{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:54:13Z","timestamp":1785902053421,"version":"3.56.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"14","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000050","name":"national heart, lung, and blood institute","doi-asserted-by":"publisher","award":["R01HL130484"],"award-info":[{"award-number":["R01HL130484"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Evidence on the cardiovascular health effects of cannabis use is limited. We designed a prospective cohort study of older Veterans (66 to 68 years) with coronary artery disease (CAD) to understand the cardiovascular consequences of cannabis use. We describe the cohort construction, baseline characteristics, and health behaviors that were associated with smoking cannabis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To understand the cardiovascular consequences of cannabis use.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Design<\/jats:title>\n                <jats:p>We designed a prospective cohort study of older Veterans (66 to 68 years) with CAD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Participants<\/jats:title>\n                <jats:p>A total of 1,015 current cannabis smokers and 3,270 non-cannabis smokers with CAD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Main Measures<\/jats:title>\n                <jats:p>Using logistic regression, we examined the association of baseline variables with smoking cannabis in the past 30 days.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The current cannabis smokers and non-current smokers were predominantly male (97.2% vs 97.1%, <jats:italic>p<\/jats:italic>=0.96). Characteristics associated with recent cannabis use in multivariable analyses included lack of a high school education (odds ratio [OR] 2.15, 95% confidence interval [CI]: 1.10 to 4.19), financial difficulty (OR 1.47, 95% CI: 1.02 to 2.11), tobacco use (OR 3.02, 95% CI: 1.66 to 5.48), current drug use (OR 2.82, 95% CI: 1.06 to 7.46), and prior drug use (OR 2.84, 95% CI: 2.11 to 3.82). In contrast, compared to individuals with 0 to 1 comorbid conditions, those with 5 chronic conditions or more (OR 0.43, 95% CI: 0.27 to 0.70) were less likely to smoke cannabis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In this older high-risk cohort, smoking cannabis was associated with higher social and behavioral risk, but with fewer chronic health conditions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11606-021-07302-6","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T17:02:50Z","timestamp":1641834170000},"page":"3535-3544","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Heart and Cannabis (THC) Cohort: Differences in Baseline Health and Behaviors by Cannabis Use"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9124-9618","authenticated-orcid":false,"given":"Salomeh","family":"Keyhani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth E.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzieh","family":"Vali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine J.","family":"Hoggatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn M.","family":"Bravata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Lum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah S.","family":"Hasin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Grunfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Shlipak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"7302_CR1","unstructured":"Marijuana Policy Project: State-By-State Medical Marijuana Laws. https:\/\/www.mpp.org\/issues\/medical-marijuana\/state-by-state-medical-marijuana-laws\/state-by-state-medical-marijuana-laws-report\/. Accessed October 7, 2020."},{"key":"7302_CR2","doi-asserted-by":"crossref","unstructured":"Keyhani S, Steigerwald S, Ishida J, et al. Risk and benefits of marijuana use: a national survey of US adults. Ann Intern Med. 2018;169(5):282-290.","DOI":"10.7326\/M18-0810"},{"issue":"9","key":"7302_CR3","first-page":"879","volume":"371","author":"ND Volkow","year":"2014","unstructured":"Volkow ND, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;371(9):879.","journal-title":"N Engl J Med."},{"issue":"1","key":"7302_CR4","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1161\/CIR.0b013e318282ab8f","volume":"127","author":"AS Go","year":"2013","unstructured":"Go AS, Mozaffarian D, Roger VL, et al. Executive summary: heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation. 2013;127(1):143-152.","journal-title":"Circulation."},{"issue":"3","key":"7302_CR5","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1007\/s11606-019-05235-9","volume":"35","author":"M Ghasemiesfe","year":"2020","unstructured":"Ghasemiesfe M, Ravi D, Casino T, Korenstein D, Keyhani S. Acute cardiovascular effects of marijuana use. J Gen Intern Med. 2020;35(3):969-974.","journal-title":"J Gen Intern Med."},{"key":"7302_CR6","doi-asserted-by":"crossref","unstructured":"Page RL, 2nd, Allen LA, Kloner RA, et al. Medical marijuana, recreational cannabis, and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2020:CIR0000000000000883.","DOI":"10.1161\/CIR.0000000000000883"},{"issue":"3","key":"7302_CR7","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.jacc.2019.11.025","volume":"75","author":"EM DeFilippis","year":"2020","unstructured":"DeFilippis EM, Bajaj NS, Singh A, et al. Marijuana use in patients with cardiovascular disease: JACC Review Topic of the Week. J Am Coll Cardiol. 2020;75(3):320-332.","journal-title":"J Am Coll Cardiol."},{"issue":"3","key":"7302_CR8","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1038\/nrcardio.2017.130","volume":"15","author":"P Pacher","year":"2018","unstructured":"Pacher P, Steffens S, Hasko G, Schindler TH, Kunos G. Cardiovascular effects of marijuana and synthetic cannabinoids: the good, the bad, and the ugly. Nat Rev Cardiol. 2018;15(3):151-166.","journal-title":"Nat Rev Cardiol."},{"issue":"7","key":"7302_CR9","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.tcm.2018.11.004","volume":"29","author":"S Rezkalla","year":"2019","unstructured":"Rezkalla S, Kloner RA. Cardiovascular effects of marijuana. Trends Cardiovasc Med. 2019;29(7):403-407.","journal-title":"Trends Cardiovasc Med."},{"issue":"12","key":"7302_CR10","doi-asserted-by":"publisher","first-page":"890","DOI":"10.7326\/M18-1681","volume":"169","author":"S Steigerwald","year":"2018","unstructured":"Steigerwald S, Wong PO, Cohen BE, et al. Smoking, vaping, and use of edibles and other forms of marijuana among U.S. adults. Ann Intern Med. 2018;169(12):890-892.","journal-title":"Ann Intern Med."},{"issue":"6","key":"7302_CR11","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1056\/NEJM198802113180603","volume":"318","author":"TC Wu","year":"1988","unstructured":"Wu TC, Tashkin DP, Djahed B, Rose JE. Pulmonary hazards of smoking marijuana as compared with tobacco. N Engl J Med. 1988;318(6):347-351.","journal-title":"N Engl J Med."},{"issue":"2","key":"7302_CR12","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1056\/NEJM197407112910203","volume":"291","author":"WS Aronow","year":"1974","unstructured":"Aronow WS, Cassidy J. Effect of marihuana and placebo-marihuana smoking on angina pectoris. N Engl J Med. 1974;291(2):65-67.","journal-title":"N Engl J Med."},{"issue":"2","key":"7302_CR13","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1021\/tx700275p","volume":"21","author":"D Moir","year":"2008","unstructured":"Moir D, Rickert WS, Levasseur G, et al. A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two machine smoking conditions. Chem Res Toxicol. 2008;21(2):494-502.","journal-title":"Chem Res Toxicol."},{"issue":"6","key":"7302_CR14","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1165\/ajrcmb.20.6.3424","volume":"20","author":"TA Sarafian","year":"1999","unstructured":"Sarafian TA, Magallanes JA, Shau H, Tashkin D, Roth MD. Oxidative stress produced by marijuana smoke. An adverse effect enhanced by cannabinoids. Am J Respir Cell Mol Biol. 1999;20(6):1286-1293.","journal-title":"Am J Respir Cell Mol Biol."},{"key":"7302_CR15","unstructured":"Wang X, Derakhshandeh R, Narayan S, et al. Brief exposure to marijuana secondhand smoke impairs vascular endothelial function [abstract]. In: American Heart Association Annual (AHA) 2014 Scientific Sessions; 2014 Nov 15-10; Chicago, IL. Circulation; 2014. Abstract nr. 19538."},{"issue":"3","key":"7302_CR16","doi-asserted-by":"publisher","first-page":"187","DOI":"10.7326\/M17-1548","volume":"168","author":"D Ravi","year":"2018","unstructured":"Ravi D, Ghasemiesfe M, Korenstein D, Cascino T, Keyhani S. Associations between marijuana use and cardiovascular risk factors and outcomes: a systematic review. Ann Intern Med. 2018;168(3):187-194.","journal-title":"Ann Intern Med."},{"issue":"4","key":"7302_CR17","doi-asserted-by":"publisher","first-page":"601","DOI":"10.2105\/AJPH.2017.303654","volume":"107","author":"JP Reis","year":"2017","unstructured":"Reis JP, Auer R, Bancks MP, et al. Cumulative lifetime marijuana use and incident cardiovascular disease in Middle Age: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Public Health. 2017;107(4):601-606.","journal-title":"Am J Public Health."},{"issue":"5","key":"7302_CR18","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1111\/add.14110","volume":"113","author":"R Auer","year":"2018","unstructured":"Auer R, Sidney S, Goff D, et al. Lifetime marijuana use and subclinical atherosclerosis: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Addiction. 2018;113(5):845-856.","journal-title":"Addiction."},{"issue":"3","key":"7302_CR19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0193706","volume":"13","author":"S Keyhani","year":"2018","unstructured":"Keyhani S, Vali M, Cohen B, et al. A search algorithm for identifying likely users and non-users of marijuana from the free text of the electronic medical record. PLoS One. 2018;13(3):e0193706.","journal-title":"PLoS One."},{"key":"7302_CR20","doi-asserted-by":"publisher","DOI":"10.17226\/24625","volume-title":"The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research","author":"National Academies of Sciences, Engineering, and Medicine","year":"2017","unstructured":"National Academies of Sciences, Engineering, and Medicine. 2017. The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. Washington, DC: The National Academies Press. https:\/\/doi.org\/10.17226\/24625."},{"key":"7302_CR21","unstructured":"VA Data Sources. VA Information Resource Center. http:\/\/www.virec.research.va.gov\/. Accessed October 7, 2010."},{"issue":"1","key":"7302_CR22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034274","volume":"10","author":"S Keyhani","year":"2020","unstructured":"Keyhani S, Abraham A, Cohen B, et al. Development of a Cannabis Assessment Tool (CAT-1) to measure current and lifetime marijuana use among older Veterans. BMJ Open. 2020;10(1):e034274.","journal-title":"BMJ Open."},{"issue":"4","key":"7302_CR23","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1176\/ajp.2006.163.4.689","volume":"163","author":"DSSS Hasin","year":"2006","unstructured":"Hasin DS SS, Nunes E, Meyden J, Matseoane K, Waxman R. Diagnosis of comorbid psychiatric disorders in substance users assessed with the Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV. Am J Psychiatry. 2006;163(4):689-696.","journal-title":"Am J Psychiatry."},{"key":"7302_CR24","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/1742-5573-5-8","volume":"5","author":"CLLD Backinger","year":"2008","unstructured":"Backinger CL LD, Swan J, et al. . Using the National Health Interview Survey to understand and address the impact of tobacco in the United States: past perspectives and future considerations. Epidemiol Perspect Innov. 2008;5:8.","journal-title":"Epidemiol Perspect Innov."},{"issue":"7","key":"7302_CR25","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1111\/j.1530-0277.2007.00403.x","volume":"31","author":"KA Bradley","year":"2007","unstructured":"Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007;31(7):1208-1217.","journal-title":"Alcohol Clin Exp Res."},{"key":"7302_CR26","unstructured":"CARDIA:Scientific Resources Section. http:\/\/www.cardia.dopm.uab.edu\/study-information\/nhlbi-data-repository-data\/cardia-documentation\/78-cardia-documentation. Accessed May 22, 2017."},{"issue":"4","key":"7302_CR27","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1016\/j.amjcard.2006.03.024","volume":"98","author":"N Rodondi","year":"2006","unstructured":"Rodondi N, Pletcher MJ, Liu K, Hulley SB, Sidney S, Coronary Artery Risk Development in Young Adults S. Marijuana use, diet, body mass index, and cardiovascular risk factors (from the CARDIA study). Am J Cardiol. 2006;98(4):478-484.","journal-title":"Am J Cardiol."},{"key":"7302_CR28","unstructured":"The Health and Retirment Study: Documentation. https:\/\/hrs.isr.umich.edu\/about?_ga=2.13722935.1447945758.1495738406-1295912009.1495738399. Accessed May 23, 2017."},{"issue":"8","key":"7302_CR29","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","volume":"35","author":"CL Craig","year":"2003","unstructured":"Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-1395.","journal-title":"Med Sci Sports Exerc."},{"key":"7302_CR30","doi-asserted-by":"crossref","unstructured":"Arroll B, Goodyear-Smith F, Crengle S, et al. Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Ann Fam Med. 2010;8(4):348-353.","DOI":"10.1370\/afm.1139"},{"key":"7302_CR31","unstructured":"USPSTF. Patient Health Questionnaire (PHQ-9). http:\/\/www.uspreventiveservicestaskforce.org\/Page\/Document\/UpdateSummaryFinal\/depression-in-adults-screening. Published 1999. Accessed 01\/07\/2015."},{"issue":"5","key":"7302_CR32","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1002\/jts.22037","volume":"28","author":"M Price","year":"2015","unstructured":"Price M, Kuhn E, Hoffman JE, Ruzek J, Acierno R. Comparison of the PTSD Checklist (PCL) administered via a mobile device relative to a paper form. J Trauma Stress. 2015;28(5):480-483.","journal-title":"J Trauma Stress."},{"key":"7302_CR33","unstructured":"Corporation R. 36-Item Short Form Health Survey (SF-36). http:\/\/www.rand.org\/health\/surveys_tools\/mos\/mos_core_36item_survey.html. Published 1992. Accessed 02\/18\/2016."},{"key":"7302_CR34","doi-asserted-by":"crossref","unstructured":"Sonnega A, Faul JD, Ofstedal MB, Langa KM, Phillips JWR, Weir DR. Cohort profile: the Health and Retirement Study (HRS). Int J Epidemiol. 2014;43(2):576-585.","DOI":"10.1093\/ije\/dyu067"},{"key":"7302_CR35","unstructured":"VA Corporate Data Warehouse. VA Informatic and Computing Infrustructure. http:\/\/www.hsrd.research.va.gov\/for_researchers\/vinci\/cdw.cfm. Accessed Feb 23, 2016."},{"key":"7302_CR36","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.drugalcdep.2018.01.040","volume":"191","author":"LR Pacek","year":"2018","unstructured":"Pacek LR, Copeland J, Dierker L, Cunningham CO, Martins SS, Goodwin RD. Among whom is cigarette smoking declining in the United States? The impact of cannabis use status, 2002-2015. Drug Alcohol Depend. 2018;191:355-360.","journal-title":"Drug Alcohol Depend."},{"key":"7302_CR37","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.drugalcdep.2018.06.016","volume":"191","author":"AH Weinberger","year":"2018","unstructured":"Weinberger AH, Pacek LR, Wall MM, et al. Trends in cannabis use disorder by cigarette smoking status in the United States, 2002-2016. Drug Alcohol Depend. 2018;191:45-51.","journal-title":"Drug Alcohol Depend."},{"issue":"1","key":"7302_CR38","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1038\/npp.2017.198","volume":"43","author":"DS Hasin","year":"2018","unstructured":"Hasin DS. US epidemiology of cannabis use and associated problems. Neuropsychopharmacology. 2018;43(1):195-212.","journal-title":"Neuropsychopharmacology."},{"key":"7302_CR39","doi-asserted-by":"crossref","unstructured":"Choi NG, DiNitto DM. Marijuana use\/nonuse among those aged 50+: comparisons of use-to-nonuse, initiation\/reinitiation, and continued use over 24 months. Aging Ment Health. 2021;25(6):1134-1142.","DOI":"10.1080\/13607863.2020.1732292"}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-021-07302-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-021-07302-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-021-07302-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T20:25:15Z","timestamp":1666297515000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-021-07302-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,10]]},"references-count":39,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["7302"],"URL":"https:\/\/doi.org\/10.1007\/s11606-021-07302-6","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,10]]},"assertion":[{"value":"7 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Michael Shlipak reports that he served as a consultant for Cricket Health and Intercept Pharmaceuticals and he is a scientific advisor for TAI Diagnostics. The other authors report no financial conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}