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There are two common types of high blood pressure, primary (or essential) and secondary. Primary hypertension accounts for about 90 to 95% of cases whereas secondary accounts for the remaining amount.
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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Dr. Bonni Goldstein, a medical adviser to Weedmaps and the director of Canna-Centers in Lawndale, California, outlined the potential effects of THC on blood pressure:
To answer this question, we should focus on two of the primary cannabinoids present in cannabis : cannabidiol (CBD) and tetrahydrocannabinol (THC). Both may exert an influence on blood pressure levels.
Does marijuana lower or raise blood pressure?
Goldstein explained, “Smoking cannabis can be harmful for those with heart disease or hypertension since the smoke contains carbon monoxide. This gas binds to the hemoglobin in red blood cells, displacing oxygen off of the red blood cells which results in less oxygen going to the body’s tissues, including the heart. People with heart disease or high blood pressure should avoid smoking.”
While it is possible for warfarin and other medications to interact with cannabis, there are no guarantees, and the 2017 study focused on patients with epilepsy rather than on the general population. As Dr. Bone reported, “In my private practice, I have not encountered a significant negative interaction between blood pressure medication and cannabis.”
Bone, however, argued, “On careful study, many of the patients also smoked cigarettes and were obese, making it hard to draw absolute conclusions. Also, the observations were made on cannabis of unknown origin, not cannabis from a dispensary.” The fact that the cannabis did not come from a registered dispensary is significant, as there is no available lab testing to determine what other compounds may have been present.
Cannabinoids exert different effects on blood pressure depending on the route of administration and the frequency of use. 1 A National Health and Nutrition Examination Survey study of more than 12,000 adults found that when compared with never users, cannabis users had higher systolic, but not diastolic, blood pressure. The researchers noted that for daily cannabis users, the increase in systolic blood pressure was a modest 3 mm Hg, which may be difficult to discern in clinical practice. 3
While 42 states and the District of Columbia have legalized the use of marijuana for medical or recreational purposes, the evidence of its alleged safety has not kept pace. 2 The Drug Enforcement Administration still classifies marijuana as a schedule I substance, with high potential for abuse like the addictiveness of heroin. 2
With some 200 million users globally, marijuana has been both pilloried and extolled for its effects on cardiovascular function. 1 After tobacco and alcohol, cannabis, the active ingredient in marijuana, is the most frequently used psychoactive substance. 2 Early signals from human and animal studies have found that the vasodilation properties of cannabinoids may show promise in arterial, pulmonary, and portal hypertension. 1 While cannabinoids may benefit hypertension, recent studies have shown that one of the most consistent changes in humans who use cannabis — orally, intravenously, or by smoking — is tachycardia. 1
Tracking Cannabis’ Deleterious Effects
Amitoj Singh, a cardiology fellow in the Department of Cardiology at St. Luke’s University Health Network in Bethlehem, Pennsylvania, and colleagues found that if the United States were to keep a registry of cannabis-related emergency department visits, such as France’s Addictovigilance Network, clinicians and policymakers would take a more cautious approach to the adoption of cannabis for medical and recreational uses. 2