CBD - Friend or Foe? All Hearts Want to Know | cannabisMD

CBD – Friend or Foe? All Inquiring Hearts Want to Know

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The leading cause of death in the United States is heart disease, accounting for 1 in every 4 deaths, according to the CDC. Be it the standard American diet or being sedentary, our cardiovascular systems are taking the “fall” for our less than ideal Western lifestyles. Approximately 600,000 Americans die from heart disease each year, thus warranting not only diet and exercise interventions but also the discussion of other prospective medicinal tools such as herbal interventions like CBD. If you have cardiovascular disease, know someone who does or is just looking for cardiovascular support and endurance, CBD may offer some key benefits for improving heart health.

For information on CBD and cardiovascular treatment: The Benefits of CBD Oil Are Perfect for Treating Many Heart Issues.

It is purported that improving cardiorespiratory fitness, in particular, can decrease the incidence of chronic disease states, along with delaying the incidence of CVD and mortality. Given the importance of cardiovascular fitness, there should be in place a standardized criterion for measuring normative cardiorespiratory values. With that said, improving cardiovascular endurance should be at the forefront of all preventative care models and carefully managed treatment plans of those with heart disease by a physician.

When considering the basic physiological demands placed on the heart during aerobic exercise, we have to recall that the heart is a muscle, thereby requiring oxygen-rich blood. With increased energy demands placed on it during exercise, there is an increased requirement and consumption of oxygen. Your “ticker” responds by contracting harder and faster to get blood to the muscles so you can move for prolonged periods of time.

Blood vessels pitch in by vasodilating to accommodate the increased demand for blood flow and oxygen. In individuals with cardiovascular disease, be it atherosclerosis or cardiomyopathies, the blood vessels are too blocked with inflammation and plaque or the heart muscle is too incompetent to contract efficiently. As a naturopathic doctor, I have “tools in my tool kit” to improve vasodilation, particularly when treating hypertensive patients, but am always researching new and upcoming vasodilator options.

When it comes to heart health, CBD research is focusing its efforts on demonstrating whether or not cannabidiol can successfully open or widen blood vessels to improve circulation, thereby improving hemodynamics. CBD studies are also investigating the prospective anti-inflammatory properties of CBD. If cannabidiol could illustrate their effectiveness on either of these two fronts, it could serve to show promise in lending to a healthier cardiovascular system and improved endurance and fitness downstream.

What we know so far is that if we want to improve endurance, we need healthy lung function and skeletal muscle stamina with optimal ATP production. But what we don’t often think about is that we’re also relying on vasodilation of blood vessels for maximum oxygen output, which requires the blood vessels to be free from inflammation, elastic and sufficiently plaque-free. There are a number of cardiovascular inflammatory markers you could have tested via blood draw to examine the health and integrity of your arteries. I run these labs on all my new, adult patients to get a baseline for evaluating what degree of damage is going on within the vascular system.

If we are looking to optimize the integrity of the blood vessels to prevent heart disease in both men and women and improve cardiorespiratory endurance, we have to concede that having open or vasodilated blood vessels is a necessity. We should appreciate that minimizing vascular inflammation and plaque are going to also be key players in facilitating this.

Our discussion in this section will explore CBD as a prospective:

  • Vasodilator
  • Anti-inflammatory

Question 1: Can CBD directly cause blood vessels to vasodilate?

Answer: Not exactly.

Let’s explore this briefly together.

What is vasodilation?

“Vasodilation is an increase in the internal diameter of blood vessels or widening of blood vessels that is caused by relaxation of smooth muscle cells within the walls of the vessels, particularly in the large arteries, smaller arterioles and large veins, thus causing an increase in blood flow. When blood vessels dilate, the blood flow is increased due to a decrease in vascular resistance”.

Can CBD improve vasodilation systemically for improved blood flow?

To date, research has demonstrated that specific cannabidiol can induce vasorelaxation, which should be differentiated from vasodilation. Vasorelaxation is a decrease in pressure on the arterial walls, but not an increase in the diameter of the blood vessels, as one would see in vasodilation. This is not discouraging news, however, since decreased pressure within the blood vessels results in less shear force on the tunica intima (inner lining of the artery) and ultimately less inflammation and oxidative stress.

Though there appears to be conflicting evidence about whether or not an obvious shift in the hemodynamics occurs with CBD use, vasorelaxation may someday illustrate improved arterial health over time and indirectly improve blood pressure secondarily to improved arterial health via decreased inflammation and thereby, less plaque formation. At this junction, CBD has demonstrated to be effective at causing vasorelaxation, but in specific isolated arteries only.

Below is a simplified flow of how CBD initiated vasorelaxation in both rat aortas and human mesenteric arteries.

Rat aorta: Two-hour exposure of CBD stimulated PPARg (peroxisome proliferator activated receptor) resulting in a decrease in calcium into the muscle layer, followed by entry of super oxide dismutase (SOD) into the muscle, finally resulting in vasorelaxation. (Stanley et al. 2012)

Human mesenteric artery: Acute exposure to CBD stimulated an increase in nitric oxide (NO) and the CB1 (cannabinoid receptor), followed by an efflux of potassium, lending to vasorelaxation. (Stanley et al. 2012)

A systemic review and meta-analysis of the hemodynamic effects of cannabidiol was researched in 2017 by Sultan et al. and aimed to determine whether CBD altered hemodynamics in vivo (in living organisms) since CBD studies had purportedly had numerous positive cardio effects in vitro (outside living being-i.e. test tube). Their analysis revealed that acute or chronic dosing of CBD had no effect on blood pressure, heart rate or blood flow under normal conditions. However, in stressful situations, CBD reduced the mean blood pressure in rats.

Since epidemiological studies show a positive relationship between long-term stress and the development of cardiovascular disease, perhaps the anxiolytic properties (anxiety-reducing effects) of CBD may be what was responsible for decreasing blood pressure with the subjects presented with stressful events. CBD may ultimately serve to be useful in improving the hemodynamics of those suffering from blood pressure secondary to stress or anxiety.

  • Attenuates high glucose-induced pro-inflammatory changes in human coronary artery endothelial cells.
  • Preserves endothelial integrity in diabetic retinal microvasculature
  • In vivo administration of CBD before cardiac ischemia and reperfusion reduces ventricular arrhythmias and infarct size.
  • Modulates cardiovascular response to stress.

To view this study with references click on the link below.



There is hope and growing research supporting that CBD may be a game-changer for cardiovascular health and endurance. It shows promise as an anti-inflammatory, inducer of vasorelaxation and an anxiolytic. It may only be a matter of time and research before we know whether or not CBD can be used to co-manage heart disease and improve endurance and athletic performance.

Importance of Cardiovascular Health

If your cardiovascular health is less than superb, I strongly suggest meeting with your doctor and discussing lifestyle changes such as diet, exercise and stress levels. Since cardiovascular disease is the number one killer in this country, it becomes the most important topic of discussion in medical settings and clinics.

It’s especially important to promote heart health early in life, as children develop food habits and lifestyle trends. Children should get at least 1 hour of exercise daily if not more. They should be eating an organic, whole foods, plant-based diet.

One of the first things a cardiologist is going to do with a patient who has had a heart attack or bypass surgery is to implement a vegetarian diet because of the anti-inflammatory properties in vegetables. But why do we wait until CVD has set in before switching to a plant-based diet? I don’t know the answer to that, but I can assure you that prevention is the best medicine.

Why are heart health and building endurance important?

  1. Decreases blood pressure
  2. Makes each heart contraction more efficient
  3. Improves cholesterol levels
  4. Increases circulation
  5. Improves mood/decreases depression
  6. Decreases incidences of dementia
  7. Balances hormones
  8. Anti-aging

Fact or Fiction? 10 facts about CBD and Heart Disease

CBD oil: Fountain of youth

Having anti-inflammatory properties, CBD oil shows promise in preventing age-related diseases, which are often the result of inflammation. As a naturopathic doctor, I work with patients on age management regularly, but my focus is at the cellular- and hormonal-level, concentrating on the wellness of the inner-workings of the systems rather than esthetics. This is where true age is defined, for the skin is just a reflection of what’s going on inside after all. On the bright side, the downstream effect of taking care of the body’s vital systems results in a younger-looking you! I call that a “secondary gain.”

The aging population will suffer from one or more of these inflammatory processes (which could possibly be mitigated with anti-inflammatory supplementation such as CBD oil):

  • Coronary artery disease
  • Arthritis
  • Dementia
  • Anxiety/Depression
  • Autoimmune disease
  • Cancer

Interested in additional information related to CBD oil and anti-aging? Please check out The Anti-Aging Properties Of CBD and Endurance for Life.

Endocannabinoid system

The endocannabinoid system describes a neurotransmitter system innate to our bodies, made of receptors and molecules, fitting like a lock-and-key system. It is active in each of us all of the time, and is present in tissues all over the body. The body makes cannabinoid molecules on a regular basis. They are biochemicals made by our body (the key) and the receptors that they stimulate (the lock).

The two receptors can be found in different places:

  • CB1: Found in the brain and nervous system, peripheral organs and tissues, it is responsible for marijuana’s psychoactive effects and plays a role in affecting mood, memory, appetite, and pain.
  • CB2: Found outside the nervous system and in the immune system, helping to reduce inflammation.

The two most well-known endocannabinoids molecules are:

  • Anandamide
  • 2-arachidonoylglycerol (2-AG).

Ultimately, the role of the endocannabinoid system is to promote homeostasis. It is postulated that the reason phytocannabinoids found in the cannabis sativa plant can have positive health effects in a variety of ways for humans is that our already built-in endocannabinoid system is molecularly similar to the phytocannabinoids found in cannabis sativa. Those suffering from what is coined “clinical endocannabinoid deficiency,” may especially benefit as they do not produce enough endocannabinoids. We can speculate that they may, as a result, respond favorably to phytocannabinoid treatment, provided proper dosing.

Dosing for this condition is not within my scope of practice or expertise. If you live in a state where medical marijuana is legal, and your doctor can prescribe it, it would behoove you to inquire about the benefits and precautions with regard to your symptomology, along with the therapeutic dose that is right for you. I do not use or prescribe this herb as a naturopathic doctor since it is out of my scope of practice to do so. I encourage, as always, that when supplementing with any herb or pharmaceutical, that we apply the first tenant in naturopathic medicine, which is to first do no harm.

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