While most Americans consider marijuana safe, new research published this week found that use of the drug is associated with a higher risk of stroke and heart attack, including among younger adults.

The analysis, which examined data from 24 studies and was published in the journal Heart, also found that marijuana use was associated with a twofold increase in the risk of death from cardiovascular disease. While this data only shows a correlation and cannot prove that marijuana caused these effects, it is well-established that the drug can raise blood pressure and heart rate and alter the heart’s rhythm, said Dr. Ersilia DeFilippis, a cardiologist at Columbia University Irving Medical Center. And a number of other studies have also suggested a link between the drug and cardiovascular issues.

The analysis comes at a time when nearly half of U.S. states have legalized marijuana for recreational use, and when a record share of U.S. adults — 15 percent in 2022 — report using it. Emilie Jouanjus, the senior author of the new study and a pharmacologist at the University of Toulouse in France, said that while there may be good reasons for people to take marijuana, including for stress and anxiety, patients can’t assume that it is harmless.

She and other experts said that everyone should be treating marijuana with caution, and suggested several ways people can mitigate their risk.

Who is most at risk?

Generally speaking, older adults and people with underlying conditions such as diabetes, high cholesterol or pre-existing heart issues are at the greatest risk, experts said. That’s because their cardiovascular systems tend to be more fragile, and marijuana further stresses the heart. In 2023, about 7 percent of U.S. adults age 65 and older reported using marijuana in the past month.

But the average age of patients included in the new analysis was just 38, an indication that marijuana increases risks among younger people, too.