CBD Oil and Heart Failure
Could CBD oil ease your heart failure symptoms or help you manage your condition? This herbal supplement is sold over the counter and may be marketed with various health claims, but heart experts arenвЂ™t so sure itвЂ™s worthwhile or even safe if you have heart failure.
вЂњHeart failure patients should know that while CBD has been touted as a wonder compound and seems to be in almost everything these days, it has never been shown to have any significant cardiovascular benefits in human studies,вЂќ says Scott Lundgren, DO, a transplant cardiologist at Nebraska Medicine in Omaha.
What Is CBD Oil?
CBD oil contains cannabidiol, an herbal liquid supplement made from the cannabis plant. It doesnвЂ™t have the same effect on the brain as THC, another compound found in cannabis that gives you a вЂњhighвЂќ when smoked or eaten, says Larry Allen, MD, associate division head for clinical affairs in cardiology at University of Colorado Anschutz Medical Campus.
вЂњThere are no known cardiovascular benefits for cannabis or cannabidiol, and there may even be some adverse effects, so people should not take these products and think that it will have positive effects on their cardiovascular health,вЂќ says Allen, whoвЂ™s also co-author of the American Heart AssociationвЂ™s statement on all cannabis products.
In 2018, the FDA approved the first oral, purified CBD drug, Epidiolex, to treat seizures in two rare forms of epilepsy. Two synthetic versions of cannabidiol were later approved: dronabinol (Marinol, Syndros) for treatment of nausea during cancer chemotherapy and nabilone (Cesamet) to treat weight loss associated with AIDS.
Some of CBDвЂ™s proven benefits in other health conditions may be intriguing to people living with heart failure, Allen says.
вЂњDoes it stimulate your appetite? Yes. Do people gain weight if they take it? Possibly true. Patients with severe heart failure do have cachexia,вЂќ or severe weight loss and muscle wasting, he says. вЂњOne could argue that people with nausea, lack of appetite, or who are losing weight could think CBD would help them. People with heart failure have a fair amount of discomfort, including edema [swelling] and somatic or pain-related issues, so you could think CBD has a role.вЂќ
But there isnвЂ™t really any evidence to prove that it will relieve heart failure symptoms or be safe to use if you have heart failure, he adds.
What We Know About CBD
Some research suggests that CBD oil may improve some heart-related symptoms:
- A very small study conducted in 2017 in England found that CBD improved resting blood pressure and blood pressure spikes related to stress in people without heart conditions.
- Various studies in animals have shown that CBD could improve vasorelaxation, or opening of arteries for better blood flow, as well as reduce inflammation. A small clinical trial from Mexico studying CBD in people with heart failure hasnвЂ™t reported any results yet.
- A large study of more than 161,000 people hospitalized for heart failure who had used marijuana found that they had, on average, a lower risk of death and shorter hospital stays. But this doesnвЂ™t necessarily mean CBD oil would have the same benefit.
ItвЂ™s illegal in the U.S. to market CBD by adding it to any food or calling it a dietary supplement. Also, although the FDA has approved a few CBD drugs to treat certain diseases, donвЂ™t expect CBD sold over the counter to be safe or beneficial for heart failure, Lundgren says.
вЂњCBD oil may not have the same properties, and it can actually cause gastrointestinal distress like diarrhea or cause decreased appetite. CBD products can include unknown ingredients and may not be accurately labeled,вЂќ he says.
When you use CBD oil, your liver breaks it down. During this process, it could interfere with your medications for heart failure or other heart conditions. вЂњCBD has known interactions with warfarin, certain statins, calcium channel blockers, beta-blockers, and nitrates. Just because a supplement is вЂnaturalвЂ™ doesnвЂ™t mean that it is safe,вЂќ Lundgren says.
CBD May Have Health Risks
CBD oil must be studied in randomized clinical trials on people, not animals, before it can be considered safe or effective for heart failure, Lundgren says. Until that happens, he advises against buying or using CBD. вЂњThere is some evidence that CBD can cause liver injury as well as lead to male infertility issues. When consumed with alcohol, individuals may experience increased drowsiness, which can lead to household injuries.вЂќ
If you have heart failure, you might feel like youвЂ™re taking control of your own care by trying herbal treatments that donвЂ™t require a prescription. To be safe, talk to your cardiologist first: Ask questions about CBD oil and make decisions together about using this or any other supplement, Allen says.
вЂњCBD products cost money and can distract you from taking prescribed treatments for heart failure that are evidence-based. They could do indirect harm to people with heart failure. . We already have a half-dozen treatments for heart failure symptoms and to help you live longer.вЂќ
Larry Allen, MD, MHS, University of Colorado Anschutz Medical Campus.
Scott Lundgren, DO, Nebraska Medicine.
FDA: вЂњWhat You Need to Know (And What WeвЂ™re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD,вЂќ вЂњFDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy,вЂќ вЂњFDA and Cannabis: Research and Drug Approval Process.вЂќ
JCI Insight: вЂњA single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study.вЂќ
Oxidative Medicine and Cellular Longevity: вЂњTherapeutic Applications of Cannabinoids in Cardiomyopathy and Heart Failure.вЂќ
Cannabis and Cannabinoid Research: вЂњAn Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies.вЂќ
ClinicalTrials.gov: вЂњCannabidiol in Patients With Heart Failure in AHA/ACC Stages A-C (CAPITAL-AC).вЂќ NCT03634189.
Journal of Cardiac Failure: вЂњMarijuana Use is Associated with Better Hospital Outcome in Patients with Acute Heart Failure: A Propensity Match Analysis from National Inpatient Database.вЂќ
CBD oil is made from cannabis plants but wonвЂ™t make you high. Still, this natural supplement could interact with some heart medicines. Find out what you need to know before you try CBD oil for heart failure.
Cannabis, heart disease and stroke
Cannabis has been legal for medicinal use in Canada since 2001. Since 2018, many cannabis products have been legal for recreational use, including dried cannabis, fresh cannabis, cannabis oil and cannabis seeds for cultivation. In 2019, cannabis edibles, topicals and extracts (including cannabis vape products) became legal.
There is currently little high-quality scientific evidence about the impact of recreational cannabis use on heart conditions and stroke.
- Emerging evidence shows an increased risk for heart disease and stroke from the effects of cannabis on blood pressure, inflammation of the blood vessels and cardiac arrhythmias 1,2,3,4
- Other reports link cannabis use with cardiovascular emergencies, including heart attack, arrhythmias, heart failure, stroke and cardiac arrest (cardiopulmonary arrest). 5,6,7
- Some research shows that long-term or excessive use of cannabis, increases the risk for heart disease and stroke. 1,3,8
- Respiratory illness and deaths in the United States have been linked to vape products, many of which are cannabis (THC) vaping products obtained through informal sources. 9
Heart & Stroke recommends reviewing the Lower-Risk Cannabis User Guidelines to assess the safest modes of cannabis use. Consumers should follow guidance and advisories from Health Canada related to vape products and if vaping cannabis, always obtain THC extracts for vaping from authorized dealers.
Recreational use of cannabis
If you are considering using cannabis for recreational purposes, read the Lower-Risk Cannabis Use Guidelines. However, the guidelines have not been updated since early 2019 and predate the surge in vaping-related lung illness throughout 2019. Heart & Stroke recommends that people follow the advice of health agencies – including the Centre for Disease Control (CDC) and Health Canada – with regards to the use of vape products. We also recommend that you speak to your healthcare provider about the effects of cannabis on your personal health – especially if you have a higher risk for heart disease and stroke.
Vape products and cannabis
There have been over 2,600 cases of vaping related respiratory illness in the US, including over 60 related deaths. 9 Several cases have emerged in Canada, without any deaths. The CDC has recently identified Vitamin E acetate (an additive in some THC vape products) as a chemical of concern in this outbreak and is warning e-cigarette users to avoid using THC products especially from informal sources. 9 The CDC has not yet ruled out other chemicals of concern. Heart & Stroke warns that vape devices of all kinds are not without harm.
Smoking cannabis is considered the most harmful for respiratory health and ingestion of cannabis is the least harmful. Vaping cannabis is somewhere in the middle in terms of level of harm. All modes of delivery have some level of overall health risk.
Heart & Stroke is working to ensure government regulations are in place to make sure young people are protected from vape products with nicotine or THC. These include:
- warning labels
- marketing restrictions
- flavour ban
- restricting sales to special vape shops
- increasing the legal purchase age to 21 years of age
Cannabis for medical purposes for heart disease and stroke
Using cannabis products to help you with pain from heart disease and stroke is a personal decision. To get cannabis for medical purposes, you need a prescription from a healthcare provider. 10 There are discussions taking place about allowing Canadians access to cannabis health products for minor ailments (muscle soreness, pain relief) without a prescription. 11
Talk to your healthcare provider about the risks and benefits of using cannabis for medical purposes. While cannabis products are legal, Health Canada does not endorse, nor has it evaluated, the use of cannabis for medical purposes. 12
Gaps in research
Further research is needed into the short-term and long-term effect of cannabis on heart disease and stroke. Heart & Stroke encourages more research on the impact of recreational cannabis use and the medicinal benefits of cannabis products on heart disease and stroke.
More research is needed to understand the effects of cannabis on your heart and brain. Learn about cannabis, heart disease and stroke.