Evidence based

CBD and Atherosclerosis: Current Research & Understanding

Atherosclerosis involves inflammation and hardening of the arteries, leading to heart disease. Heart disease is one of the leading causes of death. How can CBD be used to relieve the symptoms?

Article By
Justin Cooke , posted 1 month ago

According to the World Health Organization, cardiovascular disease has been the leading cause of death in the developed world for the last 15 years running.

Atherosclerosis — pathological hardening of the arteries — is one of the primary causes of cardiovascular disease.

CBD is quickly becoming a popular treatment option for this condition due to the connection between the endocannabinoid system and the cardiovascular system.

So, does CBD prevent atherosclerosis? How does it work? What does the research say?

Let’s get straight into it.

  • Table of Contents

Summary: CBD for Atherosclerosis

CBD offers powerful benefits for people with atherosclerosis because of its anti-inflammatory profile.

This is because atherosclerosis itself is an inflammatory disease. The inside layers of the arterial system become damaged and inflamed, and long-term inflammation will change the architecture of the arteries.

If these changes go on for too long, they become permanent. Therefore, stopping or slowing the process early is important for achieving the best results.

There are six primary underlying causes of atherosclerosis:

  1. High blood sugar [7]
  2. Obesity [7]
  3. Chronic inflammation [8]
  4. High blood lipid levels [1]
  5. High blood pressure [1]
  6. Oxidative damage [12]

All of these underlying causes are intimately connected — as one gets worse, the others follow. Treating the condition involves targeting all of these symptoms simultaneously. CBD offers an interesting treatment option for this condition because it exerts beneficial effects on all of the symptoms — both directly and indirectly [13].

CBD offers benefits for people with atherosclerosis in the following ways:

  1. Stabilizes blood sugar levels [9]
  2. Promotes weight loss [9]
  3. Stops inflammation [2]
  4. Lowers blood pressure [12]
  5. Protects the arteries from oxidative stress [16]

Treating atherosclerosis relies on multiple different organ systems. Trying to stop the progression of the disease through just one of these pathways is likely to fail. The most successful treatments come from multi-faceted approaches.

Compounds in the cannabis plant — including both THC and CBD — offer excellent treatment options for the condition. They target multiple causes of the condition at the same time.

Tips for getting the best results from CBD:

  1. Use a full-spectrum extract
  2. Long-term CBD use produces the best results
  3. Dietary and lifestyle changes should also be made
  4. Discuss CBD use with your doctor to avoid drug interactions
  5. Use oral CBD only — avoid smoking at all costs

What is Atherosclerosis?

Atherosclerosis involves a gradual buildup of fatty deposits, calcium, cholesterol, and coagulated red blood cells on the walls of the arteries. Over time, these plaques oxidize and harden — causing blockages and reduced blood flow.

Atherosclerosis develops gradually over many years. It can eventually lead to heart attacks, stroke, and death.

There are three important changes that happen as atherosclerosis develops [6]:

  1. Loss of flexibility of the arterial walls due to cholesterol and cartilage buildups (atherosclerosis)
  2. Cracks begin forming in the artery walls (atherosclerosis)
  3. Immune cells begin accumulating in damaged areas of the arteries — further increasing inflammation

What Causes Atherosclerosis?

Atherosclerosis doesn’t have just one cause — it’s a combination of factors involving dietary choices, lifestyle habits (such as lack of exercise or smoking), and genetic factors.

There are some key genetic markers that doctors use to assess the likelihood that someone will develop atherosclerosis. These genes are involved in regulating fat metabolism, cholesterol production, and blood sugar regulation.

There are several theories around how atherosclerosis develops, and researchers are still working to understand this process in more detail.

The main theory is that oxidative damage caused by high blood sugar, smoking, and low antioxidant consumption leads to damage in the arterial walls. Over time, the arteries become more rigid, leading to ruptures in the arterial walls from the force generated from the heart.

Cholesterol is deposited into these ruptures as the body tries to heal the damage, which can build up over time. Blood clots and calcium deposits start to accumulate on these cholesterol plaques, causing the arteries to narrow.

Causes of Atherosclerosis

  • High blood lipid levels (hyperlipidemia)
  • Diabetes and hyperinsulinemia (insulin resistance)
  • High blood pressure (hypertension)
  • Obesity
  • Smoking
  • Genetic predisposition
  • Clotting disorders
  • High trans fat consumption
  • Age
  • Lack of physical activity

Using CBD for Atherosclerosis: How Does It Work?

CBD offers several benefits for people with atherosclerosis — it provides antioxidant support, reduces inflammation of the arterial walls, supports liver function to lower cholesterol levels, and regulates blood sugar levels. It also supports the endocannabinoid system, which is a key player in the regulation of homeostasis throughout the body — including the cardiovascular system.

All of these actions combine to exert beneficial effects on the cardiovascular system and slow the progression of atherosclerosis.

There are two types of endocannabinoid receptors involved with the cardiovascular system that we need to be aware of [2].

CBD and the Endocannabinoid System

The endocannabinoid system is a collection of similar receptors found throughout the body. This system is very complex and plays a role in many different organ functions.

There are two main endocannabinoids in the body that regulate these effects.

The Endocannabinoids

1. Anandamide

Anandamide activates the endocannabinoid receptors. It’s manufactured by an enzyme known as NAPE-selective phospholipase D (PLD) and is broken down by another enzyme known as fatty acid amide hydrolase (FAAH) [4]

This is important because most of CBD’s effects on the endocannabinoid system come from its ability to inhibit FAAH — and this prevents the breakdown of anandamide.

2. 2-AG

2-AG has very similar effects to CBD. It’s used to regulate anandamide levels by controlling how fast it breaks down.

This endocannabinoid is manufactured by the enzyme sn-1-specific diacylglycerol lipase (DAGL) and broken down by FAAH, just like anandamide [4].

The Endocannabinoid Receptors and Atherosclerosis

1. CB1 Receptors

CBD doesn’t bind to the CB1 receptors directly — instead, it prevents the breakdown of our primary endocannabinoid, anandamide, which is what goes on to activate these receptors.

The CB1 receptors are primarily found in the central nervous system but are also found in other areas of the body. Blocking these receptors decreases appetite, stabilizes blood sugar, and reduces inflammation [9].

2. CB2 Receptors

Similar to the CB1 receptors, CBD doesn’t directly bind to the CB2 receptors. Instead, it increases levels of anandamide, which is the primary regulator of CB2 receptor activity.

The CB2 receptors are primarily found in immune tissues but are also located throughout the body and brain. These receptors regulate immune activity and support the function of organs such as the pancreas, spleen, and liver — all of which are implicated in the processes driving atherosclerosis.

CBD and Non-Cannabinoid Receptors

CBD doesn’t only interact with the endocannabinoid system — it’s also involved with pain receptors, serotonin receptors, and adenosine receptors. Each of these effects leads to an overall benefit for people with atherosclerosis.

Receptors Affected by CBD and Their Effects on Atherosclerosis

Receptor NameEffectEffect on AtherosclerosisReference
Adenosine (A2)Inhibits reuptakeLowers blood pressure and improves heart contractility3
Vanilloid pain receptors (TRPV1, TRPV2, TRPV3)StimulatesLowers blood pressure5
5HT1A receptors (Serotonin)InhibitsReduces appetite to promote weight loss and regulate blood sugar levels3
FAAHInhibitsIncreases anandamide and 2-AG4
µ opioid receptorsStimulatesReduces atherosclerotic pain17
PPARγStimulatesRegulates blood sugar and fat metabolism11

What Does the Research Say?

In animal studies, prevention of anandamide breakdown leads to a decrease in blood pressure, heart rate, and vascular resistance (a metric of arterial rigidity) [10].

A review article investigated how CBD and THC are effective at reducing the pathological processes underlying atherosclerosis. Researchers in this study reported that the primary benefits come from THC and its activity on the CB2 receptors associated with the immune system (aka the anti-inflammatory benefits) [1].

(Image Source: Mach & Stevens., 2008 [2])

The dose of CBD can vary significantly from one person to the next, so it’s important to start small and build up gradually over time to see how it affects you individually.

Animal studies showed that low-dose cannabinoid supplementation (1 mg/kg per day) resulted in a significant decrease in the progression of atherosclerosis [18].

This dose lands somewhere between the medium and high-strength dosages listed below.

For atherosclerosis, we recommend starting at the low-strength dose (according to your weight) and building up slowly to the medium or high dose. It’s important to keep taking this dose every day for maximum benefits. Atherosclerosis is a progressive disease, taking many years to develop. Prevention of the disease, therefore, needs to continue for many years to be effective.

Daily Doses of CBD by Weight and Strength (in mg)

Weight (lbs)Low StrengthMedium StrengthHigh Strength

100 lbs

10 mg

30 mg

60 mg

125 lbs

13 mg

38 mg

75 mg

150 lbs

15 mg

45 mg

90 mg

175 lbs

17 mg

52 mg

105 mg

200 lbs

20 mg

60 mg

120 mg

225 lbs

22 mg

67 mg

135 mg

250 lbs

25 mg

75 mg

150 mg

The Takeaway: CBD for Atherosclerosis

Atherosclerosis is a chronic condition with serious health consequences. The condition involves inflammation and gradual hardening of the arteries around the body. Over long periods of time, this can result in high blood pressure and the buildup of cholesterol plaques that can cause a heart attack or stroke.

CBD is a useful health supplement for atherosclerosis through its anti-inflammatory, blood glucose stabilizing, and protective antioxidant effects on the cardiovascular system. It’s useful for addressing some of the primary causes of atherosclerosis — such as insulin resistance/diabetes, fatty liver disease, obesity, and high blood pressure. These effects give CBD mechanisms to slow the progression of the disease over long periods of time (months to years).

Whenever taking any supplement or medication for atheroslcerosis it’s important to remember these key points:

  • Always discuss your supplements with your doctor
  • Always follow dietary and lifestyle changes on top of CBD supplementation — these changes are going to offer the biggest impact on the condition
  • Make sure to take the right dose of CBD (avoid drop-dosing)
  • Be patient — CBD can take several weeks, months, or even years to show signs of improvement on atherosclerosis
  • Seek out high-quality CBD products only — low-quality options often contain harmful contaminants that can make the condition worse

References

  1. Mach, F., & Steffens, S. (2008). The role of the endocannabinoid system in atherosclerosis. Journal of neuroendocrinology, 20, 53-57.
  2. Klein, T. W., Newton, C., Larsen, K., Lu, L., Perkins, I., Nong, L., & Friedman, H. (2003). The cannabinoid system and immune modulation. Journal of leukocyte biology, 74(4), 486-496.
  3. Nelson, K., Walsh, D., Deeter, P., & Sheehan, F. (1994). A phase II study of delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. Journal of palliative care.
  4. Petrocellis, L. D., Cascio, M. G., & Marzo, V. D. (2004). The endocannabinoid system: a general view and latest additions. British journal of pharmacology, 141(5), 765-774.
  5. Bisogno, T., Hanuš, L., De Petrocellis, L., Tchilibon, S., Ponde, D. E., Brandi, I., … & Di Marzo, V. (2001). Molecular targets for cannabidiol and its synthetic analogues: effect on vanilloid VR1 receptors and on the cellular uptake and enzymatic hydrolysis of anandamide. British journal of pharmacology, 134(4), 845-852.
  6. Glass, C. K., & Witztum, J. L. (2001). Atherosclerosis: the road ahead. Cell, 104(4), 503-516.
  7. Grundy, S. M. (2004). Obesity, metabolic syndrome, and cardiovascular disease. The Journal of Clinical Endocrinology & Metabolism, 89(6), 2595-2600.
  8. Hansson, G. K., & Libby, P. (2006). The immune response in atherosclerosis: a double-edged sword. Nature reviews immunology, 6(7), 508.
  9. Matias, I., & Di Marzo, V. (2007). Endocannabinoids and the control of energy balance. Trends in Endocrinology & Metabolism, 18(1), 27-37.
  10. Bátkai, S., Pacher, P., Osei-Hyiaman, D., Radaeva, S., Liu, J., Harvey-White, J., … & Kunos, G. (2004). Endocannabinoids acting at cannabinoid-1 receptors regulate cardiovascular function in hypertension. Circulation, 110(14), 1996-2002.
  11. O’sullivan, S. E., Sun, Y., Bennett, A. J., Randall, M. D., & Kendall, D. A. (2009). Time-dependent vascular actions of cannabidiol in the rat aorta. European journal of pharmacology, 612(1-3), 61-68.
  12. Stanley, C. P., Hind, W. H., & O’sullivan, S. E. (2013). Is the cardiovascular system a therapeutic target for cannabidiol?. British journal of clinical pharmacology, 75(2), 313-322.
  13. Singla, S., Sachdeva, R., & Mehta, J. L. (2012). Cannabinoids and atherosclerotic coronary heart disease. Clinical cardiology, 35(6), 329-335.
  14. Peng, J., & Li, Y. J. (2010). The vanilloid receptor TRPV1: role in cardiovascular and gastrointestinal protection. European journal of pharmacology, 627(1-3), 1-7.
  15. Shryock, J. C., & Belardinelli, L. (1997). Adenosine and adenosine receptors in the cardiovascular system: biochemistry, physiology, and pharmacology. The American journal of cardiology, 79(12), 2-10.
  16. Booz, G. W. (2011). Cannabidiol as an emergent therapeutic strategy for lessening the impact of inflammation on oxidative stress. Free Radical Biology and Medicine, 51(5), 1054-1061.
  17. Kathmann, M., Flau, K., Redmer, A., Tränkle, C., & Schlicker, E. (2006). Cannabidiol is an allosteric modulator at mu-and delta-opioid receptors. Naunyn-Schmiedeberg’s archives of pharmacology, 372(5), 354-361.
  18. Steffens, S., Veillard, N. R., Arnaud, C., Pelli, G., Burger, F., Staub, C., … & Mach, F. (2005). Low dose oral cannabinoid therapy reduces progression of atherosclerosis in mice. Nature, 434(7034), 782.

Conditions that May Respond to Cannabidiol