Therapeutic potential of cannabidiol (CBD) in the treatment of cardiovascular diseases

ABSTRACT

Introduction

Cannabidiol (CBD) is the primary non-psychoactive chemical derived from Cannabis Sativa, and its growing popularity is due to its potential therapeutic properties while avoiding the psychotropic effects of other phytocannabinoids, such as tetrahydrocannabinol (THC). Numerous pre-clinical studies in cellular and animal models and human clinical trials have demonstrated a positive impact of CBD on physiological and pathological processes. Recently, the FDA approved its use for the treatment of seizures, and clinical trials to test the efficacy of CBD in myocarditis and pericarditis are ongoing.

Areas covered

We herein reviewed the current literature on the reported effects of CBD in the cardiovascular system, highlighting the physiological effects and the outcomes of using CBD as a therapeutic tool in pathological conditions to address this significant global health concern.

Expert opinion

The comprehensive examination of the literature emphasizes the potential of CBD as a therapeutic option for treating cardiovascular diseases through its anti-inflammatory, vasodilatory, anti-fibrotic, and antioxidant properties in different conditions such as diabetic cardiomyopathy, myocarditis, doxorubicin-induced cardiotoxicity, and ischemia-reperfusion injury.

KEYWORDS:

• Arrhythmias
• cannabidiol
• cardiovascular disease
• CBD
• diabetic cardiomyopathy
• doxorubicin-induced cardiotoxicity
• ischemia-reperfusion injury
• myocarditis

Article highlights

• The US Food and Drug Administration (FDA) approved the use of a highly purified Cannabidiol (CBD) formulation to be given orally for treating seizures associated with Dravet and Lennox-Gastaut.

• CBD has been extensively tested in animal disease models and several clinical trials in patients with different diseases, such as neurological disorders, inflammatory diseases and pain, kidney disease, metabolic disease, cardiovascular diseases, and Coronavirus Disease- 2019.

• Benefits of CBD in treating cardiovascular diseases are due to physiological factors, like the observed blood pressure-lowering effects, its antioxidant and anti-fibrotic effect, and its anti-inflammatory activity.

• The effects of CBD are multiple, and rigorous pre-clinical and clinical testing are warranted to gain from its therapeutic potential in each specific disease and offset possible undesired effects.

• CBD has shown cardioprotective effects in different endpoints in animal models of myocardial ischemia-reperfusion injury, doxorubicin cardiotoxicity, arrhythmias, myocarditis, pericarditis, and diabetic cardiomyopathy. Most importantly, two clinical trials are being performed to assess its effectiveness on pericarditis and myocarditis in humans.

Declaration of interest

A Abbate received research grant funding and has served as a paid scientific advisor to Implicit Biosciences, Kiniksa, Lilly, Merck, Novartis, Novo Nordisk, Olatec, R-Pharm, Serpin Pharma, and Swedish Orphan Biovitrum. S Toldo has served as a paid scientific advisor to Cardiol Therapeutics, and received research grant funding from Kiniksa, and Cardiol Therapeutics. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution

N Martinez-Naya and S Toldo contributed to the conceptualization of this comprehensive review. N Martinez Naya and J Kelly reviewed the literature and drafted the original version of the manuscript. A Hogwood, A Abbate, and S Toldo reviewed and edited the manuscript. All authors have read and agreed to the published version of the manuscript.

Acknowledgments

All figures were created with BioRender.com

Additional information

Funding

This paper was not funded.