Cannabidiol and Resistant Hypertension: Evidence on Blood Pressure Modulation

Introduction: Resistant hypertension, defined as uncontrolled blood pressure despite the use of three or more antihypertensive agents, represents an important cardiovascular risk factor and a therapeutic challenge. Cannabidiol (CBD), a phytocannabinoid from Cannabis sativa without significant psychoactive effects, has gained attention for its vasodilatory, anti-inflammatory, antioxidant, and autonomic-modulating properties. Method: An Integrative Literature Review was conducted in PubMed, ScienceDirect, SciELO, and Web of Science databases, using the descriptors Cannabidiol, Blood Pressure, Resistant Hypertension, and Hypertension. Original articles published between 2019 and 2025, in Portuguese and English, directly addressing the use of CBD in blood pressure modulation were included. After a systematized screening, 14 studies composed the final sample. Results: The studies show that CBD may promote discrete yet consistent reductions in baseline blood pressure and attenuate pressure spikes in stress-induced situations. Preclinical models reinforce its role in vasodilation and improvement of endothelial function, in addition to effects on inflammatory modulation and autonomic nervous system activity. Clinical trials in humans corroborate these findings, but present limitations related to sample size, methodological heterogeneity, and short follow-up duration. Discussion: Controversies remain regarding dose standardization, formulation, and route of administration, as well as long-term safety. Potential drug interactions with antihypertensives warrant caution in clinical practice. Final considerations: CBD emerges as an innovative and promising alternative for patients with resistant hypertension, though still at an experimental stage. Multicenter, randomized, long-term trials are essential to consolidate evidence on efficacy and safety, enabling future clinical recommendations.