Best of JAMA 2025: Episode 8:Association of Endothelial Dysfunction With Chronic Marijuana Smoking and THC-Edible Use

The CANDIDE study investigated the impact of long-term cannabis use on cardiovascular health by comparing non-users to those who frequently smoke marijuana or consume THC-infused edibles. By measuring how well blood vessels dilate and testing cell reactions to user serum, researchers discovered that both forms of consumption lead to significant endothelial dysfunction, a condition where the lining of the blood vessels fails to function properly. Interestingly, while the physical impairment of the arteries was similar to that caused by tobacco, the underlying biological mechanisms appeared to differ depending on whether the THC was inhaled or ingested. Ultimately, the findings suggest that frequent cannabis use, regardless of the delivery method, may pose a substantial risk to vascular integrity that correlates directly with the frequency and dosage of use.