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The effects of CBD on blood pressure has not been fully studied. There are some animal studies and a few small studies in humans available that describe the effects of CBD on the vascular system, however the majority of studies are with other cannabinoids such as tetrahydrocannabinol.
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As before, HR was higher in volunteers who had taken CBD (mean difference 7 bpm; 95% CI: 2–13; P < 0.05; Figure 5D ), and EJT was lower (mean difference -0.01 sec; 95% CI: 0 to –0.02; P < 0.05; Figure 5G ). Sidak post-hoc analysis showed that SV was significantly lower with CBD throughout ( Figure 5E ; P < 0.05 to < 0.0001), but there was no decline in cardiac output ( Figure 5F ).
Mental arithmetic has been shown to cause a rise in MAP and muscle sympathetic nerve activity (MSNA) (25) and vasodilatation in forearm skeletal muscle (26). In our study, none of the cardiovascular parameters other than HR, DBP, and SV were affected, suggesting that the level of stress to this test was minimal. This could be because of the added visual stimulus of a computer screen, which would have helped volunteers perform the task. Overall, there was trend for lower SBP, DBP, MAP, SV, TPR, and forearm skin blood flow in subjects who had taken CBD, particularly in the pre– and post–stress test periods. Like resting cardiovascular parameters, these changes may indicate anxiolytic effects of CBD and/or generalized sympathoinhibition.
Subjects who had taken CBD had increased HR (mean difference 10 bpm; 95% CI, 5–14, P < 0.01, Figure 4D ) and decreased SV (mean difference –13 ml; 95% CI, –4 to –22, P < 0.01, Figure 4E ) and EJT (mean difference –0.01 sec, 95% CI, –0.001 to –0.03, P < 0.05, Figure 4G ) during the exercise stress. There was no difference in CO during the exercise stress ( Figure 4F ).
Safety and tolerance.
Mental stress caused a rise in HR (P < 0.05; Figure 3D ) and a decline in SV (P < 0.01; Figure 3E ), which was seen in both the CBD and placebo groups. There was a rise in DBP (P < 0.05; Figure 3B ) and a decline in EJT (P < 0.05; Figure 3G ), seen only in those who had taken CBD.
The effects of placebo (closed square) and CBD (open square) on systolic blood pressure (SBP) (A), diastolic blood pressure (DBP) (B), mean arterial blood pressure (MAP) (C), heart rate (HR) (D), stroke volume (SV) (E), cardiac output (CO) (F), ejection time (EJT) (G), total peripheral resistance (TPR) (H), and forearm blood flow (I), measured continuously over 2 hours after drug ingestion, except for forearm blood flow. Forearm blood was measured over a time period of 2 minutes just before the start and in between the stress tests. Dotted line denotes baseline values between the stress tests. Repeated measures 2-way ANOVA; mean ± SEM (*/ + / # P < 0.05, **/ ++ / ## P < 0.01 using Bonferroni’s post-hoc analysis; + and # represent significant change in any parameter over time seen with placebo and CBD, respectively; denotes overall significant difference between 2 treatments).
Based on preclinical evidence, the aim of this study was to test the hypothesis that CBD would reduce the cardiovascular response to stress in healthy volunteers. We found that resting blood pressure was lower after subjects had taken CBD and that CBD blunted the blood pressure response to stress, particularly in the pre- and poststress periods. Post-hoc analysis showed an overall trend of lower SBP, MAP, DBP, SV, TPR, forearm skin blood flow, and left ventricular EJT and a higher HR in subjects who had taken CBD. These hemodynamic changes should be considered for people taking CBD and suggest that further research is warranted to establish whether CBD has any role in the treatment of cardiovascular disorders.
Our data show that a single dose of CBD reduces resting blood pressure and the blood pressure response to stress, particularly cold stress, and especially in the post-test periods. This may reflect the anxiolytic and analgesic effects of CBD, as well as any potential direct cardiovascular effects. CBD also affected cardiac parameters but without affecting cardiac output. Giving the increasing use of CBD as a medicinal product, these hemodynamic changes should be considered for people taking CBD. Further research is also required to establish whether CBD has any role in the treatment of cardiovascular disorders such as a hypertension.