Lifetime Marijuana Use and Subclinical Atherosclerosis: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Auer, Reto; Sidney, Stephen; Goff, David; Vittinghoff, Eric; Pletcher, Mark J; Allen, Norrina B; Reis, Jared P; Lewis, Cora E; Carr, Jeffrey; Rana, Jamal S (2018). Lifetime Marijuana Use and Subclinical Atherosclerosis: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Addiction, 113(5), pp. 845-856. Wiley-Blackwell 10.1111/add.14110

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BACKGROUND AND AIMS Unlike tobacco, the effect of marijuana smoke on subclinical atherosclerosis, a surrogate measure for cardiovascular disease, is not known. This study aimed to determine the association between lifetime exposure to marijuana and measures of subclinical atherosclerosis in mid-life. DESIGN, SETTING AND PARTICIPANTS We used data from the US-based Coronary Artery Risk Development in Young Adults (CARDIA) Study, a cohort of black and white men and women aged 18-30 years at baseline in 1985-86, with up to 7 follow-up exams over 25 years. The number of CARDIA participants included in this study was 3,498. MEASUREMENTS Cumulative years of exposure to marijuana (expressed in 'marijuana-years', with 1 marijuana-year equivalent to 365 days of use) using repeated assessments every 2-5 years, over 25 years. Abdominal artery calcium (AAC) and coronary artery calcium (CAC) scores measured by computed tomography at Year 25 exam. RESULTS Among 3,117 participants with AAC and CAC measurements, 2,627 (84%) reported past marijuana use and 1,536 (49%) past daily tobacco smoking. Compared with tobacco smokers, of which 46% reported 10 or more pack-years of use, only 12% of marijuana users reported 5 or more marijuana-years of use and only 6% reported having used marijuana daily. We found a significant interaction between never- and ever- tobacco users on the association between cumulative marijuana use and AAC (p=0.05). Among those who never smoked tobacco, cumulative marijuana-years were not associated with AAC or CAC in models adjusted for demographics, cardiovascular risk factors, licit and illicit drug exposure and depression symptoms. However, among ever tobacco smokers, marijuana exposure was associated with AAC and CAC. At 5 marijuana-years of exposure, using AAC=0 and CAC=0 as a reference group, the odds ratio (OR) was 1.97 (95%CI:1.21-3.21,p=0.007) for AAC>0/CAC=0 and 1.83 (95%CI:1.02-3.31,p=0.04) for CAC>0, regardless of AAC. Tobacco smoking was strongly associated with both AAC and CAC. CONCLUSION Marijuana use appears to be associated with subclinical atherosclerosis, but only among ever tobacco users.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Auer, Reto


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services








Doris Kopp Heim

Date Deposited:

11 Jan 2018 14:22

Last Modified:

23 Oct 2019 12:49

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Marijuana abdominal aorto-iliac calcium coronary artery calcium tobacco




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