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Marijuana use may increase the risk of developing peripheral artery disease, even in younger people. Emilija Manevska/Getty Images
  • New research suggests there may be a link between marijuana use and developing vascular disease.
  • A study of over 623,000 cannabis users found that they had a higher risk of developing peripheral artery disease (PAD).
  • Though PAD typically develops in people over 60 years of age, the study found that younger cannabis users were also at an increased risk.

Smoking cigarettes has long been known to be a risk factor for peripheral artery disease (PAD), a condition where the buildup of fatty plaque in the arteries limits blood flow to the legs or arms.

But a new study suggests that cannabis users may also have a higher risk of developing PAD, compared to the general population.

Even younger adults are at risk, the results show.

In the United States, 6.5 million people age 40 and older have PAD, reports the Centers for Disease Control and Prevention.

With over 48 million Americans using cannabis at least once in 2019, and cannabis use on the rise among younger adults, the authors of the new study say cannabis users should be aware of the symptoms of this condition.

One well-known symptom of PAD is pain, aches or cramps in the leg, hip or buttock while walking or doing other physical activity, with relief upon rest.

Other signs in the leg that may indicate PAD include muscle weakness, hair loss, smooth and shiny skin, sores or ulcers that don’t heal, and cold or numb toes.

The new study was presented May 17 at the annual meeting of the Society for Cardiovascular Angiography & Interventions, in Phoenix, Ariz. Findings presented at scientific meetings should be considered preliminary until published in a peer-reviewed journal.

In the study, researchers examined data from 2016 to 2019 on over 623,000 hospital patients who were diagnosed as cannabis users. Patients were 38 years of age on average, with around the same percentage of men and women.

The majority of patients were white.

Of these patients, around 2,400 were diagnosed with PAD — less than one percent.

Marijuana users had more than three times the risk of being diagnosed with PAD, compared to the general population.

However, they did not have an increased risk of dying or requiring a procedure to open a clogged artery.

In light of these results, “patients and physicians both need to be aware that there is some association here [between cannabis use and PAD],” study author Dr. Hirva Vyas from Hackensack University Medical Center in New Jersey, told Healthline.

One particularly concerning aspect of the results, she said, is that patients were younger.

PAD more commonly occurs in people 60 years or older, especially in those with other risk factors such as:

If younger adults “have pain in their legs while walking, they may attribute it to something else, like a muscle ache or sprain,” said Vyas.

So if cannabis users — of any age — have symptoms that could be PAD, it would be worthwhile to see a doctor, she added.

Because of the way the study was designed, it cannot show a cause-and-effect link between cannabis use and PAD.

However, Dr. Michael Go, who specializes in vascular surgery at The Ohio State University Wexner Medical Center in Columbus, Ohio, said cannabis use has been associated for some time with cardiovascular problems.

For example, one study found that young adults who reported recent cannabis use were more likely to have had a heart attack.

Dr. Claudia Martinez-Bermudez, a cardiologist and associate professor at UHealth, the University of Miami Health System, who was not involved in the new study, also pointed to a 2020 American Heart Association statement, which reviews the potential risks of medicinal and recreational cannabis, including cardiovascular ones.

In the new study, researchers did not have information on which types of cannabis products people used. So the study can’t show whether the increased risk of PAD was related to smoking plant cannabis or from using gummies, , or other edibles.

Martinez-Bermudez said more research is needed about cannabis composition in relation to PAD, because some products “may be more harmful — and others not — depending on the THC/CBD [cannabidiol] composition,” she told Healthline.

In addition, more information is needed on how people who develop PAD have been using cannabis.

“Cannabis can be used in many ways including smoking and in combination with tobacco,” said Martinez-Bermudez, “all of which could contribute to peripheral vascular disease.”

Go, who was not involved in the new study, pointed out that the link between cannabis and PAD has been less studied than other types of cardiovascular problems.

However, “there have been a handful of articles over the last ten years showing that cannabis use may be related to several forms of PAD,” he said.

One study found that cannabis use disorder is linked to a sudden decrease in blood flow to the limbs. Another showed that cannabis users had a higher risk of inflammation of the arteries in the lower limbs.

“All these conditions come with higher risks of amputation,” Go told Healthline.

With limited research to date, scientists are not certain how cannabis use may increase the risk of PAD.

The authors of the new paper suggest that cannabis may affect how blood clots form or how blood vessels function.

“It is also unclear if it is the THC [delta-9-tetrahydrocannabinol] itself or other components of smoke inhalation” that increases the risk of PAD, said Go.

While cannabis users in the new study did not have a higher risk of dying or requiring a procedure to open a clogged artery, Go cautioned that it’s still too soon to know whether or not cannabis use results in severe PAD.

In the meantime, he recommends that people at higher risk of PAD use cannabis in moderation.

In addition, “doctors should ask patients about cannabis use, and consider it to be an additional risk factor for PAD in their patients,” he said.