Congestive heart failure (CHF) is often a difficult condition to manage. The safety of cannabis use in the setting of CHF depends on several factors. CHF in the US is most often due to the progression of coronary artery disease, often in the setting of other conditions such as high cholesterol, hypertension, and diabetes. We generally advise people with coronary artery disease or peripheral artery disease to avoid smoked cannabis since it contains many of the same volatile compounds as tobacco smoke which is known to lead to progression of CHF and coronary artery disease. Tinctures are likely a safer option but it depends on how much your using and what strain. High THC products, or overuse of low-THC products can lead to increases in blood pressure and heart rate which can worsen CHF over time and in some case lead to acute heart failure exacerbation. The safest cannabis products you can use if you have CHF are the topical products since they can provide localized pain relief without causing the cardiac side effects of THC in the blood stream.
In summary, cannabis tinctures are probably safe if used responsibly in low doses. The topical cannabis products are safest since they can provide local pain relief with minimal THC getting into your bloodstream. NSAID medications such as Advil, Aleve, and generic Ibuprofen as well as opiate medications should be avoided for those with CHF as well. Please consult both a cannabis recommending physician and your primary care doctor to discuss your specific situation before considering cannabis use.
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