Studies of Effects of CBD on the Cardiovascular System

By Sandra Nomoto

Studies suggest the therapeutic potential of cannabis in cardiovascular disorder treatment; more research required

Cannabidiol (CBD) is a non-intoxicating and well-tolerated constituent of cannabis, which has potential benefits in a wide range of diseases, including cardiovascular disorders. CBD affects the cardiovascular system in different ways. This recap of studies reviews the influence of CBD on this system in health and disease to determine the potential risk of cardiovascular side effects during CBD use for medicine and wellness, and to identify therapeutic potential in cardiovascular diseases.

In tests done on animals with hypertension, although CBD exhibited vasodilatory (widening of blood vessels) and antioxidant properties, it did not affect blood pressure. They revealed the hypotensive action of CBD under stress conditions.

Cannabis is also suggested to have therapeutic potential in the treatment of cardiovascular complications of diabetes, which is connected with vasodilatory, cardioprotective, antioxidant, anti-inflammatory and neuroprotective properties of CBD.

Multiple studies have shown that CBD has many effects independent of interaction with CB1/CB2 receptors. Besides direct exposure to receptors, CBD indirectly increases the concentration of biologically active compounds. However, in many cases its activity occurs at very high concentrations, and to date only in vitro.

One case of interaction of CBD (Epidiolex®) with cardiovascular drugs (warfarin, an anticoagulant) intensified the antithrombotic effect. Patients should exercise caution while taking CBD simultaneously with other drugs.

Effects of CBD Under Physiological Conditions

The administration of phyto-, endo- and synthetic cannabinoids has a diverse influence on blood pressure (BP) and heart rate (HR) depending on the species, route of administration, presence of anaesthesia, and other conditions.

Under physiological conditions, CBD has a minimal impact on the cardiovascular system. Therefore, it does not carry an increased cardiovascular risk compared to THC. In addition, CBD can attenuate some THC-induced effects in the cardiovascular system. Low doses of CBD, when combined with THC, enhanced its intoxicating effects (but did not influence heart rate), while high doses of CBD attenuated both THC-induced intoxication and tachycardia (a condition that makes your heart beat over 100 times per minute). Thus, proportions of THC and CBD might be essential for protective influence of CBD on cardiovascular effects caused by THC.

In another study, oral CBD did not alter the cardiovascular effects of smoked cannabis. In a study on humans, a CBD and THC mixture did not prevent tachycardia (in contrast to anxiety and other effects of cannabis) induced by THC alone.

Effects of CBD Under Pathological Conditions

Positive effects of CBD were observed in experimental models of heart diseases, stroke, neonatal hypoxic ischemic encephalopathy, sepsis-related encephalitis, cardiovascular complications of diabetes, and liver and kidney ischemia/reperfusion. In these pathological conditions, CBD decreased organ damage and dysfunction, oxidative and nitrative stress, and inflammatory processes, among others.

The endocannabinoid system does not seem to be significant for cardiovascular regulation under physiological conditions. CBD may act as an anti-anxiety agent under stress conditions both in animals and humans. The neuroprotective properties of CBD were shown in a wide range of animal models of neurological disorders including epilepsy, Alzheimer’s disease, Huntington’s disease, Parkinson’s disease and multiple sclerosis. There is also some evidence for beneficial effects of CBD in brain disorders associated with stroke and neonatal hypoxic-ischemic encephalopathy (HIE).

CBD was shown to protect against ischemia/reperfusion injury of the kidneys and liver.

Diabetes mellitus causes heart and blood vessel complications such as atherosclerosis, retinopathy or cardiomyopathy. CBD did not influence blood glucose in diabetic animals or humans. In addition, in patients with type 2 diabetes, CBD did not affect glycaemic control, insulin sensitivity, lipid profile, body mass, or hemodynamic parameters.

However, CBD can mitigate cardiovascular complications of diabetes due to its antioxidative, anti-inflammatory, and vasculo-, cardio- and neuroprotective properties.

Effects of Abnormal-CBD on the Cardiovascular System

CBD may affect the cardiovascular system directly and indirectly. With a few exceptions, the effect of CBD on the cardiovascular system under physiological conditions appears to be negligible. On the other hand, in experimental pathological conditions, the protective effect of CBD associated with its anti-inflammatory, antioxidant, antiapoptotic, vasculoprotective, cardioprotective or neuroprotective effects was revealed.

Despite its vasodilatory properties, CBD has not been demonstrated to exhibit hypotensive action in animals. However, this compound might lower stress-induced increases in blood pressure in both humans and animals.

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 clinical studies are warranted to recommend the use of CBD in cardiovascular disorder treatment.

All information for this piece was derived from a study published in the International Journal of Molecular Sciences, published on September 14, 2020.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. We advise readers to always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.

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