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Cannabidiol Shows Promise To Help Lower Blood Pressure 

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Heart disease is the leading cause of death in the United States, regardless of sex or ethnicity. One person dies every 37 seconds from cardiovascular disease. High blood pressure, high cholesterol and smoking are key risk factors in the progression of cardiovascular disease1. Panacea Life Sciences

Although there are numerous prescription medications available to increase heart health, Americans can institute small lifestyle and dietary changes that may lower risk factors. Among the possible dietary supplements available that has a small but significant effect on blood pressure is cannabidiol (CBD) hemp oil, according to Golden, Colorado-based Panacea Life Sciences.

Blood pressure, or hypertension, is a very common cardiovascular condition with more than 30 percent of Americans experiencing blood pressure issues1. Often called the “silent killer,” high blood pressure usually does not have symptoms and is only discovered through testing. Hypertension is highly correlated to heart attacks and failure, stroke, kidney failure and vision issues. Those at greater risk for hypertension include people over 55 years of age, smokers, excessive alcohol users and the obese. African Americans also have a higher risk incidence of high blood pressure.

Although hypertension tends to run in families, various lifestyles can influence blood pressure, such as lack of exercise, diets high in salt, as well as commonly taken drugs such as aspirin.

As mentioned, hypertension is typically only discovered during medical checkups where blood pressure is measured. Blood pressure is reported through two numbers: systolic pressure, the upper number in blood pressure measurement, and diastolic pressure, the lower number. Both are reported as mm Hg.

Systolic pressure measures the force in arteries when the heart beats, while diastolic measures the pressure between heart beats. Normal blood pressure is typically 120/80, with prehypertension measurements up to 130/90, with higher pressures having diagnoses as hypertension.

For those with pre-hypertension, exercise, weight loss, cessation of smoking, decreasing alcohol consumption and focusing on eating a healthy diet may lower blood pressure to a normal level. A large range of dietary supplements, ranging from minerals to plant extracts, have been clinically shown to moderate effects on blood pressure (see Table 1 below). As with any supplement, consumers should evaluate whether the reported effects are real or that the supplement will have the desired magnitude of effect. For example, low Vitamin D is associated with high blood pressure, but taking a Vitamin D supplement does not have a noticeable effect on hypertension2. On the other hand, the most effective supplement in lowering blood pressure appears to be Coenzyme Q10 (CoQ10), which reportedly lowers systolic blood pressure by 10 mmHg, and diastolic pressure by an average of 17 mm Hg3.

 

Supplement Effect on Systolic   Blood Pressure                        (mm Hg) Effect on Diastolic Blood Pressure   (mm Hg) Reference
Vitamin D N/A N/A 2
CoQ10 17 10 3
Folic Acid 2 0.01 4
Magnesium 0.36 0.32 5
Potassium 4.7 3.5 6
Garlic 4.8 6.7 7
Melatonin (nocturnal) 6 3 8
Pomegranate Juice 21% lowering 9
Cannabidiol 6 4 10

 

Interestingly, amongst a number of reported health benefits, cannabidiol derived from industrial hemp has been shown to decrease blood pressure and may have the ability to improve various aspects of cardiovascular health11. Cannabidiol is one of the major cannabinoids found in the industrial hemp plant. Preclinical studies have shown that CBD relaxes various arteries, allowing these blood vessels to improve function11,12and decreases the damage caused by myocardial infarction (heart attack)13. There are few studies on CBD cardiovascular effects in humans, but one study demonstrated a significant effect on lowering blood pressure10.

In this small clinical study, healthy subjects, were given a single dose of CBD and positive effects on blood pressure were observed. CBD lowered resting systolic blood pressure by 6 mm Hg and diastolic pressure by 4 mm Hg. Interestingly, CBD decreased stress-induced blood pressure increases by 5 mm Hg as measured through mental-, exercise- and cold-induced stressors.  The researchers hypothesized that the reduction of blood pressure normally induced by stress was through anti-anxiety activity of CBD through the brain serotonin receptors. While this is a single study with a small number of study subjects, these results show promising effects and warrant further studies.

 

How does CBD potentially lower blood pressure?

Cannabidiol interacts with a complex collection of enzymes and receptors, more than 75, in the body termed the Endocannabinoid System, or ECS14,15,16. The ECS influences several physiological processes ranging from reduction of anxiety to anti-inflammatory activity in the body to maintain balance, stimulating where a stronger response is needed and attenuating where there may be too strong a response. The complex activity of CBD and the large number of different pathways that effect cardiovascular function suggests that there are several mechanisms where CBD may have a positive effect on hypertension.

One way to explore how CBD works on blood pressure is to examine how current blood pressure medications work and compare that to how CBD may work similarly. There are a number of different medications currently prescribed to alleviate hypertension that work through a variety of distinct mechanisms. The overlap in CBD molecular activity and these prescription medications suggest that CBD may exert positive effects on blood pressure through three mechanisms:  The adrenergic system, both alpha- and beta- blockers, the angiotensin system by both blocking angiotensin converting enzyme and the angiotensin receptor and through blocking calcium channels16. To verify such a hypothesis, more detailed studies need to be conducted.

The ability of CBD to help lower stress and effects on blood pressure may utilize a completely different mechanism. Everyone has, at one time or another, had a stressful moment where the heart beats faster, anxiety increases and as one consequence blood pressure becomes elevated. CBD has been reported by several groups to promote a sense of calm17.

CBD has been suggested to lower anxiety and stress through a specific serotonin receptor that in turn lowers blood pressure18. CBD may also exert anti-anxiety effects through inhibition of other brain receptors such as inhibiting the serotonin reuptake inhibitor16.

 

Negatives of CBD and prescription blood meds

While cannabidiol oils may provide a multitude of health benefits, including moderate effects on hypertension, those wishing to add cannabidiol to their daily regimen should be aware of possible side effects with their existing medications.

CBD has been shown to be safe and well tolerated unless taking very high doses, greater than 10 mg/kg body weight per day19. For the average American this would be equivalent of taking 850 mg of CBD per day, which would be a huge pill! At these high doses a small proportion of CBD users have reported dizziness, lethargy, upset stomach, diarrhea and elevated liver enzymes that could indicate liver damage with long term use. The side effects are rapidly reversible by taking lower quantities of CBD.

If people are currently taking prescription medications, they should consult with their doctor before starting a CBD regimen. CBD, like most exogenous substances such as prescription medications, are broken down in the liver by Cytochrome P450 enzymes (CYP450)20.21.  When taking CBD, a portion of the CYP450 enzymes will be occupied to break down CBD, leaving a lower amount of enzyme available to metabolize other medications. The end result is existing medications may have elevated concentrations in the blood stream with the same dosage taken that would cause stronger effects, including unwanted side effects specific to the prescription medication.

In the case of blood pressure medications, having an elevated level may lower blood pressure too much, causing dizziness or feeling faint, especially when getting up from a prone or sitting position. Until the full extent of drug-drug interactions is understood, consider CBD effects on prescription drug metabolism similarly as grapefruit juice22. We always recommend consumers consult with their physicians before starting a CBD regimen, and to start with small doses of CBD to increase as needed until the desired effect is obtained.

In conclusion, hypertension or high blood pressure is a very common condition in Americans with severe health consequences if not monitored and efforts made through lifestyle changes, supplements or medications to decrease hypertension. While more research is needed, cannabidiol shows very good promise to help those with pre-hypertension lower blood pressure, especially stress-induced blood pressure as well as lowering anxiety.

References:

  1. https://www.cdc.gov/heartdisease/facts.htm
  2. D. Witham et al. Database of Abstracts of Effects, 1995
  3. L. Rosenfeldt, et al. Journal of Hypertension 2007 v21 p297
  4. P. McRae, J Chiropr Med 2009 v8 p15
  5. Kass et al. European Journal of Clinical Nutrition 2012 v44 p411
  6. Binia et al. Journal of Hypertension 2015 v33 p1509
  7. J.Xiong et al. Phytomedicine 2015 v22 p 352
  8. Grossman et al. Am J Med. 2006 v119 p898
  9. Aviram et al. Clinical Nutrition 2004 v23 p423
  10. A. Jadoon et al. JCI Insight 2017 V2 e93760.
  11. R. Sultan et al. Frontiers in Pharmacology February 24, 2017
  12. P. Stanley et al. Cardiovasc. Res 2015 v107 p 568
  13. Durst et al. Am. J Physiol. Heart Circ. 2007 v293 pH3602
  14. I. Bih et al. Neurotherapeutics 2015 v12 p 699
  15. Ligresti et al. Physiol Rev 2016 v96 p1593
  16. Panacea Life Sciences, unpublished molecular pharmacology study
  17. M. Bergahamashi et al. Neuropsychopharmacology 2011 v36 p 1219
  18. L.c. Lee et al. J. Pharmacol 2017 v 174 p 3242
  19. http://www.epidiolehcp.com/efficacy-and-safety/safety
  20. Jiang et al. Life Sci. 2011 v89 p165
  21. Zendulka et al. J. Curr. Drug Metab. 2016 v 17 p 206
  22. https://www.health.harvard.edu/staying-healthy/grapefruit-and-medication-a-cautionary-note

 

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