New studies link increased heart disease risk to tobacco and cannabis use

New clinical results from multiple studies show coronary heart disease death associated with tobacco use is anticipated to rise up to 40% in the next five years and people with cannabis use disorder are 50% more likely to experience cardiogenic shock, acute myocardial infarction, and arrhythmias. These studies were presented today at the Society for Cardiovascular Angiography & Interventions (SCAI) 2025 Scientific Sessions.

Tobacco and cannabis are two of the most used substances in the United States, with 22% of Americans aged 12 or older reporting any past-month tobacco use and 13.0 % reporting any past-month cannabis use. As the rise in use continues, more research is needed to understand the impact and better inform patient care.

Despite major public health campaigns to raise awareness for the harms of tobacco and cannabis, usage is still commonplace as we continue to see their effects on cardiovascular health. This new research presented at SCAI's 2025 Scientific Sessions is vital for quantifying the burden tobacco and cannabis use have on certain communities, prompting tailored action and additional education for the patients that need it the most."

James B. Hermiller, MD, MSCAI, SCAI President 

Tobacco use-related deaths on the rise at a significant rate: Black women and American Indian most at risk 

Ischemic heart disease, also known as coronary heart disease, is a condition where the heart weakens due to reduced blood flow from narrowed or blocked coronary arteries. Studies have linked tobacco use to ischemic heart disease-related mortality and morbidity. Subsequently, government and public health organizations have launched campaigns to raise awareness and reduce deaths associated with tobacco use. 

Researchers analyzed national CDC-WONDER data from 1999-2020 on ischemic heart disease mortality related to tobacco use (IHD-T) in individuals aged 25 and older. Death rate per 100,000 and annual and average annual percentage changes (APC, AAPC) were analyzed to identify trends and calculate projections until 2030.

In 1999, 4,669 deaths occurred in relation to IHD-T, increasing 14-fold to 56,367 deaths by 2020. Data projected a 43.7% increase in IHD-T-related deaths by 2030 (80,985). While the mortality trends in females decreased in 2005 (APC 2.68) and 2015 (APC 0.53), males saw the opposite with a sharp uptick in deaths until 2005 (APC 40.39). American Indian/Alaska Native, Black Americans, and Asian/Pacific Islander groups saw a sharp early rise in death rates, with annual changes over 30%, before those rates eventually leveled off. Overall, death rates continued to rise steadily across all racial groups, with average annual increases of over 10%. However, in women, Black women saw an average annual rise of 10.39%, and white men saw the highest average annual rise of 12.01%. 

"Tobacco-related ischemic heart disease is not just a problem of the past. It is still a major cause of death today. Our analysis found that risks are not evenly distributed, as Black women experienced the higher annual increases in mortality compared to white women. If we hope to design more targeted interventions, it's vital for clinicians to recognize that certain racial and geographic groups are disproportionately affected," said Roopeessh Vempati, MD, PGY 1 Internal Medicine at Trinity Health Oakland in Pontiac, Mich. and Wayne State University in Detroit, Mich and lead author of the study. "Stronger, more targeted action through preventative cardiology and public health strategies are needed to reverse these trends and protect the most vulnerable."

This abstract is published in the SCAI Abstract Supplement, which appears in SCAI's official journal, JSCAI. You can access it here: https://doi.org/10.1016/j.jscai.2025.103178. 

Data reveals heart failure patients with cannabis use disorder 50% more likely to experience heart attack

Cannabis use disorder (CUD) is a condition where individuals have a problematic pattern of cannabis use, leading to distress or impairment in day-to-day life and impacts. As the condition becomes more prevalent, this analysis aims to understand the association of heart failure (HF) hospital admissions and CUD. 

Through National Inpatient Sample (NIS) data from 2016 to 2020, researchers identified patients who were admitted with HF and divided the population into two groups based on secondary diagnosis of CUD. Mortality risk and in-hospital complications in the HF/CUD group were analyzed and compared to the HF/non-CUD group.

The analysis revealed patients with HF and CUD experienced a greater risk of serious cardiovascular events. Retrospective data found 1,372,419 patients were admitted with HF during the study duration, with 19,445 (1.4%) of patients having CUD. While the HF/CUD group displayed higher odds of cardiogenic shock (27% more likely), acute myocardial infarction (50% more likely), and arrhythmias (48% more likely) as compared to the HF/non-CUD group, they also revealed lower odds of mortality (50% less likely), and respiratory failure (75% less likely).

"We were surprised to discover individuals with cannabis use disorder and heart failure are at a lower risk of mortality than those without the disorder," said Syed Ishaq, MD, Internal Medicine resident at the Sinai Hospital of Baltimore in Md., and lead author of the study. "However, despite a lower chance of death, they are at significantly greater odds of developing other related cardiovascular conditions like heart attack or irregular heartbeat. This understanding is necessary for doctors and public health professionals to warn individuals of the potential side effects of consistent cannabis use from the start, even before heart failure occurs." 

Additional research into HF patients with accompanying substance use disorder is warranted. 

This abstract is published in the SCAI Abstract Supplement, which appears in SCAI's official journal, JSCAI. You can access it here: https://doi.org/10.1016/j.jscai.2025.102905.