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By Miguel Ordoñez


The cardiovascular system plays vital roles in the body. Comprising the heart, lungs, and blood vessels, this system is responsible for the critical task of transporting nutrients, hormones, and oxygen to cells via the bloodstream. It also disposes of waste products via the same mechanisms, such as carbon dioxide and nitrogenous waste.

Given the importance of the cardiovascular system, it will come as no surprise that any malfunctioning or disorder could have catastrophic consequences. Unfortunately, that's the reality facing millions of people worldwide.

Follow along as we explore the details surrounding cardiovascular disease, and see if CBD presents any avenues for addressing this global health issue.

What Is Cardiovascular Disease (CVD)?

Cardiovascular disease is the leading cause of death worldwide. Conditions within this category include:

Chronic rheumatic heart diseases Hypertension
Coronary heart disease Stroke
Diseases of the arteries, arterioles, and capillaries

There are numerous causes of cardiovascular diseases, but lifestyle is a major factor. This is somewhat of a blessing and a curse. On the one hand, changes to diet, exercise, and tobacco use can significantly improve quality of life. However, the caveat is that of the 17.9 million people affected by CVD in 2019[1], many cases were preventable.

  • Are Cardiovascular Disease and Heart Disease the Same?

It's a common question, but one worth clarifying. When we talk about cardiovascular disease, we refer to several conditions affecting the heart (cardio) and the blood vessels (vascular). Heart disease focuses specifically on heart conditions such as coronary heart disease, heart arrhythmia, and congenital heart disease.

Of course, given how closely linked these systems are, it's common to see overlap, with conditions that technically fall under both categories. The simplest explanation is that all heart diseases fall under the umbrella of cardiovascular disease, while not all cardiovascular diseases affect the heart.

What Is Cardiovascular Disease (CVD)?

Types of Cardiovascular Disease

We briefly mentioned several of the conditions under the cardiovascular disease umbrella, but given the prevalence and severity of CVD, it's worth taking a closer look. Highlighting critical diseases and their symptoms will also help us better understand the role of the endocannabinoid system, and why researchers are looking at the impact of compounds like CBD.

Common cardiovascular disorders include:

Deep vein thrombosis Affecting veins in the lower leg, thigh, and pelvis, deep vein thrombosis (DVT) is a blood clot that can be very dangerous if left untreated. Symptoms typically manifest as swelling, throbbing, and red or darkened skin (in the affected area).
Rheumatic fever Fortunately, rheumatic fever is rare, only developing due to complications of bacterial throat infections. Symptoms include higher heart rate, breathlessness, and swelling of the joints.
Coronary heart
disease
Mostly the result of lifestyle choices, coronary heart disease (CAD) occurs when fatty deposits block or limit blood flow in the heart's main arteries. Symptoms start as chest pains (angina), shortness of breath, and nausea, but can quickly worsen.
Peripheral arterial disease Similar to CAD, peripheral arterial disease occurs because of blocked arteries, this time in leg muscles, rather than the heart. Symptoms centre in and around the legs, and include loss of hair, wasting muscles, and numbness.
Heart attack and stroke Left unchecked, many of the conditions highlighted above will ultimately lead to a heart attack or stroke. The former occurs from a lack of blood supply to the heart, while the latter is when blood cannot reach your brain. Strokes are also caused by burst blood vessels.

Traditional Treatment of Cardiovascular Disease

It depends on the severity of the condition, but much of the focus for CVD treatment is lifestyle adjustments. Not only are these a great way to prevent disease in the first place, but they can help to rehabilitate patients.

  • Lifestyle changes: Regular exercise, changes to diet, and a balanced approach to alcohol can significantly change CVD severity. In fact, it's thought that most cases of cardiovascular disease could be avoided by addressing what the World Health Organization calls "behavioural risk factors".
  • Medical intervention: For more severe instances of CVD, doctors usually prescribe medication and surgery. Both focus on improving blood flow, restoring a regular heartbeat, and repairing damaged valves or arteries.

Understanding the Role of the ECS in Cardiovascular Disease

It's now time to dive into the role of the endocannabinoid system in heart health[2]. Research is ongoing, but from what is understood so far, the ECS plays a supportive role in heart health, stepping in when it detects a stressed or unbalanced state. It does this using a combination of CB receptors, endocannabinoids (internally produced compounds similar to the cannabinoids found in cannabis) and non-CB receptors.

  • Cannabinoid Receptors

Starting with cannabinoid receptors, there are two main types, CB1 and CB2. Both exist all over the body, but for the heart, we're primarily interested in CB2 receptors. Animal studies[3] suggest that activation of CB2 receptors may influence cases of atherosclerosis and ischemia.

  • Endocannabinoids

Then, there's the proposed role of endocannabinoids, most notably anandamide (AEA). Things get a little more complex here, as scientists still aren't sure which receptor(s) anandamide acts upon. What they have found, however, is that anandamide may play a part in the relaxation of arteries and other aspects of cardiovascular disease, according to a 2001 study from the University of Cambridge[4].

If anandamide could prove helpful to heart health, there's a catch—the endocannabinoid doesn't hang around for long. Unfortunately, a naturally occurring enzyme called FAAH inhibits AEA production, breaking it down into two smaller metabolites.

CBD and Cardiovascular Health

The quest to overcome the interaction between anandamide and FAAH has led researchers to CBD. It appears that cannabidiol may inhibit FAAH[5], subsequently raising levels of anandamide inside the body. Given the current understanding of anandamide in heart health, this could prove a useful interaction. Still, as we pointed out, there are several “potential” mechanisms of action, and much more research is needed to verify any findings.

Then, there's the balancing influence of CBD on the endocannabinoid system as a whole. You see, cannabidiol differs from compounds like THC or CBN in that it doesn’t have much of an affinity with CB receptors. Instead, CBD appears to take a behind-the-scenes role, bolstering the regular function of the ECS.

With that in mind, it’s clear to see why scientists are keen to explore the influence of CBD[6]. A properly functioning endocannabinoid system could prove pivotal to advancing our understanding of alternative cardiovascular disease treatments.

CBD and Cardiovascular Health
  • What Are the Risks of CBD?

Some research into the impact of CBD on conditions such as hypertension[7] and cardiac arrhythmia[8] has taken place. But here is where we encourage caution on the topic. One relevant study used a tiny sample size, while another was examining an animal model.

Because it's too early to talk about practical application, it's also premature to say that there aren't any risks. The honest answer is that we just don't know either way. We've previously explored the prospect of cannabis, CBD, and THC on hypertension, but it's important to remember that decreasing heart rate is a double-edged sword. Lower heart rate in healthy individuals is generally a good thing, but if your heart rate is already low, the potential for heart palpitations or arrhythmia becomes greater.

The final watch-out with CBD is its potential interaction with certain medications. Earlier, we highlighted how prescription medication is often used to treat cases of CVD. For alternative treatments to be effective, they would need to work alongside existing therapies, and there are still a lot of variables to explore in this regard.

Is the Cardiovascular System a Target for CBD?

There's a lot to unpack with CBD and the cardiovascular system, so it's worth recapping the ground we've covered. Cardiovascular disease is a prevalent problem affecting millions of people worldwide—the need for effective treatments is a top priority. The difficulty, of course, is that the cardiovascular system comprises several different parts of the body, which makes understanding every possible interaction challenging.

Underpinning the cardiovascular system is the endocannabinoid system, a regulatory network that helps to balance the body's needs. Researchers believe that the ECS could play a crucial role in heart health, so exploring its full potential is vital. This brings us nicely to CBD, a compound found in cannabis and hemp that may improve the functionality of the ECS. There's still plenty of dots to connect, but the good news is, researchers remain hopeful on the relationship between CBD and cardiovascular disease.

External Resources:
  1. Cardiovascular diseases (CVDs) https://www.who.int
  2. Endocannabinoids and the Heart https://www.ncbi.nlm.nih.gov
  3. The Endocannabinoid System and Heart Disease: The Role of Cannabinoid Receptor Type 2 https://www.ncbi.nlm.nih.gov
  4. Mechanisms of anandamide-induced vasorelaxation in rat isolated coronary arteries https://www.ncbi.nlm.nih.gov
  5. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia | Translational Psychiatry https://www.nature.com
  6. Is the cardiovascular system a therapeutic target for cannabidiol? https://www.ncbi.nlm.nih.gov
  7. A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study https://www.ncbi.nlm.nih.gov
  8. Acute administration of cannabidiol in vivo suppresses ischaemia-induced cardiac arrhythmias and reduces infarct size when given at reperfusion https://www.ncbi.nlm.nih.gov
Disclaimer:
This content is for educational purposes only. The information provided is derived from research gathered from external sources.