser and have the constellation of symptoms known as "athlete's heart" including an A-Fib diagnosis that I don't really believe [1] as well as concerning findings that may or not really be concerning because doctors don't know to evaluate us. I'm the kind of person who might get told by a doctor to exercise less instead of more! Mostly it's been smoking, though I've had access to edibles and was lately impressed by cannabis beverages that contain 10mg of THC and some CBD that give an experience competitive to drinking alcohol. I find it easy to not use it if is not around, but once I get into it I will keep using it and quitting is a few days of hell followed by almost forgetting it ever existed. But maybe I get depressed a bit a few months later and think "I will feel better if I use" and then I will use for a few weeks to months, start feeling strung out and quit. Never dabbed, I haven't found a vape I like the way I like smoking but for me it has always been green weed, not extracts. It is legal to grow in NY and I know enough amateur and pro growers who owe me a favor that I rarely have to pay for weed and don't expect to ever go into a dispensary. I do know that I gain/lose several kg of wait depending on if I am using cannabis. Despite being rather athletic and having a lot of lean muscle mass I have many signs of "metabolic syndrome" including somewhat high blood sugar, blood pressure, etc. [2] I am off cannabis now and just started Zepbound which I am hoping will help with my metabolic syndrome. [1] once i got into a biosignals hobby and started looking at EEG traces to evaluate heart rate variability where I often can't make out the P wave on a two or three lead ECG, how can you say 20 beats out a million were bad with any accuracy? [2] with somewhat aggressive pharmacological treatment including high dose fish oil without which my triglycerides would have another 0 on the right; showed up my docs with a sheaf of pubmed abstracts, switched to Montelukast as my asthma controller because it may be cardioprotective whereas my academic advisor and galactic astronomer Edwin Salpeter and his daughter wrote a paper finding LABAs are probably the opposite; my pulmonologist switched me to using a LABA/Steroid inhaler for rescue because a recent study has shown that the holy grail of "just one inhaler" has been attained for a lot of people and the LABA isn't much slower to hit than Albuterol. Also added Nebivolol as a BP med which I think should be more popular than it is.
    - darkerside 4mo ago
  - projektfu 4mo ago
    That's a weird statement. I don't think I'll ever visit a cardiologist (as a patient) unless I had a suspicion of heart disease. Is it common to get checked out by specialists for no reason in your locale?
    - embedding-shape 4mo ago
      Well, I been a cannabis smoker for more than 15 years and not checked my heart once, so made sense to ensure it looked healthy. But then I live in a country (Spain) where healthcare isn't incredibly expensive, something you can do just to make sure nothing is funky wonky. I think is relatively common for people to use the healthcare we available to us, yeah.
      - projektfu 4mo ago
        Did you have an echocardiogram?
        embedding-shape 4mo ago
        Yeah, that was exactly what I did. Looking at the valves opening/closing, and so on.
- swed420 4mo ago
  If people are this concerned about heart health, they'd be wise to continue a zero-covid lifestyle into 2026 and beyond, since each re-infection (which vaccines don't prevent) increases the risk of severe health outcomes, including heart-related issues among lots of others. Yet I only see about .5-1% of the population in my area these days wearing any kind of mask/N95 respirator in public.
  - basisword 4mo ago
    Doesn't this apply to colds and flus too?
    - swed420 4mo ago
      If you look into the effects, they're two separate categories of damage. Also, considering COVID keeps mutating, it's much harder to control. Anybody curious might consider scanning the sticky posts on /r/zerocovidcommunity for more information and links to external sources.
  - esikich 4mo ago
    A - masks don't protect you, they protect others, B - what % of the population leaves the house when they feel sick enough that they should wear a mask?
    - watwut 4mo ago
      B - a lot of them, actually. You see sick people going to work or shops all the time. And most them them see themselves as some kind of "pushing through it" tough hero.
    - swed420 4mo ago
      > A - masks don't protect you, they protect others This is flat wrong, but also a demonstration of how far the Back To Normal propaganda propagated, because it's a common misconception. They protect both; especially at an N95 level of filtration. > B - what % of the population leaves the house when they feel sick enough that they should wear a mask? For starters, ~40% of COVID infections are asymptomatic (and still carry the same aforementioned long-term risks).
Dan_- 4mo ago
Exactly. Being unable to account for this covariate (tobacco use) pretty much invalidates this analysis. The odds ratio for tobacco use is basically the same (3x). Also, title needs a 2025.
- mil22 4mo ago
  This article refers to two studies. The retrospective study of 4.6 million people did account for tobacco use. > The findings are from a retrospective study of over 4.6 million people published in JACC Advances and a meta-analysis of 12 previously published studies being presented at the American College of Cardiology's Annual Scientific Session (ACC.25). > Kamel and his team conducted the retrospective study using data from TriNetX, a global health research network that provides access to electronic medical records. Their findings indicate that over an average follow-up of over three years, cannabis users had more than a sixfold increased risk of heart attack, fourfold increased risk of ischemic stroke, twofold increased risk of heart failure and threefold increased risk of cardiovascular death, heart attack or stroke. All study participants were younger than age 50 and free of significant cardiovascular comorbidities at baseline, with blood pressure and low-density lipoprotein (LDL) cholesterol levels within a healthy range and no diabetes, tobacco use or prior coronary artery disease.
  - chuckadams 4mo ago
    I know you can't judge a study by its abstract, but they don't even mention the dosing mechanism, it's just "cannabis use".
    - mil22 4mo ago
      That's not really a fair standard by which to judge the study, abstract or not. The dosing mechanism information was not present in the underlying dataset available to them: > This retrospective cohort study utilized the TriNetX health research network, which aggregates deidentified electronic medical records from health care organizations worldwide. > 1) The cannabis-user group with cannabis use diagnoses (International Classification of Diseases, 10th Revision: F12.1, F12.9, F12.90). You can't expect them to work miracles and come up with data they didn't have. They produced a valuable piece of research furthering our understanding of the cardiovascular risks of cannabis use based on a very large existing dataset that was available to them. Of course they would love to be able to answer the question of whether smoking is worse for your heart than edibles and so on, and they stated they would like to do this in a future study. But that costs time and money to create an entirely new dataset, and you know what funding for science is like these days. There's plenty of other evidence in the literature on the cardiovascular effects of THC if you want to see what our current understanding is there. TL;DR: smoking is worse than vaping or edibles; myocardial infarction risk spikes within the first few hours of using cannabis; but the risks are not limited to inhalation because THC itself has physiological effects that raise cardiovascular risk factors (increased heart rate, endothelial dysfunction, platelet activation raising clotting risk, inflammation and oxidative stress, etc.).
latexr 4mo ago
> Nothing is good for you in too great amounts, even water https://youtube.com/watch?v=XewVicFzRxw&t=152s https://youtube.com/watch?v=XewVicFzRxw&t=152s
- sscaryterry 4mo ago
  Yep, https://en.wikipedia.org/wiki/Median_lethal_dose https://en.wikipedia.org/wiki/Median_lethal_dose
- ngvrnd 4mo ago
  cf. paracelsus on the dose and the toxin
deleted 4mo ago
[deleted]
kranner 4mo ago
Edible forms of cannabis raise heart rate and blood pressure substantially as well.
- johnisgood 4mo ago
  I think this is making the assumption that temporally elevated HR and BP is bad.
  - kranner 4mo ago
    It's a fair assumption being a known potential cause of death. Of course I'm now assuming death is bad.
    - kataklasm 4mo ago
      By that argumentation sport is bad and a potential death risk factor, it also elevates heart rate and blood pressure!
      - brookst 4mo ago
        Not to mention art, sex, walking, etc, etc
      - literalAardvark 4mo ago
        I think you'd be surprised how often doctors still say that
      - parineum 4mo ago
        It has substantially more benefit than that risk. Physical exertion also has the added benefit of lowering rest hr and bp.
      - johnisgood 4mo ago
        Yeah! I added that as an example and then edited it out. Your parent's comment makes no sense. Water can kill you, too! It does not mean that drinking water is bad.
stego-tech 4mo ago
I mean, probably? There's definitely a statistical likelihood of folks who use cannabis also using tobacco products or other substances. It's not a "gateway drug" so much as a "anyone who enjoys thing X is likely to try related things" object. I recall those early studies about alcohol in moderation being good for you eventually being debunked as, "actually, folks who could afford alcohol consistently in moderation also ended up being able to afford health insurance and that created the better outcome"; I suspect there's something similar with cannabis when we look retrospectively, given its illegality for so long (users are less likely to seek medical attention for symptoms or precursors to avoid the stigma). The thing is we don't know without doing more research, which I genuinely appreciate the authors essentially calling out point blank. They're not saying cannabis is bad, they're saying that looking at the thin amount of valid data we have available thus far, there's definitely a correlation there worth investigating further.
- Thraway198 4mo ago
  In my experience there is no overlap between cannabis and tobacco users. Cannabis users dont smoke because cigarettes cause cancer. There was never a link published around cannabis & cancer because no research even existed!
graeme 4mo ago
The physical act of smoking itself is harmful. Not just tobacco specifically, burning and inhaling anything.
- rascul 4mo ago
  There are of course other delivery methods with different trade offs and generally less harmful but it seems to me as if smoking is still most common.
topranks 4mo ago
Also all the bad food choices me and my fellow stoners make when we’re high.
bogota 4mo ago
[dead]
MrSkelter 4mo ago
You make some reasonable points but the implication, that cannabis is as benign as water, is farcical. The popularity of cannabis doesn’t justify pretending it’s entirely harmless. Consumed as an inhalant it’s impossible to claim that it won’t have similar negative impacts to putting anything in our lungs which isn’t clean air. Consumed orally the harm will be in the dose. But there no evidence that the doses people consume for their pleasurable effect are within the safe range long term. I am sure based on the available evidence cannabis is less harmful than alcohol, but it’s so unproductive that any research on its harms is immediately shouted down by fans who want to pretend it’s “water”.

xattt 4mo ago

I tried to look up the source article, but there doesn’t seem to be any mention of consumption of edibles versus smoking.

honeycrispy 4mo ago

Do you smoke?

embedding-shape 4mo ago
Literally just wrote about that: https://news.ycombinator.com/item?id=48794178 https://news.ycombinator.com/item?id=48794178 > I've smoked cannabis daily for maybe 15 years [...] Visited a cardiologist like two months ago and have perfectly fine heart despite the smoking.
- Noaidi 4mo ago
  Many people have had cardiologists say they have perfectly fine hearts go on to have heart attacks months later. My brother was one of these people. He was going in for spinal surgery, cardio said his heart was fine. Two weeks after surgery he was short of breath. Turns out he needed a triple bypass. And that was a physical change. Heart attacks happen because of electrocardiac issues as well.
  - yehosef 4mo ago
    [flagged]
  - pipes 4mo ago
    Did you brother have a Coronary Artery Calcium score scan?
    - Noaidi 4mo ago
      No. This was about ten years ago. But not much has changed as I cannot get CAC score on Medicare even though they wanted to put me on statins. Cardiologist says I am fine. :/
      - ses1984 4mo ago
        They only cost about $100.
        Noaidi 4mo ago
        Can I have $100?
  - embedding-shape 4mo ago
    Yeah, but I mean what can you do really? Many people have CAT scans then it turns out the technician/whoever missed something, or a surgeon forgets an instrument inside of the patients body, shit happens.
  - tyjen 4mo ago
    Information asymmetries are a bane in the medical doctor market. Trust doctors with a grain of salt. There are many bad doctors that market themselves as good doctors, but are in reality terrible providers. I recently had a scare, where I was encouraged by two separate general practitioners to seek immediate care with an ophthalmologist. I visited the ophthalmologist who I was referred to and they said everything was great, then booked my next appointment for a year out. Four days later, I started losing vision in my right eye. After visiting a competent ophthalmologist, they were flabbergasted by what the other did. Ten appointments within 2 weeks later with the new specialist and we're undoing the damage that was easily preventable. In short, some doctors are borderline DANGEROUS, but it's difficult to distinguish them with the ample legal protections they receive. Anyhow, hope your brother recovered well.
- PaulHoule 4mo ago
  I have been a heavy cannabis user (like that guy in the Bob Marley song who "smokes two joints in the morning, smokes two joints at night") on and off from my mid 20's onward. I've also been a heavy exerciser and have the constellation of symptoms known as "athlete's heart" including an A-Fib diagnosis that I don't really believe [1] as well as concerning findings that may or not really be concerning because doctors don't know to evaluate us. I'm the kind of person who might get told by a doctor to exercise less instead of more! Mostly it's been smoking, though I've had access to edibles and was lately impressed by cannabis beverages that contain 10mg of THC and some CBD that give an experience competitive to drinking alcohol. I find it easy to not use it if is not around, but once I get into it I will keep using it and quitting is a few days of hell followed by almost forgetting it ever existed. But maybe I get depressed a bit a few months later and think "I will feel better if I use" and then I will use for a few weeks to months, start feeling strung out and quit. Never dabbed, I haven't found a vape I like the way I like smoking but for me it has always been green weed, not extracts. It is legal to grow in NY and I know enough amateur and pro growers who owe me a favor that I rarely have to pay for weed and don't expect to ever go into a dispensary. I do know that I gain/lose several kg of wait depending on if I am using cannabis. Despite being rather athletic and having a lot of lean muscle mass I have many signs of "metabolic syndrome" including somewhat high blood sugar, blood pressure, etc. [2] I am off cannabis now and just started Zepbound which I am hoping will help with my metabolic syndrome. [1] once i got into a biosignals hobby and started looking at EEG traces to evaluate heart rate variability where I often can't make out the P wave on a two or three lead ECG, how can you say 20 beats out a million were bad with any accuracy? [2] with somewhat aggressive pharmacological treatment including high dose fish oil without which my triglycerides would have another 0 on the right; showed up my docs with a sheaf of pubmed abstracts, switched to Montelukast as my asthma controller because it may be cardioprotective whereas my academic advisor and galactic astronomer Edwin Salpeter and his daughter wrote a paper finding LABAs are probably the opposite; my pulmonologist switched me to using a LABA/Steroid inhaler for rescue because a recent study has shown that the holy grail of "just one inhaler" has been attained for a lot of people and the LABA isn't much slower to hit than Albuterol. Also added Nebivolol as a BP med which I think should be more popular than it is.
  - darkerside 4mo ago
- projektfu 4mo ago
  That's a weird statement. I don't think I'll ever visit a cardiologist (as a patient) unless I had a suspicion of heart disease. Is it common to get checked out by specialists for no reason in your locale?
  - embedding-shape 4mo ago
    Well, I been a cannabis smoker for more than 15 years and not checked my heart once, so made sense to ensure it looked healthy. But then I live in a country (Spain) where healthcare isn't incredibly expensive, something you can do just to make sure nothing is funky wonky. I think is relatively common for people to use the healthcare we available to us, yeah.
    - projektfu 4mo ago
      Did you have an echocardiogram?
      - embedding-shape 4mo ago
        Yeah, that was exactly what I did. Looking at the valves opening/closing, and so on.
swed420 4mo ago
If people are this concerned about heart health, they'd be wise to continue a zero-covid lifestyle into 2026 and beyond, since each re-infection (which vaccines don't prevent) increases the risk of severe health outcomes, including heart-related issues among lots of others. Yet I only see about .5-1% of the population in my area these days wearing any kind of mask/N95 respirator in public.
- basisword 4mo ago
  Doesn't this apply to colds and flus too?
  - swed420 4mo ago
    If you look into the effects, they're two separate categories of damage. Also, considering COVID keeps mutating, it's much harder to control. Anybody curious might consider scanning the sticky posts on /r/zerocovidcommunity for more information and links to external sources.
- esikich 4mo ago
  A - masks don't protect you, they protect others, B - what % of the population leaves the house when they feel sick enough that they should wear a mask?
  - watwut 4mo ago
    B - a lot of them, actually. You see sick people going to work or shops all the time. And most them them see themselves as some kind of "pushing through it" tough hero.
  - swed420 4mo ago
    > A - masks don't protect you, they protect others This is flat wrong, but also a demonstration of how far the Back To Normal propaganda propagated, because it's a common misconception. They protect both; especially at an N95 level of filtration. > B - what % of the population leaves the house when they feel sick enough that they should wear a mask? For starters, ~40% of COVID infections are asymptomatic (and still carry the same aforementioned long-term risks).

Dan_- 4mo ago

Exactly. Being unable to account for this covariate (tobacco use) pretty much invalidates this analysis. The odds ratio for tobacco use is basically the same (3x). Also, title needs a 2025.

mil22 4mo ago
This article refers to two studies. The retrospective study of 4.6 million people did account for tobacco use. > The findings are from a retrospective study of over 4.6 million people published in JACC Advances and a meta-analysis of 12 previously published studies being presented at the American College of Cardiology's Annual Scientific Session (ACC.25). > Kamel and his team conducted the retrospective study using data from TriNetX, a global health research network that provides access to electronic medical records. Their findings indicate that over an average follow-up of over three years, cannabis users had more than a sixfold increased risk of heart attack, fourfold increased risk of ischemic stroke, twofold increased risk of heart failure and threefold increased risk of cardiovascular death, heart attack or stroke. All study participants were younger than age 50 and free of significant cardiovascular comorbidities at baseline, with blood pressure and low-density lipoprotein (LDL) cholesterol levels within a healthy range and no diabetes, tobacco use or prior coronary artery disease.
- chuckadams 4mo ago
  I know you can't judge a study by its abstract, but they don't even mention the dosing mechanism, it's just "cannabis use".
  - mil22 4mo ago
    That's not really a fair standard by which to judge the study, abstract or not. The dosing mechanism information was not present in the underlying dataset available to them: > This retrospective cohort study utilized the TriNetX health research network, which aggregates deidentified electronic medical records from health care organizations worldwide. > 1) The cannabis-user group with cannabis use diagnoses (International Classification of Diseases, 10th Revision: F12.1, F12.9, F12.90). You can't expect them to work miracles and come up with data they didn't have. They produced a valuable piece of research furthering our understanding of the cardiovascular risks of cannabis use based on a very large existing dataset that was available to them. Of course they would love to be able to answer the question of whether smoking is worse for your heart than edibles and so on, and they stated they would like to do this in a future study. But that costs time and money to create an entirely new dataset, and you know what funding for science is like these days. There's plenty of other evidence in the literature on the cardiovascular effects of THC if you want to see what our current understanding is there. TL;DR: smoking is worse than vaping or edibles; myocardial infarction risk spikes within the first few hours of using cannabis; but the risks are not limited to inhalation because THC itself has physiological effects that raise cardiovascular risk factors (increased heart rate, endothelial dysfunction, platelet activation raising clotting risk, inflammation and oxidative stress, etc.).

latexr 4mo ago

> Nothing is good for you in too great amounts, even water https://youtube.com/watch?v=XewVicFzRxw&t=152s https://youtube.com/watch?v=XewVicFzRxw&t=152s

sscaryterry 4mo ago
Yep, https://en.wikipedia.org/wiki/Median_lethal_dose https://en.wikipedia.org/wiki/Median_lethal_dose
ngvrnd 4mo ago
cf. paracelsus on the dose and the toxin

deleted 4mo ago

[deleted]

kranner 4mo ago

Edible forms of cannabis raise heart rate and blood pressure substantially as well.

johnisgood 4mo ago
I think this is making the assumption that temporally elevated HR and BP is bad.
- kranner 4mo ago
  It's a fair assumption being a known potential cause of death. Of course I'm now assuming death is bad.
  - kataklasm 4mo ago
    By that argumentation sport is bad and a potential death risk factor, it also elevates heart rate and blood pressure!
    - brookst 4mo ago
      Not to mention art, sex, walking, etc, etc
    - literalAardvark 4mo ago
      I think you'd be surprised how often doctors still say that
    - parineum 4mo ago
      It has substantially more benefit than that risk. Physical exertion also has the added benefit of lowering rest hr and bp.
    - johnisgood 4mo ago
      Yeah! I added that as an example and then edited it out. Your parent's comment makes no sense. Water can kill you, too! It does not mean that drinking water is bad.

stego-tech 4mo ago

I mean, probably? There's definitely a statistical likelihood of folks who use cannabis also using tobacco products or other substances. It's not a "gateway drug" so much as a "anyone who enjoys thing X is likely to try related things" object. I recall those early studies about alcohol in moderation being good for you eventually being debunked as, "actually, folks who could afford alcohol consistently in moderation also ended up being able to afford health insurance and that created the better outcome"; I suspect there's something similar with cannabis when we look retrospectively, given its illegality for so long (users are less likely to seek medical attention for symptoms or precursors to avoid the stigma). The thing is we don't know without doing more research, which I genuinely appreciate the authors essentially calling out point blank. They're not saying cannabis is bad, they're saying that looking at the thin amount of valid data we have available thus far, there's definitely a correlation there worth investigating further.

Thraway198 4mo ago
In my experience there is no overlap between cannabis and tobacco users. Cannabis users dont smoke because cigarettes cause cancer. There was never a link published around cannabis & cancer because no research even existed!

graeme 4mo ago

The physical act of smoking itself is harmful. Not just tobacco specifically, burning and inhaling anything.

rascul 4mo ago
There are of course other delivery methods with different trade offs and generally less harmful but it seems to me as if smoking is still most common.

topranks 4mo ago

Also all the bad food choices me and my fellow stoners make when we’re high.

bogota 4mo ago

[dead]

MrSkelter 4mo ago

You make some reasonable points but the implication, that cannabis is as benign as water, is farcical. The popularity of cannabis doesn’t justify pretending it’s entirely harmless. Consumed as an inhalant it’s impossible to claim that it won’t have similar negative impacts to putting anything in our lungs which isn’t clean air. Consumed orally the harm will be in the dose. But there no evidence that the doses people consume for their pleasurable effect are within the safe range long term. I am sure based on the available evidence cannabis is less harmful than alcohol, but it’s so unproductive that any research on its harms is immediately shouted down by fans who want to pretend it’s “water”.