The Association Between Cannabis Use and Electrocardiographic Abnormalities in People Living With HIV

Cardiovascular disease is a leading cause of morbidity and mortality among people with and without HIV. Among PWoH, cannabis has been associated with cardiovascular outcomes, including coronary artery disease, myocardial infarction (MI), and stroke. However, data on subclinical changes and other cardiovascular outcomes are limited among PWH. In this study, we examined the association of cannabis use and HIV with electrocardiogram (ECG) findings-evidence of MI, other abnormalities, and normal findings. Data from study visits between 2007 and 2017 from the MACS/WIHS Combined Cohort Study (N = 3610) were used. Descriptive statistics were derived, and unadjusted and adjusted odds ratios were estimated via baseline logistic regression. Most participants were PWH (n = 2272, 63%), and 28% reported cannabis use, with no significant difference in prevalence between PWH (27%) and PWoH (28%). Overall, 59% of participants had normal ECG findings. Cannabis use was not significantly associated with evidence of ECG abnormalities in unadjusted or adjusted analyses (aOR for MI: 1.02, 95% CI: 0.82 to 1.26, P = 0.85; aOR for other abnormalities: 1.02, 95% CI: 0.80 to 1.32, P = 0.86). Abnormal findings were more common in female participants than male participants (41% vs. 35%, P = 0.0002). Among male participants, PWH had higher odds of evidence of non-MI abnormalities compared with PWoH (aOR = 1.35, 95% CI: 1.01 to 1.81, P = 0.0464). Although cannabis use was not independently associated with evidence of ECG abnormalities, sex and HIV status are important determinants. Future studies should explore the role of cannabis metabolites and usage patterns in cardiovascular outcomes among PWH.

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Publication Details

Journal
JAIDS Journal of Acquired Immune Deficiency Syndromes
Published
2025-10-23
DOI
https://doi.org/10.1097/qai.0000000000003786
Primary Topic
Cannabis and Cannabinoid Research
Type
article
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article

The Association Between Cannabis Use and Electrocardiographic Abnormalities in People Living With HIV

Phyllis C. Tien, Jared W. Magnani, Michelle Floris-Moore, María L. Alcaide et al.
JAIDS Journal of Acquired Immune Deficiency Syndromes
Cannabis and Cannabinoid Research
article

The Association Between Cannabis Use and Electrocardiographic Abnormalities in People Living With HIV

Phyllis C. Tien, Jared W. Magnani, Michelle Floris-Moore, María L. Alcaide, Ervin Fox, Nicholas Fonseca Nogueira, Caitlin A. Moran, Jorge R. Kizer, Michaela E. Larson, Kathérine C. Wu, Denise C. Vidot, Fatima Lakhani, Jennifer V. Chavez, Nataliya Pyslar, Jason Lazar, Michael W Plankey, Elise D. Riley, Andrea Santana Covarrubias, Andrew P. Lieberman, Claudia Martinez, Deborah L. Jones, Mallory D. Witt, Yue Pan, Margaret A. Fischl, Anjali Sharma, Frank J. Palella, Elizabeth Topper, Litsa Kambrakos
article en

Abstract

Cardiovascular disease is a leading cause of morbidity and mortality among people with and without HIV. Among PWoH, cannabis has been associated with cardiovascular outcomes, including coronary artery disease, myocardial infarction (MI), and stroke. However, data on subclinical changes and other cardiovascular outcomes are limited among PWH. In this study, we examined the association of cannabis use and HIV with electrocardiogram (ECG) findings-evidence of MI, other abnormalities, and normal findings. Data from study visits between 2007 and 2017 from the MACS/WIHS Combined Cohort Study (N = 3610) were used. Descriptive statistics were derived, and unadjusted and adjusted odds ratios were estimated via baseline logistic regression. Most participants were PWH (n = 2272, 63%), and 28% reported cannabis use, with no significant difference in prevalence between PWH (27%) and PWoH (28%). Overall, 59% of participants had normal ECG findings. Cannabis use was not significantly associated with evidence of ECG abnormalities in unadjusted or adjusted analyses (aOR for MI: 1.02, 95% CI: 0.82 to 1.26, P = 0.85; aOR for other abnormalities: 1.02, 95% CI: 0.80 to 1.32, P = 0.86). Abnormal findings were more common in female participants than male participants (41% vs. 35%, P = 0.0002). Among male participants, PWH had higher odds of evidence of non-MI abnormalities compared with PWoH (aOR = 1.35, 95% CI: 1.01 to 1.81, P = 0.0464). Although cannabis use was not independently associated with evidence of ECG abnormalities, sex and HIV status are important determinants. Future studies should explore the role of cannabis metabolites and usage patterns in cardiovascular outcomes among PWH.

JAIDS Journal of Acquired Immune Deficiency SyndromesVol. 101(2)
Northwestern University (US), Albert Einstein College of Medicine (US), San Francisco VA Medical Center (US), Johns Hopkins University (US), University of Miami (US), Emory University (US), University of California, Los Angeles (US), University of Pittsburgh (US), University of California, San Francisco (US), SUNY Downstate Health Sciences University (US), Georgetown University (US), Johns Hopkins Medicine (US), Georgetown University Medical Center (US), UCLA Medical Center (US), University of California System (US), University of Mississippi Medical Center (US), Northwestern Medicine (US), Global Solutions for Infectious Diseases (US), Cook County Health and Hospitals System (US)
Openalex Percentile: Top 66%
Cannabis and Cannabinoid Research
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