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Author Notes:

drrupakdesai@gmail.com; rdesa30@emory.edu

R.D. and A.J.: Conceptualization, methodology, software, formal analysis, resources, writing—original draft, writing—review and editing, visualization; W.S.: Writing—original draft, writing—review and editing; Z.G.: Writing—original draft, writing—review and editing; A.R.R.: Writing—original draft, writing—review and editing; V.J.V.: Writing—original draft, writing—review and editing; G.J.: Writing—original draft, writing—review and editing; C.A.: Writing—original draft, writing—review and editing; B.R.: Writing—original draft, writing—review and editing; Z.M.: Writing—original draft, writing—review and editing; P.G.: Writing—original draft, writing—review and editing; G.K.: Writing—review and editing, visualization, supervision; R.S.: Writing—review and editing, visualization, supervision. All authors have read and agreed to the published version of the manuscript.

The authors declare no conflict of interest.


Research Funding:

We did not receive any funding either for the scientific work or the preparation of the manuscript.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Medicine, General & Internal
  • General & Internal Medicine
  • cannabis
  • marijuana
  • hypertension
  • hypertensive crisis
  • hypertensive emergency
  • in-hospital mortality
  • young

Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis

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Journal Title:



Volume 58, Number 10


Type of Work:

Article | Final Publisher PDF


Background and Objectives: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). Material and Methods: Young adult hospitalizations (18–44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015–December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. Results: Young CUD+ had higher prevalence of HC (0.7%, n = 4675) than CUD- (0.5%, n = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06–1.24, p = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01–1.36, p = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, p = 0.154). Propensity-matched CUD+ cohort (n = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55–12.91, p < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38–2.17, p < 0.001) and stroke (aOR 1.46, 95%CI:1.02–2.10, p = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. Conclusions: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke.

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© 2022 by the authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
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