Strokes (Cerebrovascular Accidents)
Cannabis benefits the brain and heart both before and after a stroke. Cannabis can control factors that lead to strokes and protect the brain from neurological damage after a stroke. Medical marijuana also has qualities that protect the heart and brain.
What are Strokes?
A stroke is when blood supply to part of the brain is reduced or blocked. This prevents the brain from getting oxygen, causing brain cells to perish. Strokes are also called Cerebrovascular Accidents (CVA) or “brain attacks”. Heart attacks occur when the coronary artery is narrowed or blocked and blood flow to the heart muscle is restricted.
There are three main kinds of stroke - ischemic stroke, hemorrhage stroke, and transient ischemic attack or mini-stroke. According to the CDC, about 87% of strokes are ischemic strokes. Ischemic strokes happen when blood flow to the brain is blocked. Hemorrhagic strokes happen when an artery in the brain ruptures or leaks blood, putting pressure on brain cells and damaging them. A mini-stroke, or transient ischemic attack, is when blood flow to the brain is blocked for a short amount of time. This is a warning sign of a more severe stroke and should be considered a medical emergency.
Risk Factors for Strokes
Risk factors for having a stroke include being obese, excessive alcohol use, a lack of physical activity, cigarette smoking, and using cocaine or methamphetamines.
Medical conditions associated with an increased risk of stroke include high blood pressure, heart disease, high cholesterol, diabetes, sleep apnea, and a family history.
Men have a higher risk of stroke than women, as well as people over the age of 55. Birth control pills or Estrogen Replacement Therapy (ERT) used in menopause can also increase the risk.
Signs and Symptoms of Strokes
Signs that a person is having a stroke include numbness in the face, arm, or leg (usually on one side), difficulty seeing in one or both eyes, a sudden intense headaches, loss of balance, dizziness, difficulty speaking, and confusion.
Strokes can have serious long term complications and result in disability. After a stroke someone may experience loss of muscle control, paralysis on one side of the body, memory loss, pain and numbness in areas of the body affected, behavioral changes, difficulty speaking and swallowing (if facial muscles are affected), and emotional problems or depression.
Prevention and Treatment
To prevent strokes, it is important to manage medical conditions that increase their risk, such as hypertension, sleep apnea, diabetes, heart disease, and high cholesterol. Healthy lifestyle habits should be maintained, including healthy eating, not smoking, limiting alcohol use, regular exercise, maintaining a healthy weight, and avoiding saturated fat, cholesterol, and sodium.
Strokes are serious medical emergencies that require immediate medical attention. They are treated with medications and interventions to restore blood flow or oxygen to the brain or heart. Rehabilitation will depend on the individual’s needs and the severity of the event. Rehabilitation programs may include neurologists, cardiologists, dietitians, physical therapy, occupational therapy, speech therapy, and other teams of medical professionals.
Medical Marijuana and Strokes
In the past there were some studies that correlated marijuana use with an increased risk of stroke, but newer studies show that cannabis use alone is not associated with an increased risk of heart disease or stroke.
Study: Cannabis Use Doesn’t Increase the Risk of Stroke
A study from the University of Mississippi analyzed data from 9,350 patients in the hospital for a stroke and with a positive cannabis drug test. The study found that when accounting for other factors that are known to contribute to strokes, such as age, race, other conditions, hypertension, cigarette and alcohol use, family history, diabetes, and other cardiac conditions, cannabis use was not associated with an increased risk of stroke.
Before accounting for these factors, cannabis users had a lower risk of stroke than the overall control population. While previous population studies have associated cannabis use with stroke, cannabis is not shown to be an independent factor when other more serious risk factors are considered. Smoking, alcohol, age, and unhealthy lifestyle habits are more likely to play a role in stroke than cannabis use.
Researchers noted that just because someone had a stroke and previously used cannabis certainly doesn’t mean cannabis caused the stroke. Studies that consider all stroke factors find cannabis use does not increase the risk. Instead there have been numerous studies showing cannabis can reduce or treat factors that cause stroke and reduce damage when used both before and after stroke.
Medical Cannabis Reduces Damage from Strokes
Pre-clinical studies from Japan in 2007 found cannabinoids in marijuana protected the brain both before and after stroke. Results showed that THC decreased the size of the stroke by 50% and brain injury by as much as 50%. THC was shown as neuroprotective before a stroke. CBD was shown as neuroprotective before and after a stroke.
Additionally, the United States government patented the neuroprotective (brain protecting) qualities of cannabis in 2003 stating they were of particular interest in reducing neurological damage after ischemic insults, such as strokes.
Other pre-clinical studies show very low doses of THC given before a stroke reduced damage to the heart and brain after a stroke.
Reducing Factors that Cause Strokes
Medical marijuana can also benefit the biggest factors that contribute to strokes, including high blood pressure, obesity, and type II diabetes. Cannabis also has cardioprotective qualities that protect the heart and reduce inflammation.
Hypertension (High Blood Pressure) - Both THC and CBD either alone or in combination have been shown to reduce blood pressure, according to clinical studies.
In a 2020 study of patients over the age of 60, both THC and CBD in varying ratios, in either inhaled or oral forms, reduced blood pressure and heart rate over 3 months of the study. Cannabis was determined safe and well-tolerated in adults over the age of 60 who had pre-existing medical conditions.
Cannabinoids produce vasodilation - the opening of blood vessels that improves circulation, according to studies of cannabis and blood pressure. This is very beneficial in strokes, where increased blood circulation is needed. Controlling blood pressure reduces the risk of stroke.
For more information on using medical cannabis to lower blood pressure:
Type II Diabetes and Obesity - Medical marijuana is becoming a novel treatment for diabetes as well. Cannabis use is associated with smaller waist circumferences, lower incidences of type 2 diabetes, and lower insulin resistance.
In a 2016 placebo-controlled study, THCV decreased glucose levels and increased insulin production in 62 patients with type 2 diabetes. This supports patient reports that marijuana stabilizes blood sugars. Controlling diabetes is vital to reducing the risk of stroke.
For more information on the benefits of cannabis in diabetes:
Cardioprotection - The cannabinoids in cannabis are shown to protect the heart and reduce inflammation.
A meta-analysis from New Zealand in 2007 found that cannabinoids in cannabis protect the heart, control blood pressure, reduce inflammation and the progression of atherosclerosis in the heart, and improve blood circulation - all factors that reduce the risk of stroke.
Pre-clinical studies from Brazil in 2009 found that CBD reduced stress responses that negatively affect the heart, such as anxiety, rapid heart beat, and high blood pressure.
Atherosclerosis is a factor in stroke where plaque or bad cholesterol builds in the walls of the heart, leading to obstruction and complications. Cannabinoids were shown to reduce the size of atherosclerotic lesions and prevent against atherosclerosis as anti-inflammatories in pre-clinical studies. Preventing and controlling atherosclerosis is also vital to reducing the risk of stroke and heart attack.
In a recent study analyzing cannabis use in people admitted to the hospital for heart attacks, those who used cannabis had a reduced risk of death. They also had a decreased incidence of shock and intra-aortic balloon pump replacement. This indicates that marijuana use may increase the risk of survival after a heart attack, but further research is needed.
For more information on using medical marijuana for heart disease:
Using Medical Marijuana for Strokes
Cannabis can be very beneficial to prevention of strokes, overall health, and reducing damage after a stroke. Inhaling cannabis is not recommended for those with heart and lung conditions, even though it is not associated with the same detrimental health risks as smoking tobacco. Non-inhaled forms, such as capsules, oils, tinctures or edibles, are recommended for those with heart conditions or an increased risk of stroke. Cannabis and other medicines for heart conditions should always be discussed and monitored by a knowledgeable physician.
When choosing a strain or product for heart conditions, both THC and CBD are beneficial for protecting the heart and reducing blood pressure. They are also able to relieve pain and inflammation.
Higher levels of CBD to lower THC will reduce or eliminate the intoxicating effects of THC. 10:1 or higher ratios of CBD to THC are always non-intoxicating. 1:1 CBD to THC ratios may produce mild euphoria for some patients, while others find them non-intoxicating. 2:1, 3:1, or 5:1 CBD to THC ratios will also be non-intoxicating for a majority of patients. The ratio of CBD to THC that you choose will depend on your individual needs and symptoms.
Patients should also consider the time of day they need relief to choose an appropriate strain type. Sativa and sativa dominant hybrid strains and products are energizing and best for daytime relief of fatigue and other symptoms. Indica and indica dominant hybrid strains and products are relaxing, sedative, and best for nighttime relief or improved sleep and relaxation.
Medical marijuana is a viable supplement to prevent strokes and reduce their damage. Patients should always avoid cigarette smoking and alcohol, practice healthy lifestyle habits, eat healthy, and exercise regularly to further reduce the risk of stroke. Always consult a doctor if you have other concerns about using cannabis in related conditions.
Medical marijuana is a versatile medicine that can be used without intoxication.
To use medical marijuana effectively all patients should be knowledgeable about strain types, THC and CBD ratios, dosing, and ways to use the medicine.