Is marijuana not as safe as it’s cracked to be? That’s what a new study seems to indicate, finding that people who smoke marijuana have triple the likelihood of dying from high blood pressure, also known as hypertension, compared to those who don’t use the drug.

And the study found that the risk continued to grow with each year of use based on an analysis of 1,200 people. The study comes as many states are pushing to legalize the drug, which remains illegal on a federal level but has seen growing acceptance in recent years.

The study was published in the European Journal of Preventive Cardiology. The average duration of cannabis use was 11.5 years. Marijuana users showed a 3.42 times higher risk of dying from hypertension than non-users, and that risk increased by 1.04 for each year of use.

“Steps are being taken towards legalisation and decriminalisation of marijuana in the United States, and rates of recreational marijuana use may increase substantially as a result,” said lead author Barbara A Yankey, a PhD student in the School of Public Health, Georgia State University, in a statement. “However, there is little research on the impact of marijuana use on cardiovascular and cerebrovascular mortality.

“We found higher estimated cardiovascular risks associated with marijuana use than cigarette smoking,” said Yankey. “This indicates that marijuana use may carry even heavier consequences on the cardiovascular system than that already established for cigarette smoking. However, the number of smokers in our study was small and this needs to be examined in a larger study.”