Does inhalation of Tetrahydrocannabinol (THC) concentrates affect cardiovascular health similarly to smoking cannabis?

THC Concentrate Inhalation and Cardiovascular Health

THC concentrate inhalation negatively affects cardiovascular health similar to smoking cannabis, causing tachycardia, increased blood pressure, and elevated risk of adverse cardiovascular events including myocardial infarction and stroke. 1

Cardiovascular Effects of THC

Acute Effects

• Heart rate changes: THC inhalation causes significant increases in heart rate (tachycardia) by 16-17 beats per minute regardless of inhalation method 2
• Blood pressure effects:
  • Increases mean arterial pressure by 5-7 mmHg 2
  • Can cause orthostatic hypotension, particularly with heavy acute and chronic use 3
• Arterial stiffness: Pulse wave velocity increases after THC inhalation, indicating increased arterial stiffness 2
• Cardiac function: Reduces diastolic function as measured by early/late ratio 2

Mechanism of Action

THC acts as a partial agonist at cannabinoid receptor Type 1 (CB1) and cannabinoid receptor Type 2 (CB2) receptors 3. The cardiovascular effects are primarily mediated through:

• Beta-adrenergic stimulation causing tachycardia 3
• Alterations in vascular tone
• Changes in cardiac output and peripheral vascular resistance 4

Concentrate vs. Traditional Cannabis

Potency Considerations

• THC concentrates can contain up to 70% THC, compared to traditional cannabis which averaged 17% in 2017 1
• Higher potency is associated with greater risk of adverse effects 1

Inhalation Method Impact

• Research shows that cardiovascular effects occur regardless of inhalation method (smoking vs. vaporizing) 2
• However, a 2025 study found that higher concentration THC products (>60%) did not necessarily produce significantly more robust cardiovascular effects than lower concentration (<20%) products among daily users 5

Risk Factors and High-Risk Populations

Pre-existing Conditions

Individuals with pre-existing cardiovascular disease are at particularly high risk when using THC concentrates due to:

• Increased cardiac workload
• Elevated catecholamine levels
• Potential for postural hypotension 4

Frequency of Use and Tolerance

• Cardiovascular effects may not be as subject to tolerance with daily cannabis use compared to cognitive and subjective effects 5
• Acute use is associated with greater incidence of myocardial ischemia in at-risk individuals 3

Clinical Implications

Stroke Risk

• Cannabis use is associated with increased stroke risk in a dose-dependent manner 3
• More frequent than once-weekly cannabis use is associated with elevated stroke/TIA risk (adjusted incidence rate ratio, 4.7) 3
• Hospitalizations for stroke in younger cannabis users (18-38 years) are increasing 3

Monitoring Recommendations

• Assess cardiovascular risk factors in patients using THC concentrates
• Monitor for signs of tachycardia, hypertension, or orthostatic hypotension
• Be aware that THC can affect cerebral blood flow and vasodilation during stressful events like hypercapnia and hypoxia 3

Prevention Strategies

• Advise patients about cardiovascular risks of THC concentrate use
• Caution against combining THC with sedative medications or other substances that affect heart rate or blood pressure 1
• Recommend avoiding driving or operating machinery when using THC concentrates 1
• Consider screening for cannabis use patterns and frequency in patients with cardiovascular risk factors 1

The evidence clearly demonstrates that THC concentrate inhalation affects cardiovascular health through multiple mechanisms, with effects similar to those seen with traditional cannabis smoking but potentially more pronounced due to higher THC concentrations.