Cannabis, Ischemic Stroke, and Transient Ischemic Attack

Barber, P. Alan; Pridmore, Heidi M.; Krishnamurthy, Venkatesh; Roberts, Sally; Spriggs, David; Carter, Kristie N; Anderson, Neil E.

doi:10.1161/strokeaha.113.001562

Cited by 88 publications

(64 citation statements)

References 13 publications

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“…Cannabis and its synthetic analogues are generally perceived as having few serious adverse effects, yet our data 3 and those reported by Freeman et al 2 suggest this may not be true. We agree that it is important for neurologists to be aware of a potential association between these agents and stroke.…”

Section: Spice Pot and Strokecontrasting

confidence: 64%

Spice, pot, and stroke

Barber¹,

Anderson²,

Brust³

2014

Neurology

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Section: Spice Pot and Strokecontrasting

confidence: 64%

Spice, pot, and stroke

Barber¹,

Anderson²,

Brust³

2014

Neurology

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“…In contrast, Barber et al 11 were not able to find an association between cannabis and stroke, independent of tobacco. This finding is in line with our results.…”

Section: Discussionmentioning

confidence: 81%

“…A previous case-control study in Australia found that patients experiencing an ischemic stroke or transient ischemic attack were more likely to use cannabis than nonstroke patients. 11 However, after adjusting for tobacco use, an association between cannabis and stroke could not be confirmed. Another cross-sectional study from the United States found that cannabis abuse or dependence was associated with ischemic but not hemorrhagic stroke.…”

Section: Strokementioning

confidence: 96%

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Falkstedt

Wolff

Allebeck

et al. 2017

Stroke

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Background and Purpose-Current knowledge on cannabis use in relation to stroke is based almost exclusively on clinical reports. By using a population-based cohort, we aimed to find out whether there was an association between cannabis use and early-onset stroke, when accounting for the use of tobacco and alcohol. Methods-The cohort comprises 49 321 Swedish men, born between 1949 and 1951, who were conscripted into compulsory military service between the ages of 18 and 20. All men answered 2 detailed questionnaires at conscription and were subject to examinations of physical aptitude, psychological functioning, and medical status. Information on stroke events up to ≈60 years of age was obtained from national databases; this includes strokes experienced before 45 years of age. Results-No associations between cannabis use in young adulthood and strokes experienced ≤45 years of age or beyond were found in multivariable models: cannabis use >50 times, hazard ratios=0.93 (95% confidence interval [CI], 0.34-2.57) and 0.95 (95% CI, 0.59-1.53). Although an almost doubled risk of ischemic stroke was observed in those with cannabis use >50 times, this risk was attenuated when adjusted for tobacco usage: hazards ratio=1.47 (95% CI, 0.83-2.56). Smoking ≥20 cigarettes per day was clearly associated both with strokes before 45 years of age, hazards ratio=5.04 (95% CI, 2.80-9.06), and with strokes throughout the follow-up, hazards ratio=2.15 (95% CI, 1.61-2.88). Conclusions-We found no evident association between cannabis use in young adulthood and stroke, including strokes before 45 years of age. Tobacco smoking, however, showed a clear, dose-response shaped association with stroke.

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“…Westover et al 9 demonstrated an elevated rate of ischemic stroke among cannabis users entering hospital. More recently, Barber et al 10 conducted a case-control study…”

mentioning

confidence: 99%

Heavy cannabis users at elevated risk of stroke: evidence from a general population survey

Hemachandra

McKetin

Cherbuin

et al. 2016

Australian and New Zealand Journal of Public Health

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Objective: Case reports and hospital-based case-control studies suggest that cannabis use may increase the risk of stroke. We examined the risk of non-fatal stroke or transient ischemic attack (TIA) among cannabis users in the general community. Method:A general population survey of Australians aged 20-24 years (n=2,383), 40-44 years (n=2,525) and 60-64 years (n=2,547) was used to determine the odds of lifetime stroke or TIA among participants who had smoked cannabis in the past year while adjusting for other stroke risk factors.Results: There were 153 stroke/TIA cases (2.1%). After adjusting for age cohort, past year cannabis users (n=1,043) had 3.3 times the rate of stroke/TIA (95%CI 1.8-6.3, p<0.001). The incidence rate ratio (IRR) reduced to 2.3 after adjustment for covariates related to stroke, including tobacco smoking (95%CI 1.1-4.5). Elevated stroke/TIA was specific to participants who used cannabis weekly or more often (IRR 4.7, 95%CI 2.1-10.7) with no elevation among participants who used cannabis less often. Conclusions:Heavy cannabis users in the general community have a higher rate of non-fatal stroke or transient ischemic attack than non-cannabis users.

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Cannabis, Ischemic Stroke, and Transient Ischemic Attack

Cited by 88 publications

References 13 publications

Spice, pot, and stroke

Spice, pot, and stroke

Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke

Heavy cannabis users at elevated risk of stroke: evidence from a general population survey

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