Blood Pressure Medication and CBD Oil Interaction
Written by Jason Brett — Edited by Cathy Rozyczko on February 9, 2021
A growing number of Americans are turning to cannabidiol (CBD) to address a wide range of concerns from stress and anxiety, to pain and inflammation. But, with so many people using CBD oil, questions start to arise about potential interactions with common prescriptions, including blood pressure medications.
If you rely on blood pressure medication and want to use CBD oil as an alternative or supplement to your current treatment plan, here is an overview of everything you need to know about using CBD oil while taking blood pressure medications.
CBD Oil and Blood Pressure Medication Interaction
Because there are such a wide range of pharmaceuticals prescribed for lowering blood pressure, it’s impossible to speak in broad terms about how CBD oil interacts with them all. However, if you’re taking one of the more common medications for hypertension (valsartan, metoprolol beta blocker, lisinopril, amlodipine besylate, or hydrochlorothiazide), there are a few things you should take into consideration before using cannabidiol oil.
CBD oil is generally recognized as a safe and well-tolerated compound with little to no known side effects. However, while conclusive studies have not been published, it has been suggested that CBD oil may affect the efficacy of blood pressure medication in controlling hypertension. Conversely, blood pressure medication is also believed to potentially reduce the efficacy of CBD oil.
Furthermore, because cannabidiol is an inhibitor of the cytochrome P-450 enzyme system , CBD oil should be used cautiously when combined with medications that use this pathway; in the case of high blood pressure medications, metoprolol and amlodipine besylate specifically.
The cytochrome P-450 system is comprised of liver enzymes that break down medications into smaller substances that the body can more easily process. Cannabidiol and other natural substances like grapefruit slow down this pathway. This may cause medications that rely on the P-450 system, including metoprolol and amlodipine besylate, to remain for longer periods in the system and increase the likelihood that you experience their adverse side effects.
Side Effects of Using CBD Oil and Blood Pressure Medication
While adverse interactions between CBD oil and blood pressure medication are rare, they should be combined with caution and only under doctor supervision. In some cases, blood pressure medications may delay and/or reduce the beneficial effects of CBD oil. In others, CBD oil may delay and/or reduce the effectiveness of your prescribed blood pressure medication.
For reference, this table breaks down a few of the more common blood pressure medications and the side effects you may feel if taking them in conjunction with CBD oil.
|Generic Name (Brand Name)||Possible Side Effects of Combining Medication + CBD Oil|
|Valsartan (Diovan)||CBD oil may be metabolized slower when used in conjunction with Valsartan|
|Metoprolol (Lopressor; Toprol XL)||The antihypertensive function of Metoprolol may be decreased when combined with CBD oil|
|Lisinopril (Prinivil; Zestril)||The antihypertensive function of Lisinopril may be decreased when combined with CBD oil|
|Amlodipine besylate (Norvasc)||CBD oil may be metabolized slower when used in conjunction with Amlodipine besylate|
|Hydrochlorothiazide (HCTZ)||The antihypertensive function of Hydrochlorothiazide may be decreased when combined with CBD oil|
Another important thing to note is that since CBD oil reduces blood pressure on its own, when it is taken in tandem with medication designed to perform the same action, you essentially have two compounds bringing down your levels. If your blood pressure is reduced too much in a short amount of time, you may feel weak and lethargic. It is for this reason that starting with a small initial dosage of CBD is key.
Avoiding the Side Effects
With the above possible side effects in mind, you may feel dissuaded from trying CBD oil while on blood pressure medication. On the other hand, you might also consider using CBD oil on its own to manage hypertension. Amongst other benefits, CBD oil has been shown to reduce blood pressure by relieving anxiety, reducing stress, and widening blood vessels.
CBD oil’s anti-anxiety and stress-relieving properties encourage a lower heart rate, which ultimately reduces blood pressure. CBD oil’s ability to dilate blood vessels allows for easier blood flow in arteries with plaque build-up, which also reduces the symptoms of hypertension. In fact, a 2017 study found that a single dose of cannabidiol significantly lowered the blood pressure of test subjects both when at rest and in stressful conditions.
In a cumulative 2017 review of numerous studies on cannabidiol’s effect on blood flow, it was concluding that “ CBD may be used as a treatment for various cardiovascular disorders, such as hypertension, myocardial infarction, and stroke.” It is important to mention that the majority of these results were found in animal studies and more clinical research is needed in humans. Still, the findings are promising.
How to Safely Use CBD Oil and Blood Pressure Medication Together
Whether your goal is to supplement your current hypertension treatment plan with CBD oil, or to completely replace your blood pressure medication with CBD oil, you should begin by speaking with your doctor . Because CBD oil can interact with your current blood pressure medications, consulting with your physician on the possible risks—and benefits—is crucial for your safety and health.
You will want to be conscientious of dosage especially since CBD oil may amplify the effects of the medications you’re taking. CBD products generally come with an information leaflet that provides a recommended dosage, but you may want to start with an amount lower than what is recommended and gradually increase your dosage over time as needed. This will allow your body to build a tolerance to CBD oil and reduce the risk of having a sudden drop in your blood pressure.
For more information on proper CBD oil dosage, check out our dosage guide here .
Over a period of time, you may even find you are able to lower the dosage of your blood pressure medication as the CBD oil becomes most effective. If you choose to do this, speak to your doctor before discontinuing or altering your prescription medication. Any changes to your treatment plan are best done under the supervision and guidance of a medical professional.
If you’re still in need of guidance or would like more information on using CBD oil as a medical supplement, consider speaking with a naturopathic doctor who specializes in natural health treatments.
Best CBD Oil to Use with Blood Pressure Medication
In order to find the best CBD oil product, you need to know what you’re looking for. With thousands of products available online and in stores, how do you know where to start?
First, investigate the different CBD oil delivery formats to decide which one best fits your goals and lifestyle. CBD oil drops, edibles , capsules, and vapes a few of the more common options.
While the majority of people new to CBD oil opt for capsules and edibles because of their convenience and familiarity, it is worth keeping in mind that these will enter your body through the digestive system and therefore lose some potency and take longer before you feel the effects. Inhalants or sublingual drops meanwhile, allow the CBD oil to enter the bloodstream more readily, providing quick and effective results. Experiment with the different delivery methods to decide which works best for your needs and lifestyle.
Once you have decided on your preferred delivery format, look for top-rated CBD oil products that are sustainably sourced, organically grown, and third-party lab tested to ensure quality and purity. Taking these steps is the best way to ensure that your CBD oil product is free from any harmful pesticides, herbicides, and added chemicals.
And when you’re ready to shop, check out our list of the Top 10 Best CBD Products to Buy.
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Can CBD oil help treat hypertension? And is it safe to take with existing blood pressure medications?
Does CBD Oil Lower Blood Pressure? What the Research Says
With stress in the U.S. on the rise, it’s no wonder more than half of Americans suffer from high blood pressure.
CBD oil has been hailed as a cure-all for a variety of conditions, but what do researchers have to say about CBD oil and blood pressure?
Does CBD oil lower blood pressure, or is it an unfounded claim? Is it possible to skip the burdensome doctors’ visits and expensive trips to the pharmacy?
We wouldn’t go that far. Hypertension is a risk factor in heart attack, stroke and type 2 diabetes. Even though it’s common, it’s a serious issue which require medical attention.
However, there are many steps you can take to naturally reduce your blood pressure, one of which may be by using CBD oil for hypertension.
What is Hypertension?
Hypertension is the medical term for high blood pressure. As blood is pumped through your blood vessels, they undergo a degree of force. If you have high blood pressure, this force can damage the walls of your blood vessels, veins and arteries.
When you visit the doctor, you’ll usually hear your blood pressure described by two numbers, like 120/70.
The first number refers to the systolic pressure, the pressure exerted when the heart contracts and pumps blood into the arteries. The second is the diastolic pressure, measured when the heart muscle relaxes between beats. In cardiology, a systolic pressure of 140, and/or a diastolic pressure of 90, is considered the boundary between normal and high blood pressure.
High blood pressure can lead to cardiovascular complications such as heart disease, heart attack, stroke, aneurysm and heart failure. The condition is exacerbated by type 2 diabetes, stress, anxiety, inflammation, high cholesterol levels, insomnia, a diet high in salt, and alcohol and tobacco use.
Lowering High Blood Pressure: CBD and Blood Pressure
High blood pressure can be naturally lowered by reducing stress, salt intake, and consumption of alcohol and tobacco. You can also lower your blood pressure by exercising regularly and eating more fruits and vegetables.
Your doctor may prescribe medications that can lower blood pressure. Many of these medications, such as calcium channel blockers and ACE-inhibitors, cause side effects like headaches, dizziness, constipation and swollen ankles. That has naturally sparked interest in non-prescription treatments for high blood pressure.
New evidence links CBD to a decrease in blood pressure. For many people, CBD oil has fewer side effects than prescription medications, too.
We spoke with Rebecca Park, registered nurse and founder of RemediesForMe.com, who told us that CBD oil tinctures made using hemp have very few side effects and are generally well tolerated.
If you are already on high blood pressure medications, however, consult your physician before using CBD oil as there may be interactions.
What is CBD Oil?
Cannabidiol, better known as CBD, is a non-psychoactive phytocannabinoid, which is a cannabinoid found in the two forms of cannabis, marijuana and hemp plants.
Commercially-available CBD oil is cannabidiol extracted from the hemp plant, often mixed with coconut or hemp oil. Unlike its marijuana-derived counterpart, this CBD oil does not contain high levels of tetrahydrocannabinol (THC), so cannabidiol does not get you high. Instead, most users report that it makes them feel relaxed and calm, among the other generally positive effects of CBD.
According to federal law, hemp-derived CBD oil is classified as having less than 0.3% THC, making it legal to purchase and use. And since hemp has minuscule amounts of THC content, CBD oil from this type of cannabis plant does not cause any of THC’s intoxicating side effects. Marijuana-derived CBD oil, whether it’s derived from sativa or indica-dominant plants, contains more than 0.3% THC as its primary active ingredient, and may make you high. It is only legal in states with recreational or medical marijuana legalization.
Though it comes in a wide variety of forms such as capsules, vape juice, powders, topical patches and lotions, and edibles like gummies, cannabidiol is most popularly consumed as a sublingual oil. You simply place a few drops of CBD oil under your tongue and let it sit for 30 to 90 seconds.
Pharmacology research has shown a wide range of potential benefits for cannabidiol. CBD oil is commonly used to treat or supplement treatment of medical conditions like chronic pain, inflammation, arthritis, multiple sclerosis, Parkinson’s disease and epilepsy. Park added that CBD oil is also commonly used by people suffering from a wide range of mental disorders.
“CBD can be effective in treating generalized anxiety disorder (GAD), social anxiety disorder, anxiety related insomnia, and post-traumatic stress disorder (PTSD),” she said.
Additionally, emerging evidence shows that CBD may use the same mechanism to treat high blood pressure as it does to reduce anxiety.
How CBD Interacts with the Endocannabinoid System and Body
The endocannabinoid system is a biological system in your body that allows cannabinoids to send and receive messages that control most of the body’s important functions. In fact, your body naturally produces cannabinoids every day.
This system has two main endocannabinoid receptors, called CB1 and CB2. THC binds directly to the CB1 receptors, affecting areas of the brain that influence memory, motor coordination and time perception, and to the CB2 receptors which affect the pain centers in your brain and manage inflammation in the body. The interaction between THC and the endocannabinoid system is what causes the psychoactive side effects that marijuana is best known for.
On the other hand, cannabidiol does not directly bind to the CB1 and CB2 receptors. Instead, it causes a number of indirect actions leading to therapeutic benefits, such as activating TRPV1 receptors that regulate pain, body temperature, and inflammation.
Does CBD Oil Lower Blood Pressure?
While Park told us that high blood pressure can be caused by a number of factors, CBD oil appears to lower increases in blood pressure caused by stress and anxiety.
She explained that when emotional or physical stress is high, our bodies release a hormone called cortisol. High levels of cortisol can raise blood pressure.
“CBD lowers blood pressure by reducing cortisol levels and dilating blood vessels, allowing more blood flow and leading to lower blood pressure,” Park said.
Park pointed to a study of 11 participants that showed CBD oil may lower the levels of cortisol produced in the body. This study showed that volunteers saw a significant reduction in cortisol production when given 300 mg and 600 mg of CBD compared to the placebo control.
In a famous 2017 randomized crossover study led by British doctor Khalid Jadoon and published in the Journal of Clinical Investigation (JCI), a single dose of 600 mg of CBD oil or a placebo was administered to nine healthy volunteers. The resulting data showed that acute administration of CBD reduced resting blood pressure compared to placebo dosing.
The patients were then given a series of stress tests to increase heart rate. Those who were given 600 mg of CBD had lower stress-induced blood pressure spikes than the control group.
It’s amazing, but it’s true. A single dose of cannabidiol lowered the blood pressure of patients, whether they were resting or under stress.
The sample size of these studies was small and further research is required to establish whether CBD has a role in the treatment of cardiovascular disorders, but the results are promising.
How CBD Can Help With Hypertension
As Park explained, high blood pressure can be caused by many factors. Fortunately, there are several health benefits of CBD that could indirectly help with hypertension.
Anxiety can lead to rapid heart rate and palpitations, leaving you at risk for high blood pressure and heart disease.
CBD oil has been shown to reduce anxiety in animal studies by the National Institute for Drug Abuse (NIDA). This study demonstrated that symptoms that accompany anxiety, like high blood pressure and rapid heart rate, were improved by use of CBD.
Inflammation doesn’t only occur in your joints. In fact, research shows that CBD oil can reduce inflammation in the heart and blood vessels in the brain.
Called a “vasorelaxant” by researchers, CBD oil’s anti-inflammatory properties may lower blood pressure by allowing the free flow of blood through your heart, arteries and veins.
According to the National Institutes of Health (NIH), acute pain can lead to high blood pressure. Because CBD acts on the pain receptors in the brain, the pain-relieving properties of CBD could lead to decreased blood pressure.
CBD Improves Sleep
As CBD reduces stress, you may see an increase in your quality of sleep and general wellness.
Sarah Polansky, owner and developer of the CBD brand Prismatic Plants, told Public Goods that “The more you take CBD and help to regulate your adrenals, the less likely you’ll feel fatigued as your body returns to a state of balance rather than constant stress.”
She added, “This means your need for caffeine consumption could decrease and your quality of sleep could improve, which has a waterfall benefit for increasing overall health.”
Choosing CBD Oil for High Blood Pressure
No prescription or documentation is needed for CBD oil. The only exceptions are the marijuana-derived CBD oil sold in dispensaries (in medical marijuana states, you’ll need a patient card to buy it) and a medication called Epidiolex, a CBD medication only available by prescription to patients suffering from some forms of childhood epilepsy.
All of the forms of CBD that you can buy over the counter are not generic products. Their effectiveness depends largely on the quality of the manufacturer producing it, and the type of CBD that’s used.
Many of the cannabidiol products you’ll see in CBD stores or online are of lower quality, since – as with any product – it’s more expensive to produce high-end merchandise and it sells for a higher price, often with lower profit margins for the vendors.
High-quality CBD oil, capsules, topicals, juice for vaping, or edibles will always produce a better result, so it’s best to do a little research to find reputable vendors who create effective products. Look for oil sourced from Colorado or West Coast organic hemp, extracted with high-end methods (like supercritical CO2 extraction), and containing only a small number of natural or organic ingredients required for flavoring or distributing the cannabidiol (the latter is done via MCT coconut carrier oil in high-quality CBD).
Some cannabidiol delivery methods work more slowly than others.
Capsules and edibles, for example, must make their way through the digestion process before the CBD can be released into the blood stream and carried throughout the body. Vaping or administration under the tongue make the cannabidiol available almost immediately, since it’s absorbed quickly by the sublingual glands or tissues in the lungs. And topical CBD usually doesn’t even make it into the bloodstream, since it’s blocked by the epidermis.
When shopping for CBD oil, you’ll find there are three different types to choose from.
- Full-spectrum CBD is the most effective. It contains all of hemp’s natural terpenes and flavonoids, as well as all of the cannabinoids in the plant – including the small amount of THC we’ve mentioned. They all work together in the so-called “entourage effect” that boosts CBD’s performance.
- Broad-spectrum CBD provides a slightly lower entourage effect, because the THC content has been removed from the cannabidiol before it’s processed and sold.
- CBD isolate goes a step further. All of the components of hemp except cannabidiol are removed, leaving only pure CBD in the final products.
Some people believe that pure cannabidiol does the most good, but in reality, there’s only one reason to avoid CBD that contains THC: it eliminates any chance of turning up dirty on a drug test for marijuana. In reality, very few full-spectrum CBD users ever test positive, but some people’s minds are set at ease by knowing there’s no THC in their body.
What’s The Best CBD Dosage for High Blood Pressure?
Because the FDA has not approved over-the-counter CBD products, there is no official recommendation for a dose of CBD. The right dose depends on your weight, genetics, sex and medical history. More studies need to be conducted with human subjects to get an accurate dosage.
Many CBD oils come in dropperful (1 ml) doses of 10 mg/ml. Cannabidiol affects different people, particularly based on the weight, metabolism and body type. However, Park said the effective therapeutic dose is usually in the range of 20 mg to 300 mg, or 2 to 30 dropperfuls.
In a 2018 study, researchers found that a dose of 300 mg was most effective for reducing anxiety in a simulated public speaking trial. Participants who took 150 mg or 600 mg did not receive the same benefit.
Meanwhile, in the previously-mentioned study of nine healthy volunteers, blood pressure was effectively lowered with a single dose of 600 mg.
The best way to determine how effective a dose of CBD will be for you is to start small and frequently check your blood pressure using an electronic cuff. Write down the dose you took and the time you took it, as well as your blood pressure reading. Over time, you should be able to obtain a clearer picture of what dose will help you achieve low blood pressure.
Park noted that, “If CBD works for you, without the use of other medications, I would say it is a great and safe alternative.” CBD may not be a replacement for exercise and a healthy diet, but it is nice to know you might be able to lower your blood pressure with a few drops of oil under the tongue.
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CBD oil seems to be a cure-all for many ailments, but does it lower high blood pressure? Here’s what research says about CBD and hypertension.