Are There Cardiovascular Risks with Cannabis in Elderly Dementia Patients?

PostedMarch 12, 2026

UpdatedMarch 12, 2026

ByMy Patient Advice

Author: Julia Sutton, MSc | Reviewed by: Dr. Clarissa Morton, PharmD

As medical cannabis becomes more widely studied for managing agitation, pain, and sleep problems in dementia, questions remain about its safety for the heart and circulation, especially in older adults. Cannabis compounds like THC and CBD can influence blood pressure, heart rate, and blood vessel tone.

How Cannabis Affects the Cardiovascular System

Cannabis interacts with the endocannabinoid system, which regulates heart rate, blood pressure, and blood vessel function.

THC activates CB1 receptors, which can temporarily increase heart rate and lower blood pressure, particularly when standing (orthostatic hypotension). This can lead to dizziness and fainting, increasing the risk of falls.

CBD, by contrast, acts on CB2 receptors and may cause mild blood pressure reduction and anti-inflammatory effects without raising heart rate.

A 2024 Age and Ageing meta-analysis (Age and Ageing, 2024) found that older adults using THC-containing products were more likely to experience dizziness and low blood pressure, though serious cardiac events were rare. Another review in BMJ Open Heart (BMJ, 2023) reported that THC could trigger tachycardia (rapid heartbeat) and blood pressure drops in vulnerable users.

Evidence In Dementia Populations

Clinical data from dementia trials suggest similar trends.

The STAND trial (UK, 2025) using a balanced THC: CBD spray reported mild dizziness and orthostatic hypotension during early dose adjustments but no serious cardiovascular events (PMC12143470).

The Pautex et al., 2022 study in severe dementia found transient low blood pressure in a few participants using THC: CBD oil (PubMed 36247984).

CBD-dominant formulations, such as Avidekel oil, were generally well tolerated with no cardiovascular complications (PubMed 36148467).

Guidance From NICE And NHS

The NHS warns that cannabis can cause changes in heart rate and blood pressure, particularly in older adults or those taking antihypertensive medications. The NICE NG144 guidance on cannabis-based medicinal products emphasises that cannabinoids should be prescribed only under specialist supervision, with close monitoring for dizziness or cardiovascular side effects.

The Alzheimer’s Society similarly advises caution, noting that cannabis may cause drowsiness and circulatory instability in elderly patients.

Clinical Bottom Line

THC can cause short-term increases in heart rate and drops in blood pressure.

CBD is generally well tolerated and may lower blood pressure slightly without cardiac stress.

Older adults with cardiovascular disease are more susceptible to dizziness and falls.

NICE and NHS recommend specialist monitoring and caution when prescribing cannabis in this group.

Educational Context: AlleviMed

AlleviMed provides public education about medical cannabis regulation under MHRA and Home Office frameworks. It clarifies that cannabis is not licensed for dementia and must be prescribed cautiously in those with cardiovascular conditions.

Takeaway

While cannabis-based medicines may help with agitation or pain in dementia, THC-containing products can affect heart rate and blood pressure, increasing the risk of dizziness or falls. CBD formulations appear safer but should still be used carefully under specialist guidance. According to NHS and NICE, close monitoring is essential.

Julia Sutton, MSc

Author

Julia Sutton is a clinical psychologist with a Master’s in Clinical Psychology and experience providing psychological assessment and therapy to adolescents and adults. Skilled in CBT, client-centered therapy, and evidence-based interventions, she has worked with conditions including depression, anxiety, bipolar disorder, and conversion disorder. She also has experience in child psychology, conducting psycho-educational evaluations and developing tailored treatment plans to improve learning and well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Clarissa Morton, PharmD

Reviewer

Dr. Clarissa Morton is a licensed pharmacist with a Doctor of Pharmacy degree and experience across hospital, community, and industrial pharmacy. She has worked in emergency, outpatient, and inpatient pharmacy settings, providing patient counseling, dispensing medications, and ensuring regulatory compliance. Alongside her pharmacy expertise, she has worked as a Support Plan & Risk Assessment (SPRA) officer and in medical coding, applying knowledge of medical terminology, EMIS, and SystmOne software to deliver accurate, compliant healthcare documentation. Her skills span medication safety, regulatory standards, healthcare data management, and statistical reporting.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewers's privacy.