Corroon Jamie, Bradley Ryan, Grant Igor, Bancks Michael P, Jakob Julian, Auer Reto, Reis Jared P, Allen Norrina, Yeh Kuan-Hung, Allison Matthew A
Center for Medicinal Cannabis Research, Department of Psychiatry, University of California, San Diego. (J.C., I.G.).
Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego. (R.B.).
Hypertension. 2025 Aug 11. doi: 10.1161/HYPERTENSIONAHA.125.25005.
Observational evidence investigating associations between cannabis use and hypertension is inconsistent.
The association between cumulative lifetime cannabis use (cannabis-years) and incident hypertension was examined over 35 years in a sample of CARDIA study (Coronary Artery Risk Development in Young Adults) participants free of hypertension at baseline. Marginal structural models with inverse probability weighting were used to adjust for potential time-dependent confounding and censoring. Hazard ratios and 95% CIs were estimated using Cox proportional hazards regression. Sensitivity analyses included modeling cannabis-years using restricted cubic splines, stratifying the primary analyses by sex, race, alcohol and cigarette smoking, and evaluating an additional exposure measure (days of use in the past month).
The analytic sample consisted of 4328 participants at baseline and 64.9% (n=2810) at year 35. Median cannabis-years increased minimally and remained low across visits: 0.0 (Q1-Q3, 0.0-0.3) at baseline and 0.2 (Q1-Q3, 0.0-0.7) by year 35. There were 2478 cases of incident hypertension over 88 292 person-years (28.1 cases per 1000 person-years). Cannabis-years were not significantly associated with incident hypertension (adjusted hazard ratio, 0.99 [95% CI, 0.97-1.00]; =0.18). The association remained unchanged in sensitivity analyses.
In a cohort of Black and White young adults with 35 years of follow-up, no association was found between cumulative lifetime use of cannabis and risk of incident hypertension. This finding was robust to restricted cubic spline analyses, analyses stratified by sex, race, alcohol use and tobacco cigarette smoking, and an additional measure of exposure (days of use in the past month).
关于大麻使用与高血压之间关联的观察性证据并不一致。
在青年动脉粥样硬化风险发展研究（CARDIA研究）中，对基线时无高血压的参与者样本进行了35年的随访，以研究累积终生大麻使用量（大麻年数）与新发高血压之间的关联。使用逆概率加权的边际结构模型来调整潜在的时间依赖性混杂因素和删失。使用Cox比例风险回归估计风险比和95%置信区间。敏感性分析包括使用受限立方样条对大麻年数进行建模、按性别、种族、饮酒和吸烟对主要分析进行分层，以及评估另一种暴露测量方法（过去一个月的使用天数）。
分析样本在基线时有4328名参与者，在第35年时有64.9%（n = 2810）。大麻年数的中位数增加极少，且在各次随访中均保持较低水平：基线时为0.0（四分位间距，0.0 - 0.3），到第35年时为0.2（四分位间距，0.0 - 0.7）。在88292人年中发生了2478例新发高血压病例（每1000人年28.1例）。大麻年数与新发高血压无显著关联（调整后的风险比，0.99 [95%置信区间，0.97 - 1.00]；P = 0.18）。在敏感性分析中，该关联保持不变。
在一组接受了35年随访的黑人和白人青年成年人队列中，未发现终生累积使用大麻与新发高血压风险之间存在关联。这一发现对于受限立方样条分析、按性别、种族、饮酒和吸烟分层的分析以及另一种暴露测量方法（过去一个月的使用天数）均具有稳健性。
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