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Preclinical studies have reported acute cardiovascular effects of cannabis, including a dose-dependent increase in blood pressure (BP), whereas orthostatic hypotension may follow as a result of decreased vascular resistance. In case reports, evidence links cannabis with acute cardiovascular events in young and middle-aged adults. Here, we offer epidemiologic estimates on cannabis use and BP levels association from the US National Health and Nutrition Examination Surveys 2005–2012 (n = 12 426).Computer-assisted self-interviews assessed cannabis use. BP was determined by an average of up to four measurements taken during a single examination. Regression modeling was used to examine cannabis use and BP association.Recently active cannabis use was associated with increase in SBP (β = 1.6; 95% confidence interval: 0.6, 2.7) in the age–sex-adjusted model. Additional covariate adjustment did not affect the positive association. No association between cannabis use and DBP was detected.A modest association between recent cannabis use and SBP was detected among a relatively large nationally representative sample of US adults. With the legalization of cannabis, there is a need for preclinical, clinical and prospective population-based research on the cardiovascular effects of cannabis use.