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Review

Cardiovascular Effects of Cannabidiol: From Molecular Mechanisms to Clinical Implementation

1
Department of Cardiology, University Hospital of Split, 21000 Split, Croatia
2
Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia
3
Laboratory for Cardiometabolic Research, University of Split School of Medicine, 21000 Split, Croatia
4
Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia
5
Department of Integrative Physiology, University of Split School of Medicine, 21000 Split, Croatia
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2025, 26(19), 9610; https://doi.org/10.3390/ijms26199610
Submission received: 26 July 2025 / Revised: 2 September 2025 / Accepted: 30 September 2025 / Published: 1 October 2025
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)

Abstract

Cannabidiol (CBD) and other phytocannabinoids are gaining attention for their therapeutic potential in cardiovascular disease (CVD), the world’s leading cause of death. This review highlights advances in understanding the endocannabinoid system, including CB1 and CB2 receptors, and the mechanisms by which CBD exerts anti-inflammatory, antioxidative, vasoprotective, and immunomodulatory effects. Preclinical and translational studies indicate that selective activation of CB2 receptors may attenuate atherogenesis, limit infarct size in ischemia–reperfusion injury, decrease oxidative stress, and lessen chronic inflammation, while avoiding the psychotropic effects linked to CB1. CBD also acts on multiple molecular targets beyond the CB receptors, affecting redox-sensitive transcription factors, vascular tone, immune function, and endothelial integrity. Early clinical trials and observational studies suggest that CBD may lower blood pressure, improve endothelial function, and reduce sympatho-excitatory peptides such as catestatin, with a favorable safety profile. However, limited bioavailability, small sample sizes, short study durations, and uncertainty about long-term safety present challenges to its clinical use. Further research is needed to standardize dosing, refine receptor targeting, and clarify the role of the endocannabinoid system in cardiovascular health. Overall, current evidence supports CBD’s promise as an adjunct in CVD treatment, but broader clinical use requires more rigorous, large-scale studies.
Keywords: cannabidiol; cardiovascular disease; endocannabinoid system; anti-inflammatory cannabidiol; cardiovascular disease; endocannabinoid system; anti-inflammatory

Share and Cite

MDPI and ACS Style

Urlić, H.; Kumrić, M.; Pavlović, N.; Dujić, G.; Dujić, Ž.; Božić, J. Cardiovascular Effects of Cannabidiol: From Molecular Mechanisms to Clinical Implementation. Int. J. Mol. Sci. 2025, 26, 9610. https://doi.org/10.3390/ijms26199610

AMA Style

Urlić H, Kumrić M, Pavlović N, Dujić G, Dujić Ž, Božić J. Cardiovascular Effects of Cannabidiol: From Molecular Mechanisms to Clinical Implementation. International Journal of Molecular Sciences. 2025; 26(19):9610. https://doi.org/10.3390/ijms26199610

Chicago/Turabian Style

Urlić, Hrvoje, Marko Kumrić, Nikola Pavlović, Goran Dujić, Željko Dujić, and Joško Božić. 2025. "Cardiovascular Effects of Cannabidiol: From Molecular Mechanisms to Clinical Implementation" International Journal of Molecular Sciences 26, no. 19: 9610. https://doi.org/10.3390/ijms26199610

APA Style

Urlić, H., Kumrić, M., Pavlović, N., Dujić, G., Dujić, Ž., & Božić, J. (2025). Cardiovascular Effects of Cannabidiol: From Molecular Mechanisms to Clinical Implementation. International Journal of Molecular Sciences, 26(19), 9610. https://doi.org/10.3390/ijms26199610

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