(HealthDay News) — The evidence examining associations between marijuana use and cardiovascular risk factors and outcomes is limited, according to a review published online in the Annals of Internal Medicine.

Divya Ravi, MD, MPH, from the Wright Center for Graduate Medical Education in Scranton, Pennsylvania, and colleagues conducted a systematic literature review to identify observational studies that enrolled adults using any form of marijuana and reported on vascular risk factors (hyperglycemia, diabetes, dyslipidemia, and obesity) or on outcomes (stroke, myocardial infarction, cardiovascular mortality, and all-cause mortality in cardiovascular cohorts).

The researchers identified 13 studies examining associations betweenmarijuana use and cardiovascular risk factors and 11 studies examining associations with clinical outcomes. Six cross-sectional studies suggested a metabolic benefit from marijuana use, but this finding was not supported by prospective studies. Recall bias, inadequate exposure assessment, minimal marijuana exposure, and a predominance of low-risk cohorts limit the current evidence base.

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Evidence examining the effect of marijuana on cardiovascular risk factors and outcomes, including stroke and myocardial infarction, is insufficient,” the authors write. “Adequately powered prospective studies are needed to determine the effect of chronic marijuana use on cardiovascular health.”

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Ravi D, Ghasemiesfe M, Korenstein D, et al. Associations Between Marijuana Use and Cardiovascular Risk Factors and Outcomes: A Systematic Review. Ann Intern Med. doi: 10.7326/M17-1548