Cannabidiol and Heart Disease: Potential Benefits and Cautions

Written by: Hunter Podell, Subject Matter Expert and Website Founder
Published: March 15, 2024; Last updated: April 6, 2024

What potential does cannabidiol hold for individuals with heart disease? This article concisely explores how CBD might impact heart health, examining its therapeutic promise and the necessary precautions. We aim to distill complex research into practical knowledge, clarifying cannabidiol and heart disease without promoting unproven benefits.

Key Takeaways

• While CBD shows promise in cardioprotection and support of heart function, there are concerns about its interactions with medications, particularly blood thinners like warfarin, and potential side effects, underscoring the need for medical consultation and further research.

• Since more clinical research is needed, and there are no FDA approved CBD based medications for the cardiovascular system, you must consult with your healthcare professional and cardiologist before adding CBD as a supplemental treatment!

• Preliminary research indicates CBD may lower blood pressure, exhibit anti-inflammatory properties, improve lipid profiles, and promote healthier weight management, all beneficial in reducing heart disease risks.

• CBD interacts with the endocannabinoid system, potentially offering therapeutic benefits for heart disease management by reducing myocardial damage, slowing atherosclerosis, and mitigating heart dysfunction.

Understanding Cannabidiol (CBD) and Its Role in the Cardiovascular System

Cannabidiol (CBD) is one of the many cannabinoids found in the cannabis plant, but unlike its well-known cousin, THC, it doesn’t have psychoactive properties. The effects of CBD on the body are primarily mediated through its interaction with the endocannabinoid system (ECS). This complex cell-signaling system is crucial in maintaining the body’s internal balance, or homeostasis.

The ECS influences various physiological processes, encompassing those related to cardiovascular function. A dysregulated ECS has been associated with cardiovascular diseases, making its interaction with CBD of particular interest when considering heart health. The endocannabinoid system includes anandamide and 2-arachidonoylglycerol, compounds synthesized in the heart, which activate cannabinoid receptors such as CB1, CB2, TRPV1, PPARs, and potentially a novel vascular G-protein-coupled receptor.

Endocannabinoids serve a broadly protective role in the cardiovascular system, reducing damage from myocardial infarction, slowing atherosclerosis progression, and decreasing heart dysfunction during aging or stressful events. However, their impact on gene expression, including inflammation-related genes, can be complex and dual-natured, necessitating careful risk assessment in therapeutic applications.

The Endocannabinoid System and Heart Function

Endocannabinoids like anandamide and 2-arachidonoylglycerol, produced in the heart and other cardiovascular tissues, can significantly influence cardiovascular function. These endocannabinoids act on cannabinoid receptors like CB1 and CB2, decreasing cardiac work and relaxing coronary arteries. However, they do not appear involved in the tonic regulation of cardiovascular function.

Interestingly, the endocannabinoid system activates and contributes to protective physiological responses in cardiovascular diseases like myocardial infarction and shock. This suggests that CBD, through its interaction with the endocannabinoid system, could offer therapeutic benefits in the management of heart disease.

CBD’s Interaction with Cardiovascular Receptors

How CBD interacts with cardiovascular receptors is significant in its potential therapeutic influence on heart health. For instance, CBD:

• Acts as a negative allosteric modulator of the CB1 receptor

• Acts as a partial agonist of the CB2 receptor

• Modulates the activity of these vital cardiovascular receptors

• Inhibits the uptake of endogenous cannabinoid receptor ligands, such as anandamide

These interactions further influence behavioral and cardiovascular responses, including blood flow, ultimately impacting cardiovascular health and potentially leading to cardiac failure.

Beyond its interaction with cannabinoid receptors, CBD’s potential influence on regulatory cardiovascular functions includes modulating serotonin and adrenergic receptors, which are implicated in controlling heart rate and blood pressure. Moreover, CBD may influence blood vessel structure and function, impacting myocardial health. It’s also important to note that CBD may interact with other cardiovascular receptors, but these interactions require more research to understand fully.

The Impact of CBD on Heart Disease Factors

Preliminary research points to the possibility of CBD positively affecting factors related to heart disease. For instance, CBD is well-recognized for its anti-inflammatory properties that play a crucial role in mitigating factors associated with heart disease. Furthermore, CBD has demonstrated a capacity to lower blood pressure ¹, addressing one of the primary risk factors associated with heart conditions.

In addition to its anti-inflammatory and blood pressure-lowering effects, CBD may assist in:

• improving lipid profiles by raising HDL (good cholesterol) levels and lowering LDL (bad cholesterol) levels

• promoting the conversion of white fat into burnable calories, which could contribute to weight management

• potentially reducing the risk of heart disease and improving cardiovascular health.

Cannabidiol Reduces Blood Pressure

Clinical trials have shown that a single dose of CBD can improve resting blood pressure and blood pressure ¹ response to stress in healthy individuals and those with mild to moderate hypertension. CBD’s ability to lower blood pressure may stem from its:

• weak partial agonism of PPARγ

• modulation of various molecular pathways

• inducing vasorelaxation

• increasing nitric oxide concentration

The cardioprotective effects of CBD, such as vasorelaxation, reduction of cholesterol, and relaxation of arterial walls, may ultimately reduce the risk factors for heart disease, including high blood pressure.

Anti-inflammatory Properties of CBD

Apart from possibly reducing blood pressure, CBD also exhibits substantial anti-inflammatory qualities. CBD’s anti-inflammatory action in cardiovascular health is partly mediated by:

• Suppressing the activity of the NF-κβ pathway, which regulates pro-inflammatory gene expression

• Mitigating the inflammatory response by reducing cytokine production

• Reducing immune cell infiltration into cardiac tissue

This helps lower blood pressure and cholesterol levels and reduces risk factors for cardiovascular diseases such as coronary heart disease, high blood pressure, and stroke.

Furthermore, CBD contributes to myocardial health by reducing the size of myocardial infarcts and decreasing markers of cardiac injury, such as IL-6 and cardiac troponin. CBD’s antioxidative actions, including increasing superoxide dismutase activity and reducing lipid peroxidation, also modulate inflammation within the heart, further supporting CBD’s potential in cardio-protection.

CBD and Cardiomyopathy and Heart Failure

The potential advantages of CBD are not limited to managing heart disease risk factors; it could also be beneficial in treating specific heart conditions. Preclinical studies suggest CBD may help treat conditions such as myocarditis and various types of cardiomyopathy, as well as reduce myocardial ischemia. Moreover, CBD has demonstrated improvements in diastolic and systolic left ventricular function in animal models and attenuates cardiac fibrosis and myocardial dysfunction.

In addition to its potential direct effects on heart tissue, research suggests CBD treatment has shown a protective effect against cellular damage in cardiomyopathy by reducing oxidative stress markers¹ and enhancing antioxidant activity in myocardial tissues. However, it’s worth noting that a clinical trial in Mexico is currently investigating the potential effects of CBD on humans with heart failure, and conclusive results are yet to be reported. Thus, while the preclinical evidence is promising, more research is needed to fully understand the potential benefits of CBD for patients with heart failure or cardiomyopathy.

Oxidative Stress and CBD’s Antioxidant Effects

Oxidative stress is implicated in multiple forms of heart disease, including the development of cardiomyopathies and heart failure. CBD possesses antioxidant properties and has shown potential in experimental models to reduce oxidative stress associated with heart damage. It attenuates myocardial oxidative stress by enhancing superoxide dismutase activity and reducing lipid peroxidation and protein carbonylation.

Furthermore, in addition to its independent antioxidant effects, CBD may complement a heart-healthy diet, offering additional protection against oxidative stress.

Pumping Efficiency: Can CBD Help the Heart Pump Blood?

Another potential benefit of CBD for heart health is its ability to improve heart pumping efficiency. Research has considered the role of CBD in supporting heart health and its potential to enhance the heart’s pumping efficiency. A study from 2021 reported that ingesting CBD led to modest improvements in heart rate variability (HRV), a critical measure health professionals use to assess cardiovascular conditions.

While these findings are encouraging, it’s important to note that the results of a large study indicated that patients hospitalized for heart failure who used marijuana experienced a lower risk of death and had shorter hospital stays; however, these results cannot be directly attributed to CBD oil due to differences between whole marijuana use and pure CBD. As such, it is inconclusive if CBD can help the heart pump blood and more clinical research is needed to understand its impact without whole marijuana.

Interactions Between CBD and Other Medications

Despite the promising potential benefits of CBD for heart health, it’s critical also to consider its possible interactions with other medications. CBD may interfere with the metabolism of heart medications by competing with liver enzymes needed for their breakdown. Certain medications that may have severe interactions with CBD include:

• Warfarin

• Amiodarone

• Levothyroxine

• Various seizure medications

It is essential to consult with a healthcare professional before using CBD if you are taking any of these medications.

Additionally, older adults, particularly those taking multiple medications, could experience more pronounced CBD-related drug interactions due to age-related physiological changes. Taking CBD in combination with medicines that cause drowsiness or nausea could exacerbate these side effects, potentially posing additional risks. Therefore, heart patients are advised to consult with their healthcare providers before using CBD, especially if they are on medications such as blood thinners and anti-seizure drugs.

CBD and Blood Thinners

One specific concern is the interaction between CBD and blood thinners such as warfarin. Case reports have suggested that the use of CBD products can interfere with stable warfarin therapy, leading to altered INR values and an elevated risk of bleeding.

The interaction between CBD and warfarin increases the anticoagulant’s serum concentration, posing a heightened risk of bleeding complications. As such, patients taking warfarin may require careful monitoring of their INR levels and possibly a warfarin dosage adjustment if they also use CBD products. If you are taking warfarin, do not start taking CBD without consulting your healthcare professional first!

CBD’s Influence on Liver Metabolism of Drugs

The liver plays a critical role in metabolizing CBD, with cytochrome P450 enzymes, predominantly CYP3A4 and CYP2C19, playing a significant role, which could interfere with the metabolism of other medications. This interaction between CBD and blood thinners like warfarin can alter their concentration in the body due to competition for cytochrome P450 enzymes, increasing the risk of bleeding and necessitating careful monitoring of drug levels.

Cannabinoids, including CBD, have varied effects on different cytochrome P450 enzymes, with notable inhibition of CYP2C9 and potential inhibition of CYP2C19 but limited effects on CYP2D6, CYP3A4, and CYP2B6. Therefore, due to its impact on drug metabolism, CBD requires dosing vigilance when co-administered with medications for heart disease, including known interactions with certain statins, calcium channel blockers, beta-blockers, and nitrates.

Safety and Side Effects of CBD for Heart Patients

While CBD holds promising potential for managing heart disease, it’s vital to understand its safety profile and potential side effects. Heart patients using CBD may experience side effects such as:

• Drowsiness

• Nausea

• Dry mouth

• Gastrointestinal distress like diarrhea

• Decreased appetite

Inhaled forms of CBD, such as vaping, are not recommended for individuals with heart disease due to the risk of lung damage and increased cardiovascular disease risk.

CBD has been shown to have no notable adverse effects within a wide range of doses, from 3 to 1,200 mg/day. However, it is essential to consider the potential for liver toxicity still. Furthermore, inconsistent properties and potential inaccuracies in the labeling of CBD oil may lead to unpredicted safety issues. Therefore, heart patients must consult with their doctor before taking CBD, especially if they are on existing medications or supplements.

However, CBD is generally considered safe for congestive heart failure patients and is well tolerated with few side effects, according to the World Health Organization.

World Health Organization (WHO) Findings on CBD Safety

The World Health Organization (WHO) has provided some reassurance about the safety of CBD, stating that it is generally well tolerated with a good safety profile. The side effects associated with CBD use, as reported by the WHO ⁴, can include:

• Nausea

• Fatigue

• Irritability

• Dry mouth

• Diarrhea

However, as with any substance, individual reactions may vary, and it’s essential to start with low doses and increase gradually as tolerated, even for those with conditions like multiple sclerosis.

Monitoring CBD Use: Clinical Data and Precautions

Considering the potential interactions of CBD with other medications and its varied effects on individuals, it’s essential for heart patients contemplating CBD treatment to monitor CBD use and clinical data. Much of the current research on CBD’s potential cardiac benefits comes from animal studies, and definitive human claims require further clinical trials.

Clinical trials are essential to validate the anti-inflammatory benefits of CBD for heart disease observed in preclinical studies when applied in a real-world setting. Therefore, without the stringent regulatory process required for medicines, the importance of clinical data becomes paramount for heart patients considering CBD products marketed as food supplements.

Patients with heart conditions should discuss their use of CBD with healthcare providers to ensure safety, especially since specific dosages and instructions must be followed. Lastly, caution is advised for heart failure patients considering CBD usage, with a recommendation to consult a doctor before commencing treatment.

Choosing the Right CBD Product for Heart Health

In the U.S., it is illegal to add CBD to food or label it as a dietary supplement, making some over-the-counter CBD products unsafe or potentially ineffective for heart failure. In addition, people with heart disease should avoid CBD products that require vaping or smoking, due to potential lung damage and an increased risk of cardiovascular disease. When purchasing CBD products, individuals should look for quality assurances such as third-party testing and accurate information on CBD potency.

The suggested way to take CBD oil is sublingually, by positioning it under the tongue for absorption. Individuals are advised to start with a small dose of CBD, observe any side effects, and adjust the dosage gradually if necessary. These recommendations underscore the need for careful consideration when choosing a CBD product for heart health.

Types of CBD Products and Their Efficacy

The form of CBD notably affects its absorption, interactions, and potential efficacy for cardiovascular health. Inhaled CBD provides rapid absorption into the bloodstream, which can quickly reach high blood concentrations, potentially leading to an increased risk of acute side effects. In contrast, edible forms of CBD, such as oils or capsules, are metabolized slower, leading to delayed onset of effects and interactions.

Topical CBD products are less likely to enter the bloodstream and thus have a reduced likelihood of interaction with heart medications when compared to inhaled or edible forms.

Ensuring Quality and Potency in CBD Products

While choosing a CBD product for heart health, it’s critical to verify the quality and potency of the product. CBD products should be accompanied by a Certificate of Analysis (CoA) from an independent, accredited lab to confirm quality and safety. The COA should include the following:

• CBD and THC levels that match the product label

• Tests for heavy metals to ensure they are within safe consumption limits

• Tests for pesticides to ensure they are within safe consumption limits

By checking the COA, you can ensure that the CBD product you choose is of high quality and safe for consumption.

Consumers should also look for the mg/mL measurement on the product’s labeling to determine the product’s concentration of CBD. It’s important to remember that the dose, purity, and manufacturing standards can differ significantly between CBD in clinical trials and CBD available in stores, impacting its efficacy and safety for treating heart conditions.

Lifestyle and CBD: Complementary Approaches to Heart Disease Management

CBD could complement lifestyle interventions targeting heart disease management and its potential therapeutic benefits. For instance, CBD promotes the browning of white fat cells, which converts fat into burnable calories, contributing to maintaining a healthy weight. However, it’s important to note that vaping CBD is not recommended for individuals with heart disease due to potential lung damage and an increased risk of cardiovascular disease.

Thus, the potential benefits of CBD should be seen as complementary to, rather than a replacement for, a heart-healthy lifestyle, which includes:

• a balanced diet

• regular exercise

• stress management

• not smoking

Within this context, we will explore how CBD may bolster exercise and dietary strategies for heart health.

Exercise and CBD Use

CBD may aid post-exercise recovery by providing anti-inflammatory and analgesic effects, reducing discomfort. Furthermore, CBD could help manage the cardiovascular responses to exercise by modulating physiological stress responses.

Thus, CBD may serve as a supportive supplement for those engaging in regular exercise as part of a heart-healthy lifestyle, and it could be beneficial for healthy volunteers participating in related studies.

Diet, CBD, and Heart Disease

In the context of diet, CBD can improve endothelial function and promote vasorelaxation, which is beneficial for vascular health and can reinforce heart-healthy dietary measures aimed at preventing heart disease. By potentially mitigating inflammation and facilitating vasorelaxation, CBD serves as a supportive agent to dietary methods focused on reducing blood pressure and enhancing overall cardiovascular health.

The potential of CBD to lower blood pressure and influence heart rate may synergize with dietary approaches that manage hypertension and decrease cardiovascular risk. CBD’s ability to relax arterial walls and potentially reduce excess cholesterol alongside blood pressure can be advantageous when incorporated with dietary strategies tailored for cardiovascular wellness.

Summary

To sum up, the potential of CBD as a therapeutic tool for heart disease is promising, backed by emerging research on its interaction with the cardiovascular system, its potential to lower blood pressure and inflammation, and its antioxidant properties. Moreover, CBD’s potential benefits extend to specific heart conditions like cardiomyopathy and heart failure. However, while its safety profile is generally good, possible interactions with other medications, particularly blood thinners, warrant caution.

In conclusion, while more clinical trials are needed to establish the role of CBD in managing heart disease fully, the current evidence suggests that CBD could be a valuable addition to a heart-healthy lifestyle. As always, individuals considering CBD should consult with their healthcare providers to ensure its safe and effective use.

Frequently Asked Questions

Should you take CBD if you have high blood pressure?

No, it’s not recommended to take CBD if you have high blood pressure, as it may interact with blood pressure medications and cause dangerous side effects. Always consult a healthcare professional before considering CBD for high blood pressure.

What does CBD do to your arteries?

CBD has been found to directly affect the arteries, helping to reduce inflammation and causing vasorelaxation of isolated arteries. This can help reduce the inflammation of blood vessels, making it easier for the heart to pump blood throughout the body.

Does CBD interact with other medications?

Yes, CBD can interact with other medications, especially blood thinners and heart medications. It’s essential to consult with a healthcare professional before using CBD with other medications.

What is the best way to take CBD for heart health?

The best way to take CBD for heart health is by using CBD oil sublingually, placing it under the tongue for absorption. The form of CBD can influence its absorption and potential effectiveness for cardiovascular health.

References

Rajesh, M., Mukhopadhyay, P., Bátkai, S., Patel, V., Saito, K., Matsumoto, S., Kashiwaya, Y., Horváth, B., Mukhopadhyay, B., Becker, L., Haskó, G., Liaudet, L., Wink, D. A., Veves, A., Mechoulam, R., & Pacher, P. (2010). Cannabidiol attenuates cardiac dysfunction, oxidative stress, fibrosis, and inflammatory and cell death signaling pathways in diabetic cardiomyopathy. Journal of the American College of Cardiology, 56(25), 2115–2125. https://doi.org/10.1016/j.jacc.2010.07.033

As CBD use rises, clinical trials needed to determine safety, efficacy in heart disease patients. American College of Cardiology. (2022, September 6). https://www.acc.org/About-ACC/Press-Releases/2022/09/06/14/48/As-CBD-Use-Rises-Clinical-Trials-Needed-to-Determine-Safety-Efficacy-in-Heart-Disease-Patients

WebMD. (n.d.-b). CBD Oil and heart failure. WebMD. https://www.webmd.com/heart-disease/heart-failure/features/cbd-oil-heart-failure

Cannabidiol (CBD): Critical Review Report. (n.d.). https://www.who.int/docs/default-source/controlled-substances/whocbdreportmay2018-2.pdf?sfvrsn=f78db177_2

Written by Hunter Podell - Subject Matter Expert and Website Founder

Hunter has 8+ years of experience as a content writer and digital marketer. Earning his chops marketing in the healthcare space for over 5 years, Hunter is extremely familiar with the rules and regulations required to deliver high quality content that answers the user's needs while adhering to strict guidelines.