November 08, 2022 - 3 min read
The effect of CBD on the cardiovascular system under normal physiological conditions is fairly negligible. There exists potential for CBD application in treatment of some CV system disorders, however, such as hypertension, heart diseases, stroke, neonatal hypoxia-ischemia, diabetes, and hepatic and renal ischemia or reperfusion injury. This is because of CBD’s demonstrated anti-inflammatory, antioxidant, antiapoptotic, vasculoprotective, cardioprotective, and neuroprotective effects. CBD does not show direct hypotensive action in animal models of high blood pressure, for example, but there is evidence that indirectly it can lower stress-induced increases in blood pressure. Actual therapeutic potential in these various conditions is not yet known, because almost no clinical research has yet been done with CBD in diseases of the cardiovascular system, but there is good reason to investigate among them.
What CBD does in healthy organisms is polyphasic, depending on the species, route of administration, and presence of other drugs. It works on numerous receptors in the nervous system and the blood vessels and the heart. Strangely, stimulation of central CB1 receptors causes blood pressure to increase, but stimulated peripheral CB1 receptors at the endings of sympathetic neurons regulating the heart and vascular resistance behave in a hypotensive way. CB1 receptor action in the myocardium reduces contractility. Cannabinoids can also act on TRPV1 and 5-HT3 receptors on vagal nerve fibers, to elicit or inhibit the Bezold-Jarisch reflex, which is associated with bradycardia and hypotension. Generally, cannabinoids vasodilate, though sometimes they also do the opposite. Regulation of this seems to be managed partly by CB1, TRPV1, and PPARs. Other cannabinoid-friendly receptors function in vascular mechanics as well, notably CB2, GPR55, and 5-HT1As. There may also be action through metabolites, such as prostanoids. The overall effect of CBD on the CV system, however, appears slight, and in some studies it is non-existent. As an interesting footnote on cannabinoids, CBD is able to attenuate some of the effects in the cardiovascular system that associate with THC. We have written about anti-THC effects of CBD in other posts, and plan to do so again shortly.
In pathological conditions involving the cardiovascular system, the picture is somewhat different. In stress-induced changes, for example, CBD has been shown to decrease blood pressure and heart rate in animal models. Does it function merely as an anxiolytic, or is it a beneficial hemodynamic agent? This is not known. In arterial hypertension there is an associated increase of AEA in plasma. This may one day be clinically significant. So may inhibition of FAAH, which also exerts a hypotensive effect in animals. And endocannabinoids also show a modulating role in oxidative stress and inflammation in this form of hypertension. In heart disorders there may be much worth investigating. Several studies suggest that CBD is beneficial in myocardial ischemia or infarction. Pathways here might involve release of arrhythmogenic substances from platelets, and could be somehow dependent on adenosine A1 receptors. CBD has improved left ventricle function and protected against reperfusion injury, and also diminished infarct size and cardiac leukocyte infiltration in at least one rat model. This was associated with decreased serum interleukin-6 levels. It may be that cardioprotective effects of CBD in myocardial infarction are related to anti-inflammatory activity. In other kinds of CV-related conditions altogether, there is reason to hope for good things from CBD too. Because it is neuroprotective, there is reason to believe that it may be of value in limiting damage in stroke, hypoxic-ischemic encephalopathy, and sepsis-associated encephalitis. Cannabidiol, as a matter of fact, has been granted orphan drug status in the European Unionin perinatal asphyxia. Finally, CBD has been shown to be protective against ischemia or reperfusion injury of the kidneys and liver, a present danger in surgery and transplantation, possibly in part by its reduction of oxidative and nitrative stress, inflammation, and apoptosis. And it may be of use against cardiovascular complications of diabetes, not through any influence on blood glucose (which it does not have), but once again due to its antioxidative, anti-inflammatory, and vasculo-, cardio- and neuroprotective properties. About this last possibility we will write more shortly.
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The foregoing is a report on trends and developments in the cannabinoid industry. No product described herein is intended to diagnose, treat, cure or prevent any disease or syndrome.
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