Research advances in the regulation of vascular inflammation and programmed cell death by cannabidiol

Vascular inflammation and programmed cell death (PCD) jointly drive the pathogenesis of critical vascular disorders, including sepsis, atherosclerosis, and diabetic vasculopathy. However, clinically safe and effective broad-spectrum antiinflammatory agents remain lacking. As a non-psychoactive natural cannabinoid, cannabidiol (CBD) possesses multi-target antiinflammatory, antioxidant, and cell death-modulating properties. This review systematically summarizes the classical and nonclassical molecular targets of CBD, delineates its regulatory network underlying apoptosis, pyroptosis, necroptosis, ferroptosis, and PANoptosis, describes the protective effects of CBD in acute and chronic vascular inflammatory diseases, and highlights key translational obstacles such as low bioavailability, non-uniform dosing regimens, and context-dependent specificity. We aim to provide a theoretical foundation and innovative perspectives for advancing basic research and clinical translation of CBD in the management of vascular inflammatory diseases.