CBD and Pulmonary Arterial Hypertension (PAH)

CBD or cannabidiol has been touted as a potential alternative to provide relief for many conditions from stress to inflammation. As it swiftly gains popularity, wider varieties of uses for this natural compound are being investigated. Since the reduction of inflammation is a common reason many seek out CBD, and hypertension is associated with inflammation, you may have wondered whether CBD can help pulmonary arterial hypertension. If you are still wondering about the effects of CBD on pulmonary arterial hypertension, this article may offer some clarity. Let us delve deeper.

What Is Pulmonary Arterial Hypertension or PAH?

PAH is a condition whereby stiffened or narrowed arteries lead to high blood pressure in the lungs. It is a form of pulmonary hypertension, which is a broader term for conditions that are responsible for elevated blood pressure in the lungs. 

Blood pressure in the lungs differs from the blood pressure in the rest of the body. This means you can have normal blood pressure overall but still suffer from pulmonary arterial hypertension. More often than not, the pressure in the heart’s right side (responsible for pumping blood to the lungs, and the arteries in the lungs) tends to be lower than the rest of the body. This enables blood to absorb as much oxygen as possible. However, pulmonary arterial hypertension causes arteries to become narrower in your lungs, elevating blood pressure in the pulmonary arteries, and thus forcing the right side of the heart to work harder.

Ultimately, pulmonary arterial hypertension can lead to the thickening of the right side of the heart and enlarging of the chamber, making it less effective. As a result, you may have inadequate oxygen in the blood, which can have very dangerous consequences. 

Pulmonary Arterial Hypertension Causes and Risk Factors

Regardless of the severity and symptoms, all PAH cases involve injury to the cells that line the arteries in the lungs. However, researchers have yet to figure out what exactly causes the injury, even though they are aware it leads to the narrowing of blood cells. 

It is also clear that a number of environmental and genetic factors may also result in pulmonary arterial hypertension.

In the heritable type, mutations occur in a specific gene and are then passed down in the family. BMPR2 is the most prevalent problem-causing gene, but doctors have come across other genes that might also be responsible. However, some gene mutations remain unidentified. 

In the associated type, medical practitioners may identify a toxin or an illness that they believe caused the condition. Possible underlying health conditions include Scleroderma, Lupus, HIV, liver disease, and congenital heart abnormalities.

Endocannabinoid Receptors Role in Managing Blood Pressure

The endocannabinoid system (ECS) is an intricate network of cannabinoid receptors and endocannabinoids (messenger molecules) in your body. This system plays a crucial role in ensuring that your organs and other systems function optimally at all times. 

There are two primary cannabinoid molecule receptors: CB1 and CB2. These receptors feature varying distributions throughout the body and differing functions in regard to controlling blood pressure.

CB1 Receptors

These are commonly found in the neurological system and regions where blood pressure is regulated, such as the heart, lungs, adrenal glands, and blood vessels. Most of the effects that CBD has on blood pressure stem from its interaction with the CB1 receptors.

CB2 Receptors

These receptors are mainly found in the nervous system and brain, but they are also common throughout the various elements of the immune system. Given their locations, it is no surprise that CB2 receptors play a role in blood pressure regulation when someone has contracted a disease or has acute inflammation caused by an injury, infection, smoking, poor diet, or other unhealthy practices. 

CBD and PAH: What Research Has Revealed

There are numerous feedback loops throughout the body that aid blood pressure regulation, and the ECS is a vital component of most of the pathways. This makes CBD a potential candidate when it comes to conditions associated with blood pressure, including pulmonary arterial hypertension.

That being said, here are some of the ways CBD has been seen to affect hypertension in both pre-clinical and clinical research:

Antioxidant and Anti-inflammatory Activity

Most of CBD’s potential in reducing blood pressure is due to its antioxidant and anti-inflammatory properties. Preliminary animal research has suggested that the cannabinoid may protect blood vessels from damage caused by increased sugar levels and inflammation, which has been seen to cause the arteries to harden and raise blood pressure.

Cannabidiol may achieve this by controlling the activity of COX or cyclooxygenase, an enzyme that plays a major role in inflammation response. Cyclooxygenase is the same enzyme that anti-inflammatory drugs such as ibuprofen target. Cyclooxygenase promotes the production of prostanoid compounds, which are responsible for the widening or dilation of blood vessels.

CBD and Arterial Dilation

CBD may affect the arteries in several ways, but arterial dilation might be one of the most beneficial. In a study done on lab animals, the cannabinoid caused almost complete relaxation of the arteries.  

A similar study was done on human arteries that were constricted before administering the compound. The results showed a reduction in blood pressure by 40%. It was noted that cannabidiol helped to alleviate blood pressure by interacting with the CB1 receptors located in the endothelium. The endothelium is a membrane lining found inside blood vessels and the heart. This interaction resulted in the release of nitric oxide, a primary component of arterial dilation.

Studies also suggest that CBD may work outside the ECS system to directly control blood pressure in arteries. This might be achieved by preventing calcium channel influx in arteries’ muscular layer. When calcium makes its way into muscles, it causes them to contract. CBD has the potential to inhibit this influx and encourage relaxation as well as dilation of the blood vessels.

CBD Effects on the Symptoms of Anxiety

Many clinical studies have established that CBD may be an ideal remedy for the symptoms of anxiety. Cannabidiol has the potential to act on the brain’s memory centers (the hippocampus, neocortex, and amygdala) to help ease anxiety responses triggered by traumatic memories.

Research has also shown that the cannabinoid may calm the cardiovascular response to anxiety disorders. In lab tests, it was suggested that a single dose of CBD may help reduce elevated blood pressure and heart rate during bouts of anxiety.

However, clinical trials in humans remain inconclusive, with some showing no substantial blood pressure-reducing effects in people with anxiety disorders. Therefore, further research is needed to understand CBD’s full effects on the symptoms of anxiety.

Using CBD for Pulmonary Arterial Hypertension

As marijuana and hemp plants have only recently been widely legalized, studies on the effects of CBD in the human body are still in their infant stages. As with every avenue in the scientific world, the more CBD is studied, the more we become aware of the possibilities for its uses.

Even though cannabidiol has a high safety profile, it is imperative to bear in mind that any substance that has effects on your body has potential undesirable or unintended side effects. Where CBD and hypertension are concerned, it is important to consider the following:

CBD Affects People Differently

Published studies show a wide array of factors that can affect responses to cannabidiol. In one small clinical study, responses ranged from 2 to 70 percent dilation of arteries. However, the exact reasons for these variants are yet to be known. 

Generally, females may have a greater response to CBD than men. The response rates vary substantially among animal species used in lab tests. 

Drug Interactions Are Possible

It’s important to note that some drugs can affect CBD’s activity. For instance, statins for elevated cholesterol levels, beta-blockers used to manage hypertension, and some blood sugar reducing drugs have been shown to reduce CBD response. CBD can also impact the functionality of certain medications. Be sure to speak with your doctor before taking CBD if you are on any medication.

CBD Effects May Vary Based on Underlying Health Conditions

People with movement disorders as a result of hypertension may notice greater effects from CBD. A substantial decrease in standing BP was observed when these subjects consumed CBD for six weeks. 

Conversely, some conditions can reduce a person’s response to CBD, particularly elevated cholesterol and type-2 diabetes. The study found that no change in blood pressure was seen in response to cannabidiol in people with epilepsy who consumed the substance for 5 months, or in individuals with Huntington’s disease who consumed it for six weeks. 

However, body mass index, age, and smoking didn’t seem to have an effect on response to CBD. Similarly, having heart disease and cancer didn’t impact the patients’ CBD response, either. 

Is Using CBD for Pulmonary Arterial Hypertension Safe?

In this comprehensive update on the safety and side effects of cannabidiol, the National Institute of Health (NIH) tested daily doses of up to 300mg of the substance’s supplements consistently for 6 months. Upon discovering the supplements could be consumed safely even in high doses, they went ahead to test daily doses of 1200mg and 1500mg for a period of one month. 

The results found it safe to consume CBD in most conditions. However, further studies must be conducted to determine details such as the effects of higher doses for long term usage. According to the Harvard Health Letter, possible mild CBD side effects include lightheadedness, nausea, fatigue, and irritability. However, there are several variables that can affect side effects. The specific formula, how you consume it, and the other included ingredients can all have roles in CBD’s overall effect.

While CBD is generally safe, CBD may interact with certain medications. Therefore, it’s important to speak with your healthcare provider before introducing CBD into your routine.