Research shows marijuana use could cause short-term complications for heart patients, but no long-term damage has been documented.

A new review in the Journal of the American College of Cardiology states that more than two million people with an underlying heart condition use marijuana or have used marijuana in the past year. No known link exists between heart disease and cannabis use, but risks do exist, warn researchers.

Consuming cannabis elicits a calming, sedative sensation throughout a user’s body. This intensity of the experience differs depending on the delivery method used (vaping, edibles, tinctures), what kind of marijuana used (sativa- or indica-dominant), and how much you consumed. Those variables also factor into how cannabis affects your heart, researchers found.

The relationship between smoking cigarettes and cardiovascular disease is well known. But cannabis use could also result in faster heartbeats and rising blood pressures. Smoking marijuana actually raises your risk of heart attack in the first hour following consumption, a 2017 study found. Cannabis use also places you at risk of atrial fibrillation, a common heart rhythm disorder.

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This is why researchers caution not to assume smoking marijuana is any better for you than tobacco.

“When people smoke tobacco, they take frequent, small puffs,” Dr. Muthiah Vaduganathan, one of the study’s co-authors, said. “In contrast, smoking marijuana usually involves large puffs with longer breath holds.”

Smoking marijuana presents additional complications to heart patients, as cannabinoids can interact with medications in unexpected ways. Researchers found blood thinner levels were raised due to cannabis use and could cause excessive bleeding in patients. Statins were alternatively more effective and caused undesired fluctuations in blood pressure.

Vaduganathan stressed the importance of talking with your doctor about your marijuana use for this reason. “In my clinic, I ask people if they use marijuana, and most are quite open to these discussions,” he said.

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You should know, however, that no research associates using cannabis with long-term damage to your heart health. But the short-term complications are why it’s worth having a frank “cannabis conversation” with your doctor if you’re a heart patient that uses marijuana.