Your Good Health: CBD oil risky for anyone on heart medication
Dear Dr. Roach: I am a 49-year-old woman who had a massive heart attack in April of this year. My father died of a massive heart attack at 49 when I was three.
Dear Dr. Roach: I am a 49-year-old woman who had a massive heart attack in April of this year. My father died of a massive heart attack at 49 when I was three. I have four stents in three arteries and am on Brilinta, low-dose aspirin, blood-pressure medication, etc.
I have had essential tremor for all of my life, first noticing the tremors in middle school. The tremor is in my hands, making writing nearly impossible, and I have head bobs. I have an internal tremor that never stops.
A previous practitioner prescribed a month’s trial of beta blockers several years ago. I noticed no relief with the tremor, but was physically ill for the first 30 minutes of the morning in the first two weeks of the trial. Recently, while doing some research, I found an online blog regarding essential tremor and CBD oil. Nearly all of the bloggers found some level of relief using this treatment.
If I choose to try CBD oil to assist with my tremor, is there a risk of it interfering with my heart and blood-pressure medications?
Cannabidiol, or CBD, is a nonpsychoactive substance found in cannabis, as opposed to tetrahydrocannabinol, or THC, the best-known psychoactive component.
CBD is typically sold as an oil, and has been receiving press as a potential treatment for a wide variety of medical issues. Many or most of these claims have no data to support them. Anecdotal reports, such as most blogs, are neither reliable nor scientific (and may or may not be true).
There is also an issue with proving the dosage and purity of products said to contain CBD.
However, in the case of essential tremor, there is some evidence: Studies in mice have shown benefit with CBD, although a single case report showed effectiveness of THC but not CBD in essential tremor.
The issue of drug interactions is a significant one. CBD inhibits two powerful pathways the body uses to detoxify drugs, the CPY3A4 and CYP2D6 systems. This is a serious issue for you. Ticagrelor (Brilinta), an anticoagulant, is metabolized by CYP3A4, as are some of the statin drugs usually prescribed to people with heart blockages.
The effect of the anticoagulant could be much higher than expected, leading to bleeding risk. Other commonly used heart medications are metabolized by CYP2D6, and the effect on these medications is unpredictable.
I can’t recommend CBD products given the medications you are taking, but would suggest you consider alternative treatments.
You might have read about deep brain stimulation and ultrasound, two powerful and effective treatments for people whose symptoms have not responded to standard treatments.
Dear Dr. Roach: This question is for my husband. How safe is drinking tea while on warfarin?
He has his INR checked monthly, and for the most part, it stays between 2 and 3.
He watches his vitamin K intake regularly. He has read conflicting stories about how tea interacts with warfarin by making INR levels high.
Tea comes in two major types: black tea, which is fermented, and green tea, which is not. Black tea has no known interactions with warfarin (Coumadin). Green tea contains small amounts of vitamin K, which could make the INR lower and the warfarin less effective. However, the effect is likely to be small. Further, if he drinks a consistent amount per day, his dose can be adjusted to reflect his vitamin K intake.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers can email questions to [email protected]
CBD and Heart Health
What to Know About CBD for Heart Failure, Cholesterol, and Blood Pressure
Lindsay Curtis is a health writer with over 20 years of experience in writing health, science & wellness-focused articles.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Jeffrey S. Lander, MD, is a board-certified cardiologist and the President and Governor of the American College of Cardiology, New Jersey chapter.
Heart health is one of the areas being explored to determine the therapeutic health benefits of cannabidiol (CBD). Nearly 655,000 Americans die from heart disease every year, accounting for one in every four deaths.
CBD cannot cure heart disease or congestive heart failure, but it is being studied for ways it may help reduce symptoms or prevent heart disease. However, CBD has not been shown in large studies to prevent diseases that lead to heart failure.
Read on to learn more about CBD’s benefits for the heart, what CBD oil is, side effects, and forms of CBD oil.
Verywell / Jessica Olah
What Is CBD Oil?
Cannabidiol oil is extracted from the leaves and flowers of the cannabis plant. CBD is a chemical that’s unique to the cannabis plant. The two major cannabinoids contained in cannabis plants are:
- Tetrahydrocannabinol (THC): It has psychoactive properties that create a “high” feeling.
- Cannabidiol (CBD): It has no psychoactive effects but provides several therapeutic benefits.
Both CBD and THC interact with the endocannabinoid system (ECS) in the body. The ECS is a complex biological system that impacts many of the body’s functions, including appetite, memory, mood, and sleep. Researchers are learning that the endocannabinoid plays a role in the function of the cardiovascular (heart) system.
A growing body of evidence shows that dysregulated ECS is associated with a number of cardiovascular diseases. Whether you have a heart condition or want to prevent heart disease, CBD may boost your endocannabinoid system to help it regulate the cardiovascular system.
Overview of Heart Failure
Heart disease is an umbrella term that refers to several types of heart conditions. Heart disease may involve the heart valves, arteries, and heart rate, leading to heart failure.
Heart failure is a serious health condition in which the heart isn’t pumping the way it should be. The body depends on the heart’s pumping action to deliver oxygen and nutrient-rich blood to all of its cells.
With heart failure, the heart cannot supply the body’s cells with enough blood, leading to symptoms that can have a tremendous impact on your quality of life.
Heart failure has a number of causes, including genetics, other medical conditions (e.g., anemia, diabetes, sleep apnea), and lifestyle (e.g., smoking, obesity).
Symptoms of heart failure vary, depending on the type and severity of heart failure you have. Common symptoms include:
- Shortness of breath
- Increased heart rate
- Bluish-colored fingers and/or lips
- Persistent coughing or wheezing
- Lack of appetite
- Trouble concentrating
- Inability to sleep when lying flat
CBD and Heart Health
CBD has anti-inflammatory, antioxidative properties that may help reduce risk factors that can lead to heart disease. It may also be helpful in reducing the risk of related conditions, such as stroke.
Research suggests that even a single dose of CBD can lower blood pressure. High blood pressure has been linked to congestive heart failure. This is because high blood pressure makes it more difficult for blood to travel easily throughout the body, causing the heart to work harder.
While more research is needed to be sure, CBD may be helpful in lowering blood pressure to prevent congestive heart failure.
CBD oil has anti-inflammatory properties, which may help reduce cholesterol levels to improve heart health. Cholesterol is a type of lipid (fat) found in the blood.
High cholesterol levels—particularly low-density lipoprotein (LDL), aka “bad” cholesterol—increase the risk of developing cardiovascular diseases. LDL can build up in the lining of blood vessels, causing a blockage that can lead to heart attack or stroke.
CBD has properties that help relax arterial walls, which research suggests may help reduce blood pressure and excess cholesterol. In animal studies, CBD has been shown to increase HDL levels—aka “good” cholesterol—and lower LDL levels after four weeks of CBD supplementation.
CBD is perhaps best known for its anti-inflammatory properties. Research suggests that inflammation may be at the root of many chronic illnesses. Heart disease is associated with inflammation. Inflamed blood vessels make it harder for the heart to pump blood throughout the body.
One study found that CBD has a direct effect on the arteries, helping reduce inflammation and improving blood flow. This suggests that CBD reduces inflammation in arteries and blood vessels, easing the strain on the heart, potentially preventing heart failure.
Obesity is one of the leading causes of congestive heart failure, which is one reason why it is important to maintain a healthy weight for optimal heart health. There is some evidence to suggest that CBD may help maintain a healthy weight.
One study found that CBD promotes the browning of white fat cells, which aids in converting the fat into burnable calories. This is beneficial because brown fat cells contain more mitochondria than white fat cells, which helps burn calories. White fat cells contain droplets of fat that accumulate around the body and can lead to obesity.
Are There Any Side Effects?
CBD has few side effects, and the World Health Organization states that it is generally well tolerated and has a good safety profile. While relatively safe, there are a few things to consider before you try CBD.
If you are currently taking any other medications, speak with your doctor before trying CBD. Some research suggests that CBD may interfere with the way the liver processes certain medications.
This interference may prevent the liver from metabolizing other medications as it normally would, leading to higher concentrations of the medication in the body and increasing the risk of liver toxicity.
Best CBD for Heart Health
CBD comes in many different forms, including oils and tinctures, edibles, topicals, and vaporizers. Taking CBD oil sublingually (under the tongue) is an easy way to enjoy the benefits. Using sublingual oils tends to work faster and produce stronger results than other edible products, such as gummies.
Vaping CBD is a fast way of delivering CBD into your system, but it is not recommended for individuals with heart disease. Vaping is associated with lung damage, and research shows it causes an increased risk in developing cardiovascular disease.
There are a number of CBD types to choose from. Understanding these differences can help you choose which type is best for your needs. These types include:
- Isolate: CBD is the only cannabinoid contained in the product.
- Full-spectrum: Contains multiple naturally occurring cannabis plant extracts, including terpenes, other cannabinoids, and up to 0.3% THC.
- Broad: Contains CBD and other components/cannabinoids found in the cannabis plant, but does not contain any THC.
The availability of these products varies from state to state, particularly for products that contain THC.
If you’re just starting off with CBD, try a small dose first. Watch for any side effects. If you wish, you can slowly increase your dosage (no more than 5 to 10 mg increase at a time) until you find the dosage that is right for you.
How to Buy CBD
With so many CBD options available, shopping for the right product can be an overwhelming experience. Some important things to keep in mind when buying CBD include:
- Cannabis source: CBD is derived from cannabis plants, and it’s important the CBD is sourced from a company that takes care in the quality and cultivation of their plants. Look for products that come from organic plants when possible.
- Certificate of Analysis (CoA): Responsible, reputable manufacturers offer a CoA that clearly states the amounts of cannabinoids in a product. CoAs are conducted by an independent, accredited lab.
- Read the label: Read the full list of ingredients contained in CBD to know what you are consuming.
- Type of CBD: To get the best results, look for full-spectrum or broad CBD products. These may offer an “entourage effect,” combining the effects of multiple cannabis compounds that work in synergy to offer the most benefits.
CBD oil is extracted from the cannabis plant. It has anti-inflammatory and antioxidative properties. Researchers are looking into ways it could be beneficial for heart health. While it has few side effects, it may slow liver metabolism and affect other medications you are taking.
Cannabidiol comes in several forms and methods of application. People with heart disease should avoid products that require vaping or smoking.
A Word From Verywell
While CBD is not a cure for heart failure, it may prevent further damage thanks to its anti-inflammatory properties. CBD may be helpful in reducing blood pressure, decreasing inflammation and cholesterol, and maintaining a healthy weight. Improving these factors may reduce the risk of heart failure.
Speak with your doctor before trying CBD, particularly if you are on any other medications or dietary supplements. Your doctor can let you know if it is safe to take, and may have product and/or dosage recommendations.
Frequently Asked Questions
How safe is CBD for congestive heart failure?
CBD is generally considered to be safe for congestive heart failure. Research shows no significant adverse effects of CBD at a wide range of doses (anywhere from 3 to 1,200 mg/day).
CBD has significant potential to treat a variety of heart diseases and comes with few adverse side effects, though more research is needed. Talk with your doctor before using CBD for heart disease, particularly if you are currently taking any other medications.
Does CBD lead to heart problems?
CBD alone does not lead to heart problems. However, CBD is broken down and metabolized by the liver. During this process, it may interfere with your medications for any heart conditions you have. This may lead to liver problems or interfere with the effectiveness of any medications you are taking.
Exercise caution and speak with your doctor before using CBD for heart failure.
Can CBD cause heart palpitations?
The cardiovascular effects of CBD are currently being studied. Some research suggests that cannabis use may cause arrhythmia (irregular heart rate) or tachycardia (increase in heart rate).
However, those studies included products that also contain THC, the psychoactive cannabinoid found in cannabis plants. More research is needed to determine if CBD causes heart palpitations.