Atherosclerosis is a very common condition in which fat builds up in the walls of arteries, leading to cardiovascular issues. CBD for atherosclerosis has proven to have many beneficial effects, in both preventing the progression of the disease and improving severe cases.
What is atherosclerosis?
Atherosclerosis refers to the accumulation of fatty plaques behind the first layer of blood vessel walls. This is a normal process, and around 3 in 4 people develop some degree of atherosclerosis during adolescence. Atherosclerosis initially causes widening of the total diameter of the blood vessel including the walls and the lumen (where blood flows), such that the lumen is not blocked by the presence of the plaque and instead the wall is expanded outward.
Over time, the lumen becomes impeded by the plaque, which can either completely block the artery, or break off and form a clot at a narrower point downstream.
If this occurs in the coronary artery which supplies the heart, a myocardial infarction (heart attack) occurs. If it occurs in the carotid artery which supplies the brain, then a stroke can occur. If it occurs in the arms or legs, it presents as peripheral artery disease. If it occurs in the kidneys, which filter excess water and toxins from the blood, then high blood pressure and other complications can occur, including and especially kidney failure.
Because atherosclerosis is ubiquitous within an individual circulatory system, it often leads to all of the above, and its presence within and effect on the heart muscle is the number one cause of heart disease, which in turn is the number one cause of death among humans.
Through a healthy diet and lifestyle, the progression of atherosclerosis can be limited to thickening of the artery walls which doesn’t impede circulation, rather than occlusion of the artery lumen, which limits blood flow and can quickly lead to complications.
Diagnosis of atherosclerosis
To diagnose atherosclerosis, a physician typically listens for abnormal sounds through the stethoscope, and may also attempt to discern whether arteries are hardened or occluded. If there appears to be risk for atherosclerosis, then the following tests can confirm the diagnosis.
To confirm the diagnosis a physician may also order the following tests
- Blood Test: Blood tests will measure the variance between HDL and LDL, and the levels of free cholesterol, an imbalance of which signals improper lipid metabolism.
- Ankle-Brachial Index: in this test the doctor will compare the blood pressure in the ankles to the arms. There should be a slight variation between the two pressures, but a large disparity signals the potential for cardiovascular disease.
- Cardiac catheterization and angiogram: A catheter is introduced to the femoral artery and fed through the aorta into the heart, where dye is released and a subsequent x-ray will reveal portions of the heart that were not saturated with the dye, and are therefore fed by partially obstructed arteries.
Causes of atherosclerosis
The purpose of cholesterol in the body is two-fold. It provides elasticity to cell membranes, and it forms a vital piece of the HDL and LDL protein complexes which transport fat in the bloodstream. HDL, or high-density lipoprotein, is responsible for transporting fatty acids from the circulation back to the liver. LDL, or low-density lipoprotein, is responsible for transporting fat from the liver into the bloodstream where it enters cells to be stored as fat or burned as fuel.
A small portion of circulating LDL invades the endothelial lining of blood vessels, which is believed to represent the first event in the accumulation of a plaque. As a response, macrophages are recruited to the area, where they cause a perforation of the endothelial layer, leading to inflammation and the further accumulation of more LDL particles. The lesions which form where the endothelium is weakened physically attract toxins and particulates in the blood that would otherwise be filtered by physically similar notches in the vasculature of the liver or kidneys.
Monocytes and other immune-related cells also accumulate in the plaque as they die, which further incites the inflammatory attack in an endless cycle that can only be limited through a change in the ratio of HDL to LDL; directly dependent on diet and exercise.
Current treatment options for atherosclerosis
A healthy diet along with an active lifestyle are by far the best way for anyone to reduce their risk of atherosclerosis, and to slow down its progression once it has started to cause other more serious health problems. When the disease has progressed to the point of requiring medical attention, there are several levels of treatment for mild to severe atherosclerosis, including:
- Cholesterol medications (i.e. Statins and Fibrates): these drugs are meant to aggressively lower the amount of bad cholesterol (LDL-cholesterol) in order to slow down or even stop the continued build up of fat deposits in arteries.
- Calcium channel blockers. These medications lower blood pressure which slows down the build up of fat deposits. They are usually prescribed once chest pain is a recurring symptom.
- Angioplasty and stent placement. In this procedure, a balloon inflates a piece of mesh over the site of severe plaque build-up, compressing the walls of the artery and increasing the diameter of the lumen, restoring blood flow.
Is endocannabinoid deficiency involved in atherosclerosis?
Atherosclerosis consists largely of an immune-mediated assault on the endothelium of blood vessels once a fatty plaque has formed in the vicinity. The endocannabinoid system regulates the activity of the vast majority of immune system cells, and its activity is associated with the suppression of inflammatory processes. Research has suggested that abnormal endocannabinoid signaling plays a paramount role in the development of atherosclerosis, but the exact chain of effects branching from an initial endocannabinoid system imbalance to the end result of plaque formation is not entirely elucidated.
Because CBD for atherosclerosis is a newly-suggested alternative treatment for this condition, more research has been undertaken to develop our understanding of the role of the endocannabinoid system in the atherosclerotic process and in the promotion of inflammation. CB1 agonists lower blood pressure, and it has been discovered that the body releases endocannabinoids which activate CB1 receptors as an innate form of anti-inflammatory regulation.
In diseased vessels, the quantities of endocannabinoids, such as 2-AG, and of cannabinoid receptors, are elevated. This evidence confirms the theory that the endocannabinoid system is activated by the same stimuli which activate inflammatory reactions; whether the inflammation induces the ECS upregulation, or ECS upregulation is a part of the proinflammatory signalling cascade, remains to be elucidated.
The endocannabinoid system stimulates platelets to activate and promote inflammation via recruitment to an area of injury. If this process is over-regulated, it could accelerate plaque formation. However, the ECS is also associated with mitigation of the symptoms of atherosclerosis, so it is not yet conclusive the degree or kind of effect that ECS activity – or dysfunction – would have on the environment within blood vessel walls.
The endocannabinoid system is also our body’s innate line of a defense against reactive oxygen species (ROS) and free radicals, which are highly reactive molecules that bind to important cellular components and change them irreparably. Oxidation is the process of oxygen binding to and altering the chemical structure of another substance (i.e. rust is the combination of iron with oxygen ions from the environment to form iron oxide.) The endocannabinoid system requires this process for the formation of endocannabinoids, so it recruits ROS and free radicals away from sensitive cellular mechanisms and instead uses the same chemical reaction for a necessary step in ECS signalling.
Does CBD improve cases of atherosclerosis
CBD inhibits the enzyme FAAH which is responsible for degrading endocannabinoids, our body’s natural anti-inflammatory molecules. This represents one suggested mechanism of action through which CBD exerts its anti-atherosclerotic effects. By causing endocannabinoids to remain active for longer, they are able to exert a greater anti-inflammatory effect.
CBD has extensive antioxidant effects in addition to its regulatory effect on the immune system and inflammation. The process of plaque formation requires the oxidation of cholesterol, and the antioxidant effect of CBD is more effective than vitamin C or E in halting free radical activity that can lead to oxidative stress in the lining of the arteries and contribute to plaque formation.
Moreover, CBD is unique in the number and diversity of receptors to which it binds. In addition to acting as a negative allosteric modulator at cannabinoid 1 and 2 receptors, CBD binds to PPARγ, which is in a class of receptors responsible for regulating gene expression. CBD’s effects on PPARγ result in the downregulation of genes associated with pro-inflammatory processes, and the upregulation of genes associated with anti-inflammatory and cellular repair processes.
In 2015, David Bellinger and company concluded that the increase in concentration of endocannabinoids to a diseased area is likely an adaptive response to oxidative stress. Because genetic and lifestyle factors lead to atherosclerosis development, a way that the body will counteract it is by either increased biosynthesis or reduced hydrolysis of 2-AG. CBD promotes both of these functions, in addition to the above mentioned effects, and in combination they certainly suggest that CBD is an effective new alternative for both treating and preventing atherosclerosis.