A group of public health researchers at Georgia State University School of Public Health have found that marijuana use is associated with a tripling of the risk of death due to hypertension.

The results are published in the European Journal of Preventive Cardiology in the article “Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file.” The study’s lead author is Dr. Barbara Yankey, an instructor in the undergraduate program at the School of Public Health at Georgia State University and a recent PhD graduate of the program.

Data on the marijuana use of 1,213 people aged 20 and older was gathered from the 2005 U.S. National Health and Nutrition Examination Survey and linked with the 2011 mortality file of the National Center for Health Statistics at the Centers for Disease Control and Prevention.

The researchers found that the risk of death due to hypertension was triple for those who used marijuana as compared to those who did not, with an increased risk for each year of marijuana use. “Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation,” the paper states.

Though marijuana remains illegal under federal law, by the end of 2016, 28 states had legalized it for medical use, and eight states and the District of Columbia had permitted recreational use of marijuana.

This research paper focuses on recreational marijuana use, which primarily involves smoking. As the authors note, “We are not disputing the possible medicinal benefits of standardized cannabis formulations; however, recreational use of marijuana should be approached with caution.”

The study’s authors also include Georgia State public health faculty members Dr. Richard Rothenberg, Dr. Sheryl Strasser, Dr. Kim Ramsey-White and Dr. Ike S. Okosun.