Daniel Falkstedt1, Valerie Wolff1, Peter Allebeck1, Tomas Hemmingsson1, Anna-Karin Danielsson2. 1. From the Department of Public Health Sciences (D.F., P.A., A.-K.D.) and Institute of Environmental Medicine (T.H.), Karolinska Institutet, Stockholm, Sweden; Stroke Unit, Department of Neurology, Strasbourg University Hospital, University of Strasbourg, France (V.W.); Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden (P.A.); and Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden (T.H.). 2. From the Department of Public Health Sciences (D.F., P.A., A.-K.D.) and Institute of Environmental Medicine (T.H.), Karolinska Institutet, Stockholm, Sweden; Stroke Unit, Department of Neurology, Strasbourg University Hospital, University of Strasbourg, France (V.W.); Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden (P.A.); and Centre for Social Research on Alcohol and Drugs, Stockholm University, Sweden (T.H.). anna-karin.danielsson@ki.se.
Abstract
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.
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.
Authors: Janina Markidan; John W Cole; Carolyn A Cronin; Jose G Merino; Michael S Phipps; Marcella A Wozniak; Steven J Kittner Journal: Stroke Date: 2018-04-19 Impact factor: 7.914
Authors: Peter K Yang; Erika C Odom; Roshni Patel; Fleetwood Loustalot; Sallyann Coleman King Journal: Public Health Rep Date: 2021-02-26 Impact factor: 2.792