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A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study 1 Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, Royal A sublingual application of CBD oil tincture may be the best way to take CBD for high blood pressure as it gets absorbed by the body fast, and the effects are f

A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study

1 Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, United Kingdom.

Garry D. Tan

2 The NIHR Oxford Biomedical Research Centre, Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.

Saoirse E. O’Sullivan

1 Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, United Kingdom.

1 Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, United Kingdom.

2 The NIHR Oxford Biomedical Research Centre, Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.

Associated Data

Abstract

BACKGROUND. Cannabidiol (CBD) is a nonpsychoactive phytocannabinoid used in multiple sclerosis and intractable epilepsies. Preclinical studies show CBD has numerous cardiovascular benefits, including a reduced blood pressure (BP) response to stress. The aim of this study was to investigate if CBD reduces BP in humans.

METHODS. Nine healthy male volunteers were given 600 mg of CBD or placebo in a randomized, placebo-controlled, double-blind, crossover study. Cardiovascular parameters were monitored using a finometer and laser Doppler.

CONCLUSIONS. This data shows that acute administration of CBD reduces resting BP and the BP increase to stress in humans, associated with increased HR. These hemodynamic changes should be considered for people taking CBD. Further research is required to establish whether CBD has a role in the treatment of cardiovascular disorders.

Introduction

Epidemiological studies have shown a positive relationship between long-term stress and the development of cardiovascular disease (1). Factors like social isolation, low socioeconomic status, depression, stressful family and work life, and anxiety are associated with an increased risk of the development and accelerated progression of existing cardiovascular disease. Current European guidelines on the prevention of cardiovascular disease have emphasized the importance of tackling these factors (2). Mental stress induces myocardial ischaemia in patients with stable coronary artery disease, and this appears to be mediated by adrenal release of catecholamines (3).

Cannabinoids (CBs) are compounds that bind to CB receptors or are structurally similar to compounds that bind to CB receptors. They include endogenously produced compounds (called endocannabinoids), synthetic compounds and phytocannabinoids obtained from the Cannabis sativa plant. There are over 80 known types of phytocannabinoids, the most widely studied of which is Δ 9 tetrahydrocannabinol (Δ 9 -THC or THC), which is responsible for the psychoactive properties of cannabis (4). The other major phytocannabinoid is cannabidiol (CBD), which does not have psychoactive properties. CBD is currently the focus of much research due to its potential in a number of therapeutic areas, as it has been shown to have antiinflammatory, anticonvulsant, antioxidant, anxiolytic, antinausea, and antipsychotic properties (5). A number of preclinical studies have also shown beneficial effects of CBD in a range of disorders of the cardiovascular system (6). A CBD/THC combination (Sativex/Nabiximols, GW Pharmaceuticals) is licensed for the treatment of spasticity in multiple sclerosis, and CBD alone (Epidiolex, GW Pharmaceuticals) has entered an expanded access program in children with intractable epilepsies (Dravet syndrome and Lennox-Gastaut syndrome). Epidiolex has also received orphan designation status for the treatment of neonatal hypoxia-ischaemic encephalopathy.

CBD has multiple desirable effects on the cardiovascular system. It attenuates high glucose–induced proinflammatory changes in human coronary artery endothelial cells (7) and myocardial dysfunction associated with animal models of diabetes (8), and it preserves endothelial integrity in diabetic retinal microvasculature (9). In vivo administration of CBD before cardiac ischemia and reperfusion also reduces ventricular arrhythmias and infarct size. CBD also causes both acute and time-dependent vasorelaxation in isolated arteries in rats and humans (10–12). There is also evidence from animal studies that CBD modulates the cardiovascular response to stress. Resstel and colleagues (13) showed in rats that i.p. injection of CBD (10 and 20 mg/kg, –30 min) reduced restraint stress–induced cardiovascular response and behavior. Both these effects were blocked by preadministration of WAY100635 (0.1 mg/kg), a 5-hydroxytryptamine 1A (5HT1A) antagonist. These effects appear to be mediated centrally and involve the bed nucleus of the stria terminalis (BNST), a limbic structure that modulates neuroendocrine responses to acute stress (14).

Our recent systematic review showed us that there are no dedicated studies in humans to date, to our knowledge, looking at the effect of CBD on either resting cardiovascular measurement or on the responses to stress, with continuous monitoring of CV parameters (15). Therefore, the aim of the present study was to investigate whether CBD decreases the cardiovascular response to stress after the administration of a single dose of CBD (600 mg) in healthy volunteers, with the hypothesis that blood pressure would be reduced by CBD. Noninvasive cardiovascular measurements were used along with stress tests in the form of mental arithmetic, isometric exercise, and the cold pressor test.

Results

Ten male subjects were recruited, but 1 withdrew for personal reasons. The mean age, weight, and height of the volunteers were 23.7 ± 3.2 years, 77.5 ± 6.4 kg, and 178.6 ± 4.5 cm (mean ± SD).

Effect of CBD on resting cardiovascular parameters.

Changes in resting cardiovascular parameters after a single dose (600 mg) of cannabidiol (CBD) in healthy volunteers (n = 9).

The effects of placebo (closed square) and CBD (open square) on systolic blood pressure (SBP) (A), diastolic blood pressure (DBP) (B), mean arterial blood pressure (MAP) (C), heart rate (HR) (D), stroke volume (SV) (E), cardiac output (CO) (F), ejection time (EJT) (G), total peripheral resistance (TPR) (H), and forearm blood flow (I), measured continuously over 2 hours after drug ingestion, except for forearm blood flow. Forearm blood was measured over a time period of 2 minutes just before the start and in between the stress tests. Dotted line denotes baseline values between the stress tests. Repeated measures 2-way ANOVA; mean ± SEM (*/ + / # P < 0.05, **/ ++ / ## P < 0.01 using Bonferroni’s post-hoc analysis; + and # represent significant change in any parameter over time seen with placebo and CBD, respectively; denotes overall significant difference between 2 treatments).

There was a trend toward reduction in total peripheral resistance (TPR, Figure 1H ) with CBD in the latter half of the resting period, and a significant reduction in forearm skin blood flow before the start of the stress tests ( Figure 1I ; P < 0.01).

Effect of CBD on cardiovascular parameters mental stress.

The individual blood pressure responses of healthy volunteers to the stresses are presented in Figure 2 , showing the average baseline systolic or diastolic blood pressure in the 4 minutes preceeding the stress test, the peak response during stress, and the average recovery response in the 4 minutes after the stress test.

Individual systolic and diastolic blood pressure responses to all stress tests after a single dose (600 mg) of cannabidiol (CBD) or placebo in healthy volunteers (n = 9).

Green color coding shows subjectS who had a reduced (compared with placebo) blood pressure response to stress after taking CBD, and red color coding shows an increased blood pressure response to stress after taking CBD.

Mental stress test.

Cardiovascular response to mental stress after a single dose (600 mg) of cannabidiol (CBD) in healthy volunteers (n = 9).

The effects of placebo (closed square) and CBD (open square) on systolic blood pressure (SBP) (A), diastolic blood pressure (DBP) (B), mean arterial blood pressure (MAP) (C), heart rate (HR) (D), stroke volume (SV) (E), cardiac output (CO) (F), ejection time (EJT) (G), total peripheral resistance (TPR) (H), and forearm blood flow (I), measured continuously just before, during, and after mental arithmetic test (dotted line denotes stress test period), except for forearm blood flow. Measurements for forearm blood flow were made over a 2-minute window just before, during, and after the stress test. Repeated measures 2-way ANOVA; mean ± SEM (+ and # denote significant change in a parameter during the stress period seen with placebo and CBD, respectively). + / # P < 0.05, ++ /# # P < 0.01.

Exercise stress test.

Cardiovascular parameters in response to exercise stress after a single dose (600 mg) of cannabidiol (CBD) in healthy volunteers (n = 9).

The effects of placebo (closed square) and CBD (open square) on systolic blood pressure (SBP) (A), diastolic blood pressure (DBP) (B), mean arterial blood pressure (MAP) (C), heart rate (HR) (D), stroke volume (SV) (E), cardiac output (CO) (F), ejection time (EJT) (G), total peripheral resistance (TPR) (H), and forearm blood flow (I), measured continuously just before, during, and after isometric exercise test (dotted line denotes stress test period), except for forearm blood flow. Measurements for forearm blood flow were made over a 2-minute window just before, during, and after the stress test. Repeated measures 2-way ANOVA; mean ± SEM (*/ + / # P < 0.05; **/ ++ / ## P < 0.01; ***/ ### P < 0.001; ****/ #### P < 0.0001 using Bonferroni post-hoc analysis; + and # denote significant change in a parameter during the stress period seen with placebo and CBD respectively).

Cold stress test.

Cardiovascular response to cold stress after a single dose (600 mg) of cannabidiol (CBD) in healthy volunteers (n = 9).

The effects of placebo (closed square) and CBD (open square) on systolic blood pressure (SBP) (A), diastolic blood pressure (DBP) (B), mean arterial blood pressure (MAP) (C), heart rate (HR) (D), stroke volume (SV) (E), cardiac output (CO) (F), ejection time (EJT) (G), total peripheral resistance (TPR) (H), and forearm blood flow (I), measured continuously just before, during, and after cold pressor test (dotted line denotes stress test period), except for forearm blood flow. Measurements for forearm blood flow were made over a 2-minute window just before, during, and after the stress test. Repeated measures 2-way ANOVA; mean ± SEM (*/ + / # P < 0.05, **/ ++ P < 0.01, ***/ +++ P < 0.001, ****P < 0.0001 using Bonferroni post-hoc analysis; + and # denote significant change in a parameter during the stress period seen with placebo and CBD, respectively).

Looking at the individual response to the cold pressor test, 8 of 9 subjects had a lower SBP during the cold stress and in the recovery period after taking CBD ( Figure 2 ). Six of 9 subjects had a lower DBP during the cold pressor, and 7 of 9 subject had a lower DBP in the recovery period after taking CBD ( Figure 2 ).

Discussion

Based on preclinical evidence, the aim of this study was to test the hypothesis that CBD would reduce the cardiovascular response to stress in healthy volunteers. We found that resting blood pressure was lower after subjects had taken CBD and that CBD blunted the blood pressure response to stress, particularly in the pre- and poststress periods. Post-hoc analysis showed an overall trend of lower SBP, MAP, DBP, SV, TPR, forearm skin blood flow, and left ventricular EJT and a higher HR in subjects who had taken CBD. These hemodynamic changes should be considered for people taking CBD and suggest that further research is warranted to establish whether CBD has any role in the treatment of cardiovascular disorders.

We have shown for the first time that to our knowledge that, in humans, acute administration of CBD reduces resting blood pressure, with a lower stroke volume and a higher heart rate. This response may be secondary to the known anxiolytic properties of CBD (16) and may account for the lack of anticipatory rise in blood pressure seen with placebo. These findings are in contrast to previous studies in humans, where CBD at the same dose did not affect baseline cardiovascular parameters (17–19), although changes in the cardiovascular system were not the primary outcome of these studies. In the present study, CV parameters were measured continuously, while in previous studies, monitoring for SBP, DBP, and HR were performed manually at only 1, 2, or 3 hours after drug delivery. Additionally, our subjects were cannabis naive, while the subjects of other studies had used cannabis in the past. Since tolerance may develop to the hemodynamic response to CBs in humans, this may explain the differences between studies.

THC, the major psychoactive component of cannabis, is known to cause tachycardia and orthostatic hypotension in humans (20), a hemodynamic response similar to that observed to CBD in the present study. THC is a partial agonist at both CB1 and CB2 receptors (21), and the effects of THC on heart rate are mediated through CB1 receptors (20). CBD does not bind with any great affinity to CB1, but it can interact indirectly by augmenting CB1 receptors’ constitutional activity or endocannabinoid tone, the so called indirect agonism (22). We recently showed that CBD also causes endothelium-dependent vasorelaxation in isolated human mesenteric arteries through CB1 activation (11). Therefore, it is possible that the changes in hemodynamics brought about by CBD are mediated through CB1.

CBD may cause sympathoinhibition (through CB1 or some other mechanism), thereby preventing an increase in blood pressure and cardiac output, causing a compensatory rise in heart rate to maintain cardiac output. Indeed, the changes in SBP preceded any changes in HR. Another possibility is that CBD inhibits cardiac vagal tone, thereby increasing heart rate (despite any potential sympathoinhibition). A recent study in male Sprague-Dawley rats showed that GPR18 activation in the rostral ventrolateral medulla (RVLM) by abnormal CBD (Abn-CBD) resulted in reduced blood pressure and increased heart rate (23) (similar to that observed in the present study). The same study showed that pretreatment with atropine and propranolol fully abrogated the HR response, suggesting a role for the autonomic nervous system. CBD is a weak partial agonist at GPR18 (24).

Effect of CBD on cardiovascular parameters in response to mental stress.

Mental arithmetic has been shown to cause a rise in MAP and muscle sympathetic nerve activity (MSNA) (25) and vasodilatation in forearm skeletal muscle (26). In our study, none of the cardiovascular parameters other than HR, DBP, and SV were affected, suggesting that the level of stress to this test was minimal. This could be because of the added visual stimulus of a computer screen, which would have helped volunteers perform the task. Overall, there was trend for lower SBP, DBP, MAP, SV, TPR, and forearm skin blood flow in subjects who had taken CBD, particularly in the pre– and post–stress test periods. Like resting cardiovascular parameters, these changes may indicate anxiolytic effects of CBD and/or generalized sympathoinhibition.

Effect of CBD on cardiovascular parameters in response to exercise stress.

Isometric exercise produces a pressor response, via sympathoexcitation, originating in the contracting muscle and relayed to the RVLM via the nucleus of solitary tract. The end result is a rise in heart rate and cardiac output and vasoconstriction in nonexercising organs (27–29). There is increased skeletal muscle blood flow in the nonexercising limb, which is sensitive to atropine and propranolol (30). A similar response was seen in our study, where isometric exercise caused a significant rise in SBP, DBP, MAP, and HR and an increase in forearm blood flow, although this was significant in the placebo group only. Subjects who had taken CBD had reduced blood pressure during the exercise stress test, and this was most pronounced in the pre- and posttest period. Before the exercise stress, HR was higher and SV lower in volunteers when they had taken CBD, and this trend continued throughout exercise stress and in the poststress period. There was also a significant reduction in EJT with CBD, which represents a reciprocal change to increased HR. The rise in cutaneous blood flow was only seen with placebo and not with CBD, possibly suggesting reduced β2 adrenergic–mediated vasodilatation, which could be a result of general sympathoinhibition or a specific effect at the β2 adrenoceptors. The tissue distribution of β2 adrenoceptors and CB1 receptors overlaps in many tissues, including in the cardiovascular system (31). At the cellular level, a complex physical and functional interaction between these 2 receptors has been demonstrated; there is evidence of cointernalization of β2 adrenoceptors with CB1 receptors, leading to desensitisation of β2 adrenoceptors (31).

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Effect of CBD on cardiovascular parameters in response to cold stress.

Cold stress causes intense sympathoexcitation, producing a tachycardic and pressor response, and an increase in MSNA (32, 33). The pressor response is due to an initial rise in CO, in response to increased HR and a later increase in MSNA, causing vasoconstriction. Both MAP and TPR show a linear correlation with MSNA during cold stress (34). In our study, cold stress produced a pressor response in both groups, but, interestingly, while SBP and MAP continued to rise with placebo throughout the test period, the pressor response to cold was blunted in subjects who had taken CBD, and SBP and MAP were significantly lower. In keeping with this, TPR was lower with CBD than placebo, suggesting a possible inhibition of sympathetic outflow. This could also be due to analgesic properties of CBD (35), reducing cold stress and therefore minimizing the sympathetic response (also explaining why the cold pressor test was affected more by CBD than the exercise test). In the animal study of Resstel and colleagues (13), the authors suggested that the modulation of cardiovascular response was most likely secondary to attenuation of emotional response to stress. However, given our findings that CBD produced similar changes in cardiovascular parameters — though to a variable degree — during rest and stress, this may indicate that CBD also has direct cardiovascular effects.

Safety and tolerance.

CBD was well tolerated, and there were no adverse events on the day of stress tests. None of the subjects reported any adverse events over the following week.

Conclusion.

Our data show that a single dose of CBD reduces resting blood pressure and the blood pressure response to stress, particularly cold stress, and especially in the post-test periods. This may reflect the anxiolytic and analgesic effects of CBD, as well as any potential direct cardiovascular effects. CBD also affected cardiac parameters but without affecting cardiac output. Giving the increasing use of CBD as a medicinal product, these hemodynamic changes should be considered for people taking CBD. Further research is also required to establish whether CBD has any role in the treatment of cardiovascular disorders such as a hypertension.

Methods

Study design.

The study was a randomized, crossover design with each subject given CBD (BN: K12067A) or placebo (both gifts from GW Pharmaceuticals) in a capsule in a double-blind fashion, with a minimum time interval of at least 48 hours (range 3–16 days), taking place at the Division of Medical Sciences, School of Medicine, Royal Derby Hospital. Allocation was decided by a coin toss, and block randomization was employed by S.E. O’Sullivan, who assigned participants. K.A. Jadoon carried out all study visits, and data analysis was blinded.

During an initial visit, subjects were familiarized with the stress tests and with noninvasive cardiovascular (CVS) monitoring, and an electrocardiogram (ECG) was done to rule out any preexisting cardiac conditions. Subjects were advised to fast overnight, to avoid beverages containing caffeine or alcohol, and to avoid strenuous exercise for 24 hours before each of the 2 study visits. Two hours after CBD/placebo was administered, subjects performed various stress tests (36). Noninvasive cardiovascular monitoring using Finometer and laser Doppler flowmetry was carried out during the 2 hours to assess changes in baseline parameters and during the stress test periods.

Visit days.

Upon arrival, subjects were rested for 10–15 minutes, and their baseline blood pressure and heart rate were recorded using a digital blood pressure (BP) monitor. Participants were given a standardized breakfast, and 15 minutes later, they were given either oral CBD (600 mg) or placebo in a double-blind fashion. This is a dose known to cause anxiolytic effects in humans and is comparable with what is used clinically (19, 37–39). Study medication consisted of capsules containing either 100 mg of CBD or excipients, which were a gift from GW Pharmaceuticals. There was no difference between the 2 formulations in color, taste, or smell.

Two hours afterward, subjects were asked to perform the stress tests (36). Timing of the tests was chosen to coincide with peak plasma levels for CBD (18). All the experiments were performed in a sitting position under ambient temperature conditions. Maximum voluntary contraction for the isometric hand grip test was assessed for each subject prior to administering study medication.

After administration of CBD or placebo, subjects remained seated, either doing nothing, reading, or using a computer. During this time, subjects were connected to a calibrated Finometer (Finapres Medical Systems), which uses a finger-clamp method to detect beat-to-beat changes in digital arterial diameter using an infrared photoplethysmograph (40). The Finometer gives a continuous signal of beat-to-beat changes in blood pressure and blood flow, and it uses this signal to derive other parameters, including systolic, diastolic, and mean blood pressure; interbeat interval; heart rate and left ventricular ejection time; stroke volume; cardiac output; and systemic peripheral resistance. Baseline cardiovascular data was recorded for 2 hours following administration of CBD or placebo. Forearm blood flow was measured using a calibrated laser Doppler flowmeter (Perimed) (41). For each recording, 5 images of microcirculation were taken, over an area 19 mm × 19 mm, using the upper third of the left forearm under high resolution. After 2 hours, subjects underwent the cardiovascular stress tests in the following order: mental arithmetic, isometric exercise, and cold pressor test.

The mental arithmetic test consisted of calculating a sum every 2 second for 2 minutes. Subjects were seated in front of a computer screen, and a PowerPoint presentation delivered a slide with a simple mathematical sum of a 3-digit number minus a smaller number (e.g., 317 – 9, 212 – 11, 185 – 7) every 2 seconds; the subject had to give the answer verbally. In the isometric exercise stress test, using a dynamometer, handgrip was maintained at 30% of maximum voluntary contraction (MVC) for 2 min. For the cold pressor test, subjects immersed their left foot (up to ankle) in ice slush (temperature 4°C–6°C) for 2 minutes. Cardiovascular parameters were measured continuously using the Finometer, while skin blood flow measurements were taken just before, during, and 5 minutes after each test. Each stress test lasted for 2 minutes, and there was a recovery period of at least 10 minutes.

Statistics.

Data were analyzed using repeated measures ANOVA to determine the effect of treatment and time on different variables using GraphPad PRISM version 6.02. Level of significance was set at α = 0.05 and values presented as mean ± SEM. Sidak’s post-hoc test was used to see treatment affect at various time points. Data were not unblinded until after statistical analysis.

Study approval.

Ten healthy young male volunteers, mean age 24 years (range 19–29), with no underlying cardiovascular or metabolic disorders, were recruited for this study, which was approved by the University of Nottingham Faculty of Medicine Ethics Committee (study reference E18102012). Written informed consent was obtained according to the Declaration of Helsinki. Exclusion criteria included any significant cardiovascular or metabolic disorder or use of any medication. All the volunteers were nonsmokers and had taken no prescribed or over-the-counter medication within a week prior to randomization. No volunteers had ever used cannabis.

Author contributions

KAJ helped with study design, researched data, wrote the manuscript, and reviewed/edited the manuscript. GDT reviewed/edited the manuscript. SEO was involved in study design and reviewed/edited the manuscript.

Supplementary Material

Acknowledgments

GT is supported by the NIHR Oxford Biomedical Research Centre Programme. The views expressed are those of the author and not necessarily those of the NHS, the NIHR, or the Department of Health.

Footnotes

Conflict of interest: GW Pharma supplied the cannabidiol (CBD) and placebo but did not fund the study.

Reference information:JCI Insight. 2017;2(11):e93760. https://doi.org/10.1172/jci.insight.93760.

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CBD Oil for High Blood Pressure (Hypertension) – August 2022

A sublingual application of CBD oil tincture may be the best way to take CBD for high blood pressure as it gets absorbed by the body fast, and the effects are felt for an extended period.

Why People Are Taking CBD for High Blood Pressure

According to the Centers for Disease Control and Prevention (CDC), high blood pressure can harden and narrow the arteries, which decreases the flow of blood and oxygen to the heart, leading to heart disease (5 ) .

In a 2015 study conducted by researchers from the University of Nottingham Royal Derby Hospital in the UK, CBD was shown to be a potent vascular relaxant to human gut arteries, suggesting its potential benefits to dilate blood vessels and increase blood flow (6 ) .

How CBD Oil Works to Help with High Blood Pressure

CBD has been shown to possess potential benefits that may help lower blood pressure by addressing health issues that cause blood pressure to rise.

CBD’s Anti-Anxiety Effects

Some factors linked to high blood pressure are anxiety and lack of sleep.

In a 2019 study published in The Permanente Journal , sleep and anxiety scores were measured in human subjects, and the findings showed that CBD could hold benefits for anxiety-related disorders (7 ) .

In another study , which was published in the Journal of Alternative and Complementary Medicine in 2019, CBD was shown to help in the treatment of post-traumatic stress disorder (PTSD) (8 ) .

The relaxation response can reduce blood pressure in people with hypertension, as indicated in the results of a study published in the Journal of Alternative and Complementary Medicine in 2018 (9 ) .

CBD as a Vasodilator

As a natural vasodilator, CBD may help improve positive cardiovascular health by widening the blood vessels to allow smooth blood flow.

CBD’s role as a vasodilator was highlighted in a double-blind, placebo-controlled, and randomized crossover study conducted by researchers from the Royal Derby Hospital Centre and Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital in the UK in 2017 (10 ) .

In the said study , researchers explored the connection between CBD and a reduction in blood pressure, and they found that a single dose of CBD oil significantly lowered blood pressure in a small study of healthy human volunteers, both under stress and at rest.

However, the authors also noted that “there are no dedicated studies in humans to date, to our knowledge, looking at the effect of CBD on either resting cardiovascular measurement or on the responses to stress, with continuous monitoring of cardiovascular parameters.”

CBD’s Anti-Inflammatory Effects

Studies conducted by researchers from the University of South Carolina School of Medicine in 2009 also reveal that CBD possesses anti-inflammatory properties. Since inflammation can cause high blood pressure or vice versa, eliminating inflammation may help alleviate high blood pressure (11 ) .

However, inflammation may be a result of other diseases as well. Thus, leading a healthy lifestyle while using CBD oil is advised.

CBD vs. Cortisol Secretion

Cortisol, the “stress hormone,” is released by the body under stress. An elevated cortisol level may cause a physical stress response in the body that could raise blood pressure.

Results from a 1993 study published in the Brazilian Journal of Medical and Biological Research suggested that CBD interferes with cortisol secretion (12 ) . Thus, if high blood pressure is due to elevated stress levels, CBD oil may theoretically be beneficial.

CBD and The Dynamics of Blood Flow

In a systematic review and meta-analysis published in the Frontiers in Pharmacology Journal in 2017, the authors examined the hemodynamic (blood flow) effects of CBD (13 ) .

The authors of the said study concluded that CBD might be used as a potential remedy for cardiovascular disorders, such as hypertension and stroke.

However, they found no evidence that CBD provides similar results under non-stressful conditions.

Much of these data were from mice, and results from human studies on the effects of CBD on hemodynamics is still limited.

CBD Interacts with Neurotransmitters

Results of a 2017 study published in the Cannabis and Cannabinoid Research Journal show how a neurotransmitter, such as anandamide, plays a critical role in the functioning of the heart (14 ) .

Data from the study has shown that CBD oil regulates the reuptake of essential heart neurotransmitters that control the cardiovascular system.

CBD’s Neuroprotective Effects

A study published in the British Journal of Clinical Pharmacology in 2013 has shown how CBD allows blood flow in the vessels to maintain healthy blood pressur e in animal models (15 ) .

The review has also presented evidence of the positive effects of CBD in the cardiovascular system.

Data from the said study illustrate that CBD potentially provides neuroprotective effects, which may help protect the brain against stroke.

The findings also suggest that CBD can induce a healthy heart rhythm after an ischemic attack, which is caused by a build-up or blockage in the arteries. Thus, CBD was shown to potentially improve heart performance immediately after a heart attack in non-human models.

Although the results demonstrate that the cardiovascular system is a valid therapeutic target for CBD, the target sites of action for CBD remain to be established for most of the responses.

As more and more studies and clinical trials are conducted in human subjects, CBD oil’s efficacy in treating high blood pressure would become more explicit.

The Pros and Cons of CBD Oil for High Blood Pressure

The Pros
  • CBD “is generally well tolerated with a good safety profile,” as the World Health Organization (WHO) states in a critical review (16 ) .
  • CBD’s feasibility as a potential remedy to hypertension-related symptoms has been shown in the numerous studies stated above.
The Cons
  • Studies are too limited to determine whether or not CBD is an effective treatment for conditions other than the ones approved by the U.S. Food and Drug Administration (FDA).
  • As with the use of any natural chemical compound, there are risks involved in using CBD. According to the Mayo Clinic, possible side effects include drowsiness, dry mouth, diarrhea, fatigue, and reduced appetite (17 ) .
  • Most of the results from blood pressure-related studies done on CBD have been gathered through tests that involve healthy volunteers, very low population sizes, or animals, like that of a study done on rats (18 ) .

Given the limited scope, facts cannot be established that the results of previous investigations would be comparable with that of tests involving ill human subjects.

  • CBD has been shown to alter how the body metabolizes certain medications, as a 2017 research reveals (19 ) . With results published in the Cannabis and Cannabinoid Research Journal , the research suggests that the combination of CBD with other high blood pressure medications has the potential to alter the blood concentrations of either substance.

Results of a study published in the Medicines Journal indicated that the CYP450 family of enzymes is responsible for metabolizing several phytocannabinoids (cannabinoids that exist naturally in the cannabis plant), including CBD (20 ) .

If one is already on high blood pressure medication, taking CBD in combination with the prescribed drug can lower blood pressure too much. Blood pressure that is too low is as bad as blood pressure that is too high.

  • The lack of regulation makes it difficult to determine whether the CBD gummies, tinctures, patches, balms, and gelcaps contain what the product label claims.

A 2017 review published in the Journal of the American Medical Association revealed labeling inaccuracies among CBD products. Some products had less CBD than stated, while others had more (21 ) .

Experts recommend speaking with a physician before adding CBD onto the medications that are currently taken. The doctor may want to reduce the dosage strength of the blood pressure prescription before incorporating CBD oil into the daily regimen of an individual.

How CBD Oil Compares to Alternative Treatments for High Blood Pressure

Although the prescription medications currently available for hypertension are effective, they bring about side effects, which can make the treatment an unpleasant experience.

Cannabidiol (CBD), on the other hand, is a natural alternative that has shown to have little side effects, and the side effects of CBD are less common than the effects associated with most pharmaceutical medications used to treat high blood pressure.

How To Choose The Right CBD for High Blood Pressure

The best CBD oil product to use for high blood pressure is CBD tincture. By taking a sublingual dosage, the optimum level of CBD gets absorbed into the system, which means CBD works the fastest, and the effects are probably felt the longest.

However, regardless of the form of CBD product one chooses, he or she must employ careful consideration in choosing the best CBD oil for high blood pressure that is right for him or her.

The following factors are essential to ensure the safety and reliability of the CBD products purchased:

  1. Research on the exact legal stipulations applicable to CBD in the area where it would be purchased and used.
  2. Purchase only from legitimate and reliable big brands. The majority of companies that manufacture the best CBD oil products grow their hemp from their farm, or they purchase from licensed hemp producers.
  3. When buying from an online store, do some research on product reviews first. When buying from a physical store or dispensary, check whether the store is authorized by the government to sell CBD.
  4. One important thing to look for in CBD products is certification codes. Several certification authorities approve certain products only after some thorough screening tests.
  5. Compare company claims about their products’ potency with that of the third-party lab reports.
  6. Consulting with a trusted medical professional who is experienced in CBD use is ideal before purchasing any CBD product .

CBD Dosage For High Blood Pressure

In a 2019 review, Mayo Clinic suggests CBD dosages based on publications, scientific research, traditional use, and expert opinion (22 ) .

The doses and duration of treatment depend primarily on the illness. However, there is no specific dose recommended for high blood pressure.

Results of a 2017 study published in the Cannabis and Cannabinoid Research Journal provided evidence that a dosage of up to 1,500 mg of CBD a day is well-tolerated by humans (23 ) .

The authors of the study also found that at lower doses, CBD showed physiological effects that could potentially help promote and maintain health, including antioxidative, anti-inflammatory, and neuroprotection effects.

Following the dosing instructions on the CBD product of choice and starting with a low dose are the best course of action for those who would like to try CBD. Taking high doses at the beginning may bring about adverse reactions in the user.

As with any medication, the dose would depend on the metabolism, genetics, size, and body weight of a person.

How to Take CBD Oil for High Blood Pressure

There are various ways to consume CBD oil, and the delivery format would most likely depend on personal preferences and lifestyle.

CBD Oil Capsules and Edibles

CBD oil capsules and edibles, such as brownies, gummies, and lozenges, are a convenient and straightforward way to take CBD oil, especially for beginners.

This format is easy to work into a routine, and the dose is consistent. Depending on the metabolism of an individual, the effects can last between 6 and 12 hours. Thus, one dose is probably all that is needed during the day.

However, consuming CBD oil can delay its effects as it has to pass through the digestive system before it gets absorbed into the bloodstream. Given that the effects of the CBD oil could take at least 20 minutes to an hour to appear, CBD oil capsules and edibles do not provide immediate relief.

CBD Oil Tinctures or Drops

CBD oil tinctures or drops are a practical option for those who seek faster results and maximum dosage control.

Tinctures and drops are administered under the tongue, through which the CBD oil is absorbed directly into the bloodstream.

Place the desired quantity of drops under the tongue using a dropper, and then let the CBD oil stay in place for at least 60 seconds. Once 60 seconds have passed, swallow the CBD oil.

Sublingual application allows for results to be experienced within 30 to 60 minutes after its use, and the effects can be felt for 4 to 6 hours.

Since tinctures and drops are convenient and easy to store and travel with, they can be effortlessly administered when needed.

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However, one significant drawback to CBD oil tinctures and drops is the taste, as not everyone appreciates the natural, earthy, and sometimes bitter flavor of hemp.

Although some products come in various flavors to compensate for the unpleasant taste, the addition of sugar and chemicals may be something that one wants to avoid.

CBD Oil Vapes

CBD oil vapes are one of the accelerated ways to get CBD into the body since it enters the bloodstream through the lungs, without going through the digestive system.

When vaping CBD oil, effects can be felt in minutes. However, the effects last only for 30 minutes to an hour or two.

Also, with vaping, it is difficult to determine precisely how much CBD is in each draw. Although labels for CBD oil vape products usually indicate the amount per inhale, the amount may vary in individuals. Thus, getting the dose right requires a bit of experimentation at first.

Understanding High Blood Pressure

Blood pressure is influenced by how much blood the heart pumps, how hard it pumps, and the resistance to blood flow in the arteries.

According to Mayo Clinic, the higher the amount of blood the heart pumps and the narrower the arteries, the higher the blood pressure (24 ) .

The narrowing and blocking of blood vessels that is caused by high blood pressure, or hypertension, affects heart health by increasing the risk of developing heart failure.

What A Blood Pressure Reading Means

When the doctor measures blood pressure, the reading is given in two numbers. The first number, referred to as systolic blood pressure, is the pressure caused by the heart contracting and releasing blood. The second number, called diastolic blood pressure, is the pressure when the heart relaxes and fills with blood.

The blood pressure reading is given as the systolic blood pressure number over the diastolic blood pressure number, such as 135/70.

A normal blood pressure reading for adults is 120/80, according to the American Heart Association (AHA) (25 ) .

Are There High Blood Pressure Symptoms?

The American Heart Association (AHA) calls high blood pressure a “silent killer.” An individual can have high blood pressure for years without any indications (26 ) .

Most people with high blood pressure do not exhibit symptoms, even though blood pressure readings rise to critically-high levels.

Meanwhile, AHA says, some people with high blood pressure may experience shortness of breath, headaches, or nosebleeds. However, these symptoms are not specific and do not occur until high blood pressure has reached a life-threatening stage.

Still, even in the absence of symptoms, damage to the heart and blood vessels continues and can be detected, AHA says .

The agency warns that undetected or unregulated high blood pressure intensifies the risk of severe health problems, including strokes and heart attacks (27 ) .

High blood pressure typically develops over several years, and it eventually affects almost everyone (28 ) .

The National Institute on Aging (NIA) states that high blood pressure is a critical health issue that is typical among older people (29 ) .

Fortunately, it is not difficult to detect high blood pressure. One can work with a doctor to control the condition once diagnosed.

To learn more about the studies on blood pressure, go to ClinicalTrials.gov or PubMed.gov (30 ) .

Traditional Medications for High Blood Pressure

Doctors often prescribe one or more of the following pharmaceutical drugs to people dealing with high blood pressure (31 ) :

  • Diuretics, like Diuril and Lozol, increase urination which reduces sodium and fluid in the body. Because diuretics lower blood volume, they help lower blood pressure. However, one side effect of diuretics can be a loss of potassium, which is needed for proper muscular movement.
  • Angiotensin II receptor blockers (ARBs) like Diovan, which, as vasodilators, dilate blood vessels. Their potential side effects include skin rashes, swelling mouth, joint and back pain, flu-like symptoms, nausea, headaches, and diarrhea.
  • Metoprolol beta-blockers, like Toprol-XL and Lopressor, slow the heart rate. However, they can cause diarrhea, constipation, vomiting, fatigue, anxiety, depression, insomnia, shortness of breath, and decreased libido.
  • Angiotensin-converting enzyme (ACE) inhibitors like Vasoctec and Benazepril prevent the contraction of blood vessels. Some adverse side effects may include skin rash, swelling mouth, dry cough, headaches, dizziness, and diarrhea.

According to an article published in MedlinePlus by the U.S. National Library of Medicine, high blood pressure medicines may cause some common side effects, such as diarrhea or constipation, dizziness, erection problems, fatigue, nausea or vomiting, skin rash, and weight loss or gain without trying (32 ) .

Sometimes, a person may need to take more than one type of drug to manage blood pressure.

Although a single drug would often be used initially, two drugs could be started for stage 2 high blood pressure.

The AHA describes stage 2 hypertension as the stage when blood pressure consistently ranges at 140/90 mm Hg or higher (33 ) .

People taking medications for hypertension are also warned that mixing beta-blockers and angiotensin II receptor antagonists must only be done at the recommendation of a physician since the combination can lead to acute renal failure, as a 2013 study published in the Hypertension Research Journal suggests (34 ) .

Lifestyle Changes to Help Prevent High Blood Pressure

Using medications as prescribed and making lifestyle changes can enhance the quality of life and reduce the risk of hypertension, says the American Heart Association (AHA) (35 ) . These changes include:

  • Eating a healthy diet that is low in fat, cholesterol, and salt to prevent further plaque build-up in the arteries.
  • Exercising regularly to strengthen your heart. This activity could be something as simple as taking a 30-minute walk each day.
  • Engaging in activities that help manage stress, such as meditation, journaling, making art, and seeing a therapist.

What to Know About CBD Oil

CBD oil contains CBD , or cannabidiol , as its primary active ingredient. Cannabidiol is associated with the previously mentioned benefits, including controlling blood pressure.

Comparing CBD and THC

CBD comes from cannabis and is naturally found in hemp plants. CBD is one of more than 100 cannabinoids that occur naturally within the plant. This compound is also commonly used to produce CBD hemp oil supplements.

Hemp seed oil is produced by extracting the oil from the seeds of the hemp plant itself. This oil is abundant in nutrients, such as omega-3 and omega-6 fatty acids, making it ideal for digestion. Although some people refer to “hemp extract” as hemp oil, the term “hemp oil” is synonymous with the term “hemp seed oil.”

Chemical compounds in cannabis, called cannabinoids, have shown various potential benefits by activating the body’s endocannabinoid system (ECS), which is involved in regulating a variety of functions including sleep, appetite, pain and immune system response (36 ) .

The body produces endocannabinoids, which are neurotransmitters that bind to cannabinoid receptors in the nervous system.

The medicinal efficacy of cannabis can be optimized by incorporating the various cannabinoids, flavonoids, and terpenes that are intrinsic components of cannabis plants.

CBD is non-psychoactive, contrasting with THC (tetrahydrocannabinol), another primary cannabinoid. THC is the most significant factor contributing to the high associated with using cannabis.

Consuming CBD without any THC does not produce those effects, which means that nearly everyone should be able to function as they usually do when taking CBD.

The lack of high allows users to continue with work, school, and other commitments without a decrease in performance. It also makes CBD oil safe to take , even for those who must pass regular or random drug tests.

CBD oil must not contain any THC for CBD to be non-psychoactive. Products containing CBD isolates do not have THC, while full-spectrum CBD products do.

Any product that one buys should also state the percentage of THC, information which one can also get from its certificate of analysis.

Other Health Benefits of CBD Oil

Here are some of the more critical benefits associated with cannabidiol .

Treating Seizures

CBD can help treat some of the worst types of seizure disorders that exist, including Lennox-Gastaut syndrome and Dravet syndrome, both of which affect children and do not typically respond to traditional medications for treating seizures (37 ) .

Even the U.S. Food and Drug Administration (FDA) recognizes the ability of CBD to treat seizure disorders (38 ) . The first cannabis-derived medication it approved is Epidiolex, which treats these conditions. That medication contains CBD.

Treating Anxiety Disorders and Depression

Those who suffer from anxiety may experience relief with CBD. Results from a 2019 study published in the Brazilian Journal of Psychiatry showed CBD’s anxiolytic effect on public speaking, and there is plenty of anecdotal evidence (39 ) .

In another study , which was published in the Journal of the American College of Cardiology , CBD was shown to attenuate oxidative stress, as well as cardiac dysfunction, fibrosis, and cell death in a mouse model (40 ) .

Treating Pain

One of the most popular uses of CBD oil is its ability to reduce chronic pain . Animal studies, like the study published in the European Journal of Pain in 2016, show that topically applied CBD may theoretically help provide pain relief and reduce inflammation from arthritis (41 ) .

In another study published in the Journal of Experimental Medicine , CBD was shown to reduce neuropathic pain (42 ) . This finding is crucial as it is one of the hardest types of pain to treat.

Some countries approve oral sprays like Sativex, which contains both CBD and THC (43 ) . This spray effectively treats the pain associated with multiple sclerosis (MS), a potentially disabling disease of the brain and spinal cord (central nervous system).

However, as Sativex and certain medications may trigger a drug interaction, experts advise consulting with a doctor first about all the prescription, over-the-counter (non-prescription), and herbal medications that are being taken before starting to use Sativex oral spray.

Protecting the Brain

CBD research , conducted on animal models and humans and published in the Surgical Neurology International in 2018, has shown numerous therapeutic properties for brain function and protection, both by its effect on the endocannabinoid system directly and by influencing endogenous cannabinoids (44 ) .

Researchers in a study published in the Journal of Psychopharmacology noted a possible effect of CBD in improving the quality of life in patients with Parkinson’s disease without adverse outcomes (45 ) .

Studies analyzed in a 2017 review conducted by experts from the Western Sydney University in Australia also provided proof of principle for the therapeutic benefits that CBD and possibly CBD-THC combinations may provide (46 ) .

Data suggest that these combinations may help with the therapy of Alzheimer’s disease (named after Dr. Alois Alzheimer, who noted the symptoms in 1906).

May Help Fight Cancer

A 2010 study published by the American Association for Cancer Research showed a CBD-induced cell death of breast cancer cells, suggesting that the use of CBD oil may also suppress tumor growth (47 ) .

Research on cannabinoids published in the Future Medicinal Chemistry demonstrates that cannabinoids may also prove beneficial in certain types of cancers that are activated by chronic inflammation (48 ) .

In such instances, cannabinoids, as anti-inflammatory agents, can either directly prevent tumor growth or suppress inflammation .

Meanwhile, in-depth research on CBD yields mixed results.

In a recent study published in the Bosnian Journal of Basic Medical Sciences , researchers recognized the antitumor effects of cannabinoids in various cancer types (49 ) .

However, these antitumor effects of cannabinoids have to prevail over their known immunosuppressive effects, which can potentially promote the production or formation of tumors.

Recent studies are still limited when it comes to CBD and cancer prevention. Longitudinal studies of humans using specific CBD products, controlling for frequency of use and dosing are needed.

Overcoming Substance Abuse

There is some evidence that using CBD may help those with addiction overcome their substance abuse.

Published in the Journal of Substance Abuse Treatment , results from a 2015 study conducted on animal models showed CBD reduced heroin-seeking behavior and reduced morphine dependence (50 ) .

The Legality of CBD Oil

The Cannabis sativa plant produces both hemp and marijuana. The difference between the two plants is the percentage of THC that they contain.

A cannabis plant that has 0.3 percent or less of THC content classifies as hemp, while a cannabis plant containing over 0.3 percent of THC is considered marijuana.

In the United States, cannabis-related laws are continually changing. Since marijuana and THC are on the list of controlled substances, they are currently prohibited under federal law (51 ) .

Meanwhile, confusion arises due to regulations that vary depending on whether the CBD is hemp-derived or extracted from marijuana. The former is legal at the federal level, while the latter is not.

Many states and Washington, D.C. have passed cannabis-related laws, making medical marijuana with high levels of THC legal. Still, marijuana may require a prescription from a licensed physician (52 ) .

Also, several states have made recreational use of marijuana and THC legal. One should be able to buy CBD in states where marijuana is legal for recreational or medical purposes.

NORML has information regarding state laws and penalties. (53 ) .

Individuals who possess cannabis-related products in a state where they are illegal or do not have a medical prescription in states where the products are legal for medical treatment could face legal penalties.

For a complete list of legal medical marijuana states and D.C., including the corresponding laws, fees, and possession limits, visit ProCon.org (54 ) .

Conclusion

According to the Centers for Disease Control and Prevention (CDC), about 75 million American adults, or 1 in 3 adults, have high blood pressure (55 ) . People with high blood pressure have a greater risk of heart disease and stroke, the leading causes of death in the United States.

CBD oil has shown to be a natural remedy to issues that could be linked to high blood pressure, such as stress and p a in (56) .

Meanwhile, using medications as prescribed and making lifestyle changes can enhance the quality of life and reduce the risk of hypertension, says the American Heart Association (AHA) (57 ) .

Still, before experimenting with different CBD products and dosages, speak to a doctor about a CBD treatment or using CBD oil for treating high blood pressure.

For anyone still looking for more information on CBD as a medical supplement, speaking with a cannabis doctor who specializes in the subject is the best course of action.

There is a wide range of products to choose from for those who are ready to decide which product and how they would like to take CBD oil to either address medical conditions or maintain general well-being.

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