High-quality human clinical trials are needed to determine the benefits of CBD for patients with heart disease

As cannabidiol (CBD) use increases, high-quality randomized clinical trials are needed to determine whether the anti-inflammatory benefits of CBD for heart disease seen in preclinical data will work in a real-world setting, research suggests. presented at ACC Latin America 2022 In collaboration with CardioAcademic. A review of existing studies revealed that no clinical recommendations can be made given the current evidence. ACC Latin America 2022 Together with CardioAcademic will be held in Mexico City on September 9-10, 2022.

“Consumption of cannabidiol and medical cannabis, and its many products, has increased dramatically over the past decade. Nevertheless, there are few indications for its use based on good clinical trials. Here we seek to provide preclinical evidence, which ultimately serves as a cornerstone for establishing well-designed clinical trials in humans to prove the effect of CBD on coronary syndromes with solid scientific evidence,” said Mario Esteban Zúñiga Ayala, MD, researcher in cardiology at regional hospital 1 oh de Octubre ISSSTE in Mexico City and lead author of the study. “CBD has substantial evidence for the following conditions: pain, cachexia, nausea and vomiting, spasticity related to multiple sclerosis and, more recently, epilepsy. Its pharmacological profile shows that it is safe and well tolerated in humans , although it has well-described side effects. But the interaction with other drugs often used by cardiologists, such as anticoagulants and antiplatelets, is not well known.”

CBD is derived from cannabis species, commonly known as marijuana, with non-psychoactive activity. It also has analgesic, anti-inflammatory, antineoplastic and chemopreventive activities. According to the researchers, the trends indicate that marijuana is the most widely used substance compared to other drugs like cocaine, heroin, etc. As usage increases, many heart disease patients may consider using these products.

“Medical marijuana and CBD may be of interest as they are advertised and distributed anecdotally as a treatment for many conditions with possible and inconclusive evidence such as glaucoma, Alzheimer’s disease, Parkinson’s disease, anxiety and depression, inflammatory bowel disease and many other conditions that lack clinical data,” said Zúñiga Ayala.

Due to CBD’s anti-inflammatory properties, the study aimed to examine its potential role in reducing myocardial ischemia, a condition in which reduced blood flow to the heart can lead to chest pain, heart failure and a heart attack because the heart works harder to pump blood and oxygen. The researchers used the “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” guidelines to systematically search the PubMed database up to April 2022 using predefined search terms. Nine preclinical studies were included in the review, but no quality randomized controlled trials (RCTs) of the use of CBD in acute or chronic coronary syndromes were found.

A review of nine preclinical studies revealed reproducible cardiovascular results in in vivo studies with CBD. Some of the outcome mechanisms included reduced oxidative stress and inflammation.

“CBD has also shown promising results in experimental models of ischemia and reperfusion injury, myocardial infarction, arrhythmias, and metabolic syndrome-like conditions,” Zúñiga Ayala said.

According to the researchers, the preclinical evidence on CBD and its use in ischemic heart disease is strong enough to support well-designed human clinical trials in coronary syndromes.

“CBD is not a miracle drug. If you are taking other medications, try to ask a medical cannabis specialist to advise you if you are a candidate for taking CBD. Always ask about interactions with your previously prescribed medications and do not suspend any medication prescribed by your doctor,” Zúñiga Ayala said. “If you buy CBD, always look for well-established dispensaries. Clinicians should be aware of the unreliability, purity, and dosage of CBD in products. A recent study of 84 CBD products purchased online showed that more a quarter of the products contained less CBD than In addition, THC was found in 18 products.Products containing THC could potentially harm patients with heart disease.


American College of Cardiology

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