Regular marijuana users may want to think twice before taking another puff: a new study by researchers at the University of Auckland found that an unusually high number of stroke patients smoke the stuff.

Drug test results showed that 16 percent in the test group had marijuana in their system shortly after suffering a stroke, versus eight percent in the control group. Researchers found that middle-aged stroke patients were about 2.3 times more likely to have used marijuana before falling ill, but they were careful to note that the study did not directly link marijuana use to stroke.

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Researchers lamented that they were not able to eliminate tobacco users from the test group of about 160 stroke patients, and noted that most of the patients who tested positive for marijuana also smoked cigarettes, which can double one’s risk for stroke, according to the National Stroke Association.

In other words, about one in six stroke patients smoked marijuana — roughly the same number of marijuana smokers in the general population, according to The National Institute on Drug Abuse.

Speculation as to how marijuana may be linked to strokes and heart attacks is not new, and it’s long been known that smoking marijuana can cause elevated blood pressure, along with postural hypotension from sitting for long periods of time causing blood to pool, which can lead to dizziness when standing. It is possible that these functions somehow interact with blood vessels in the brain to trigger a transient ischemic attack, or mini-stroke. The Mayo Clinic says that people who suffer a mini-stroke, the symptoms of which dissipate within minutes, should still get assessed by a doctor to learn about their risk of a more serious ischemic stroke.

“We believe it is the cannabis and not tobacco,” study author P. Alan Barber, Ph.D., M.D. told MedicalXpress. “This may prove difficult given the risks of bias and ethical strictures of studying the use of an illegal substance. However, the high prevalence of cannabis use in this cohort of younger stroke patients makes this research imperative.”

Researchers will present their findings Wednesday afternoon at the American Heart Association’s International Stroke Conference.

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