CBD for Cardiovascular Disease
Well, there is some evidence from animal studies that CBD could benefit heart health in a number of ways:
- It may dilate blood vessels and lower blood pressure.
- It contains antioxidant activity and may reduce oxidative stress.
- It has anti-inflammatory properties and may reduce inflammation in and around the heart and blood vessels.
- It may benefit the brain after a stroke by minimizing damage to brain cells and blood vessels in the brain.
Side effects of CBD are usually relatively mild. The most common side effects reported include:
- Drowsiness
- Reduced appetite
- Dry mouth
- Nausea
- Diarrhea
If you choose to use CBD for any health-related purpose, there are a few things to keep in mind.
- Always buy the highest quality of CBD you can. Check for 3rd party testing reports and the company’s reputation.
- Start Low and Go Slow
- Determine your goal and keep track of how you feel. Make sure the goal is reasonable. CBD is not magic—but it may help you achieve better health.
- Start at the lowest dose you can conveniently measure—this may be ¼ of a gummie, or ½ of a dropperful of CBD oil.
- Increase the dose slowly until you reach your goal.
Different Types of Cardiovascular Disease
Cardiovascular disease is a broad term and can cover any disease of the heart or the blood vessels, including arteries, veins, arterioles, capillaries and small veins (venules). Here are some of the different types of cardiovascular diseases:
- Coronary Artery Disease (CAD) affects the arteries of the heart and is one of the leading causes of heart attacks.
- Hypertension (HTN) is high blood pressure. There may be many causes of HTN including genetic, dietary and lifestyle factors.
- Cerebrovascular diseases are diseases of the blood vessels that supply the brain. These are the underlying causes of strokes and ministrokes. Strokes can be ischemic or hemorrhagic. In ischemic strokes, the blood flow to a part of the brain is stopped by a clot. In hemorrhagic strokes, the blood vessels bleed directly into a part of the brain.
- Inflammatory heart disease can include endocarditis and myocarditis.
In theory, CBD should have some potential benefits in both preventing cardiovascular disease and preventing more significant damage if cardiovascular disease occurs. This is mostly due, it is believed, because of anti-inflammatory, antioxidant and cell/tissue protective actions CBD may have. As is often the case with CBD, we need more and better clinical studies to know more—and to better utilize the potential of CBD.
Overview of CBD Actions
The actions of CBD are quite complex and many of the studies have been done looking at how CBD affects the actions of THC rather than how CBD may work alone. CBD binds to many different receptors in the body—and we are just scratching the surface at this point. But there are some things we are beginning to understand.
CBD binds weakly with either of the cannabinoid receptors, CB1 and CB2, but it even binding with a low strength can affect a response by several different mechanisms in the presence of THC. These mechanisms may be the basis for different strains of cannabis having different effects depending on the ratio of THC and CBD in individual strains.
- CBD binds to CB2 receptors as an “inverse agonist” with THC and causes a response that is opposite to that of the natural response—so if the natural response is alertness, an inverse agonist may produce reduced alertness.
o The CB2 receptors—found primarily outside the brain—tend to be primarily anti-inflammatory with an end-result depending on the tissue location of the receptor.
- CBD binds to CB1 receptors as an “allosteric modulator”. This means that when CBD binds to a CB1 receptor that is already binding THC, the CBD changes the 3-dimensional shape of the CB1 receptor and THC can’t bind as well.
- CBD can act indirectly by inhibiting the enzymes that degrade the endocannabinoids like anandamide (AEA) or 2-arachidonoylglycerol (2-AG), allowing these endocannabinoids to remain at higher levels,
- CBD also binds with other receptors—sometimes in a positive way, enhancing a particular response while at other times, it binds in a negative way, reducing a particular response.
Cannabinoids like CBD can affect the heart and cardiovascular system in complex ways depending on the types of receptors, the concentration of those receptors and the level of CBD. This is the sort of complexity we are just beginning to look at and sort out—but it is going to take some time to figure out.
Overall Effects of CBD on the Cardiovascular System
For the most part, CBD tends to decrease blood pressure by dilating blood vessels and can reduce the strength of the contractions of the heart.
Studies have indicated that these effects are relatively small and not always reproducible—in other words, different studies have provided different conclusions regarding the effect of CBD on blood pressure and the strength of heart contractions.[1], [2], [3]
However, things may be a bit different under abnormal conditions—in other words, the findings that there were small changes in blood pressure and heart contraction strength were in normal individuals with normal cardiovascular systems. There is some suggestion that the benefits of CBD (and other cannabinoids) may be more evident under stress conditions (mental, emotional or physical), in individuals with high blood pressure, post-heart attack conditions, when the heart is damaged or when there is inflammation in the cardiovascular system.[4]
CBD may be protective for the cardiovascular system and for the nervous system. This is assumed to be due to its anti-inflammatory effects and its antioxidant effects.[4] It may also protect against cardiovascular complications in diabetes.[5]
A recent comprehensive review of pre-clinical (animal) and clinical (human) data concluded: “However, with a few exceptions, the effect of CBD on the cardiovascular system under physiological conditions appears to be negligible, which confirms a good safety profile of this cannabinoid… Nevertheless, it should be emphasized that almost no clinical research has been done with CBD in diseases of the cardiovascular system and, hence, its therapeutic potential is not translated into clinical practice. Further studies, especially clinical investigations, are warranted to recommend the use of CBD in the treatment of cardiovascular disorders.” The authors considered that the following effects held the most promise for the future:
- Some reduction of blood pressure, especially under stress conditions.
- CBD may be protective of the brain in stroke.
- CBD may be protective of the heart and blood vessels, potentially by decreasing oxidative stress, inflammation and cell death.
Conclusions
While we cannot currently say that CBD use can prevent heart and vascular disease, there is significant potential for its use to protect and support the cardiovascular system in both health and disease. As with so many issues with CBD—we won’t know until more clinical studies have been completed.
References Cited
[1] Sultan SR, O’Sullivan SE, England TJ., The effects of acute and sustained cannabidiol dosing for seven days on the haemodynamics in healthy men: A randomised controlled trial. Br J Clin Pharmacol. 2020 Jun; 86(6):1125-1138. https://www.ncbi.nlm.nih.gov/pubmed/32128848/
[2] Remiszewski P, Jarocka-Karpowicz I, Biernacki M, Jastrząb A, Schlicker E, Toczek M, Harasim-Symbor E, Pędzińska-Betiuk A, Malinowska B., Chronic Cannabidiol Administration Fails to Diminish Blood Pressure in Rats with Primary and Secondary Hypertension Despite Its Effects on Cardiac and Plasma Endocannabinoid System, Oxidative Stress and Lipid Metabolism. Int J Mol Sci. 2020 Feb 14; 21(4)
https://www.ncbi.nlm.nih.gov/pubmed/32075117/
[3] Sultan SR, Millar SA, England TJ, O’Sullivan SE., A Systematic Review and Meta-Analysis of the Haemodynamic Effects of Cannabidiol. Front Pharmacol. 2017; 8():81.
https://www.ncbi.nlm.nih.gov/pubmed/28286481/
[4] Kicman A, Toczek M. The Effects of Cannabidiol, a Non-Intoxicating Compound of Cannabis, on the Cardiovascular System in Health and Disease. Int J Mol Sci. 2020 Sep 14;21(18):6740. doi: 10.3390/ijms21186740. PMID: 32937917; PMCID: PMC7554803.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554803/
[5] Rajesh M., Mukhopadhyay P., Bátkai S., Patel V., Saito K., Matsumoto S., Kashiwaya Y., Horváth B., Mukhopadhyay B., Becker L., et al. Cannabidiol attenuates cardiac dysfunction, oxidative stress, fibrosis, and inflammatory and cell death signaling pathways in diabetic cardiomyopathy. J. Am. Coll. Cardiol. 2010;56:2115–2125. doi: 10.1016/j.jacc.2010.07.033
