BMC Public Health. 2026 Jul 28;26(1):3046. doi: 10.1186/s12889-026-28623-3.
ABSTRACT
INTRODUCTION: Cannabis use and low socioeconomic status are recognized as distinct risk factors for cardiovascular pathologies. This retrospective cross-sectional study aims to investigate the association between income status and cardiovascular disease risk among young hospitalized adults with recreational cannabis use or cannabis use disorder (CUD).
METHODS: We analyzed young adult hospitalizations (18-44 years) with known CUD from the 2020 National Inpatient Sample. Propensity score-matched analysis (1:1) was used to compare comorbidities and major adverse cardiac and cerebrovascular events (MACCE) between the high-income quartile (HIQ) and low-income quartile (LIQ) within the CUD cohort.
RESULTS: Out of the young adult admissions, a total of 286,855 individuals were identified as recreational cannabis users. After propensity matching, we divided the CUD cohort into 63,355 patients with HIQ (41.1% female) and LIQ (41.4% female). While both cohorts exhibited comparable ages and racial distribution (> 65% white), the individuals from the LIQ cohort were predominantly from the South (45.7% vs. 27.9%), visiting rural hospitals (13.9% vs. 1.3%), with Medicaid (56.3% vs. 41.1%) as the predominant payer. Additionally, the LIQ cohort had a higher prevalence of drug abuse (65.5% vs. 58.4%), tobacco use (24.9% vs. 22.6%), HTN (17% vs. 14.7%), chronic pulmonary disease (13.2% vs. 12.7%), DM (8% vs. 6.6%), and obesity (10.9% vs. 10.0%). Additionally, in-hospital outcomes like MACCE (2% vs. 0.8%) and acute ischemic stroke (AIS) (0.5% vs. 0.3%) were higher in the LIQ cohort (Graphical Abstract). After adjusting for confounding factors, the risk of AIS in the HIQ cohort was 37% lower than in the LIQ cohort (OR: 0.63 [95% CI: 0.42-0.96]). All p values < 0.05.
CONCLUSION: Higher prevalence of CVD risk factors in the LIQ-CUD group and lower odds of AIS-related admissions in the HIQ-CUD group warrant targeted interventions and policy measures to understand and address the behavioral risk of cannabis use by economic status and disparities in MACCE.
PMID:42919267 | DOI:10.1186/s12889-026-28623-3