Available online on 15.10.2025 at http://jddtonline.info

Journal of Drug Delivery and Therapeutics

Open Access to Pharmaceutical and Medical Research

Copyright  © 2025 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited

Open Access Full Text Article                                                                                 Review Article

Nutraceutical: A Promising Era for Cardiovascular Disease Prevention and Treatment

Sharuti Koundal , Monika Devi *, Kapil Kumar Verma

Minerva College of Pharmacy, Indora, H.P, India

 

 

INTRODUCTION:

In recent years, cardiovascular diseases (CVDs) have affected millions of people globally and have emerged as one of the primary causes of illness and death in both developed and developing nations. CVDs broadly include disorders of the heart and blood vessels, such as stroke (cerebrovascular disease), heart attacks (coronary heart disease), high blood pressure (hypertension), rheumatic heart disease, heart failure, peripheral artery disease, and congenital heart defects¹.Age-related arterial dysfunction is a major physiological factor contributing to the onset of cardiovascular and cerebrovascular events in older adults². Among the various types of arterial dysfunction, stiffening of the large elastic arteries - such as the aorta and carotid arteries — during midlife is especially predictive of cardiovascular and cerebrovascular incidents, as well as an increased risk of Alzheimer’s disease and other dementias later in life. This arterial stiffening leads to significant consequences, including the development of high blood pressure (hypertension) and elevated pulsatile stress (increased blood flow pulsatility) on vital organs like the heart, brain, and kidneys^3-4. Functional foods - foods that contain biologically active compounds offering health benefits beyond basic nutrition - have emerged as promising lifestyle interventions to lower cardiovascular risk. Similarly, nutraceuticals, which include bioactive nutrients and supplements, may positively influence cardiovascular risk factors⁵. This review examines the evidence supporting the use of key functional foods and nutraceuticals in preventing cardiovascular disease (CVD) and promoting heart health⁶. Prevention recommendations advocate diets high in fruits, vegetables, legumes, whole grains, and lean protein sources accompanied with a reduction or avoidance of processed foods, trans fats, and drinks with added sugar. The Dietary Approaches to Stop Hypertension (DASH), the Mediterranean, and plant-based diets have all been shown to be cardio protective to varied degrees and are recommended by professional healthcare societies; however, longer-term research is needed for other new diets like intermittent fasting and the ketogenic diet. Dietary influences on cardiovascular health and the gut microbiota have created a new avenue for precision medicine to enhance cardio metabolic risk factors⁷.

 

 

Figure 1: Disease of CVD

Epidemiology of Cardiovascular Disease (CVD):

Global Burden:                 

CVD remains the leading cause of mortality worldwide, responsible for about 17.9–20 million deaths annually, representing roughly one-third of all global deaths.

Over 80% of CVD deaths occur in low- and middle-income countries (LMICs), highlighting inequalities in prevention and care.

Women, particularly in low- and middle-income regions, continue to experience a rising burden of CVD, with over 53 million cases in women aged 15–49 by 2019, and trends continuing upward post-pandemic.

United States:

The COVID-19 pandemic (2020–2022) led to a significant increase in CVD mortality in the U.S.

Age-adjusted mortality rate for CVD rose to 451.8 per 100,000 in 2021, declining slightly to 434.6 per 100,000 in 2022, yet still higher than pre-pandemic levels.

Excess CVD deaths during the pandemic period (2020–2022) were estimated at ~190,000.

Statin and antihypertensive medication use increased slightly during this period, yet mortality from coronary heart disease and stroke also rose.

Regional Disparities:

In China, CVD mortality—especially ischemic heart disease—has risen faster in rural areas than urban areas. Rural mortality rates doubled over three decades.

In India, the prevalence of self-reported CVD in adults ≥45 years is about 5.2%, with higher rates in men and in urban populations. Risk factors such as hypertension (~47%), diabetes (~12%), obesity, and smoking are prevalent.

Risk Factors:

Major modifiable risk factors include hypertension, high LDL/non-HDL cholesterol, diabetes, smoking, physical inactivity, poor diet, and air pollution.

The Global Burden of Disease (GBD) 2020–2022 estimates ~64% of CVD burden and ~69% of CVD deaths are attributable to these modifiable risk factors^8-14.

NUTRACEUTICAL:

The term nutraceuticals is derived from the word nutrition. It was coined in 1989 by Stephen De Felice, the founder and chairman of the Foundation for Innovation in Medicine in Cranford, New Jersey, by blending the words nutrition and pharmaceutical. According to De Felice, a nutraceutical is a food or dietary component that offers therapeutic or health-enhancing effects which treat and prevent the disease¹⁵. The terms "nutrition" and "pharmaceutical" are combined to form the phrase "nutraceuticals," which describes foods or food extracts that have health and/or medical advantages, such as illness prevention and therapy¹⁶. The anti-inflammatory and antioxidant qualities of nutraceuticals contribute significantly to their positive effects, indicating that they may be used as a treatment to lessen arterial stiffness in the elderly¹⁷. It has been demonstrated that a variety of nutraceuticals have important roles in immune function and vulnerability to specific disease states. A number of oxidative stress-related ailments, such as allergies, Alzheimer's disease, cardiovascular disorders, cancer, and eye disorders, Parkinson's diseases, and obesity, can also be treated using nutraceuticals¹⁸. A wide word used to refer to any product made from food sources that offers additional health advantages beyond the fundamental nutritional worth of foods is "nutritraceuticals".The source usually determines how nutraceuticals and related items are defined. The pharmacological circumstances, chemical composition, and natural sources of these items may all be used to define their classification. The four main categories into which nutraceuticals fall are dietary supplements, functional foods, medicinal food, and pharmaceuticals¹⁹.

Figure 2: Nutraceuticals in CVD

 

The following factors may contribute to the propensity for nutraceuticals^20-24:

• The rising expenses of healthcare are causing concern for a growing number of people.
•  People who are unhappy with the way pharmaceutical medicines have improved their health are turning to nutraceuticals to help them stay healthy and prevent chronic illnesses.
•  Medical professionals understand that the highly processed food we consume, which is grown with chemical pesticides, fertilizers, herbicides, and sometimes genetically modified seeds, is deficient in nutrients for good health.
• A population inclined more toward illness prevention than therapy.
• People suffering from chronic illnesses who have not sought relief from them through allopathic remedies.
• Individuals looking for more affordable medical treatments who are limited by their financial means.

 

 

ROLE OF NUTRACEUTICALS IN CVD:

Table 1: (Role of Nutraceuticals)

Nutraceutical	Source	Role in CVD
Omega‑3 fatty acids	Fish oil, flaxseed, chia seeds, walnuts	Reduce triglycerides, lower inflammation, improve endothelial function, reduce arrhythmias
Phytosterols & stanols	Fortified spreads, nuts, seeds, vegetable oils	Lower LDL‑cholesterol by competing with cholesterol absorption
Coenzyme Q10 (CoQ10)	Organ meats, supplements	Improves endothelial function, reduces oxidative stress, may lower BP
Polyphenols  (Flavonoids, Resveratrol)	Red wine (resveratrol), cocoa, berries, green tea	Antioxidant And Anti-inflammatory, improve vascular health
Garlic (Allicin)	Garlic bulbs, supplements	Lowers BP, modestly reduces cholesterol & platelet aggregation
Vitamin D	Sunlight, fatty fish, fortified milk, supplements	Associated with lower BP, reduced inflammation (though evidence is mixed)
Probiotics	Yogurt, supplements	May improve lipid profiles, lower BP, and reduce inflammation
Curcumin	Turmeric	Anti‑inflammatory, antioxidant, may reduce arterial stiffness

 

 

Polyunsaturated fatty acids:

Polyunsaturated fatty acids are vital to bodily functions and are obtained externally through diet; they are also known as essential fatty acids²⁵. Polyunsaturated fatty acids can be divided into two categories: 

1. Fatty acids with omega-3 (n-3)
2. Fatty acids that are omega-6-(n-6)

The three main omega-3 fatty acids are docosahexanoic acid (DHA), eicosapentanoic acid (EPA), and alpha-linolenic acid (ALA). The precursors of docosahexanoic acid and eicosapentanoic acid are alpha-linolenic acid. The primary sources of eicosapentanoic acid and docosahexanoic acid are fish oils and fatty fish like salmon, herring, trout, blue fin tuna, and mackerel. Flaxseed, canola, soybeans, some nuts (including walnuts), and red or black current seeds are sources of alpha-linolenic acid.The primary components of omega-6-polyunsaturated fatty acids are arachidonic acid, gamma linolenic acid, and linolenic acid. The primary source of linolenic acid is vegetable oils, such as those found in corn, sunflower, safflower, and soy. Meat, poultry, and eggs are examples of animal products that contain arachidonic acid.

According to studies, omega-3 fatty acids have three main effects on cardiovascular diseases: they are hypolipidemic (they help lower the concentration of lipids in the serum), antithrombotic (they reduce arteriosclerosis), and antiarrhythmic (they prevent and increase irregularities in the force or rhythm of the heart)²⁶.

 

 

 

 

Figure 3: Activities of PUFAs

Probiotics:

Probiotics have a long history that began more than 2,000 years ago with the first consumption of fermented milk. The work of Metchinkoff (1907) to convert the large intestine's flora into a host-friendly colony of Bacillus bulgaricus increased scientific interest in this field²⁷.A probiotic is a type of live microbial feed additive that, when given in sufficient quantities, improves the intestinal microbial balance of the host animal²⁸. Probiotics come in a variety of forms, including liquid, gel, paste, granules, powder, and more. Certain probiotics are typically used to treat gastrointestinal disorders include severe diarrhoea, lactose intolerance, and gastrointestinal side effects linked to antibiotics²⁹.  Probiotics are non-toxic, non-pathogenic, resistant to stomach acid, and cling to the tissues of the gut epithelium to produce antibacterial compounds. There is proof that taking probiotics lowers the chance of developing chronic illnesses like cancer, allergies, asthma, and numerous other illnesses as well as urinary tract and ear infections³⁰.

Figure 4: Activities of Probiotic

Curcuma longa:

The yellow pigment found in turmeric, curcumin, possesses hepatoprotective, anti-inflammatory, anticarcinogenic, and antioxidant properties. The majority of curcumin's liver-protective properties are associated with its antioxidant properties³¹.The turmeric (Curcuma longa) rhizome is a readily available source of curcumin (diferuloylmethane), a polyphenolic category of nutraceuticals. Chinese and Indian cultures have long utilized turmeric as a traditional remedy. Because of its possible therapeutic benefits, curcumin has recently drawn the attention of experts. In addition to its well-known anticancer, antioxidant, hypoglycemic, wound-healing, anti-inflammatory, antiviral, and anti-infectious qualities, this extremely pleiotropic chemical is still being studied^32-34. By binding to target receptors implicated in virus infection mechanisms such as spike glycoprotein-RBD, PD-ACE2, and SARS-CoV-2 protease, curcumin prevents virus entrance and budding, as shown by the molecular docking approach³⁵. 

Figure 5: Activities of Turmeric

Vitamins:

A higher risk of chronic illnesses like cardiovascular disease, osteoporosis, and childhood rickets has all been connected to vitamin D supplementation³⁶. In order to maximize therapeutic approaches, it is crucial to comprehend how vitamins and drugs interact. In order to maintain good health and prevent chronic diseases, it is crucial to make sure that one consumes enough of these vitamins through a balanced diet full of fruits, vegetables, whole grains, lean meats, and healthy fats. Vitamins have pharmacological benefits that include supporting immune function, energy metabolism, antioxidant protection, bone health, and vision through a variety of phytoconstituents found in fruits, vegetables, whole grains, meats, and dairy products³⁷.

Figure 6: Activities of Vitamins

BENEFITS OF NUTRACEUTICALS:

In recent years, nutraceuticals have gained a lot of popularity. In addition to medications, they are used as additional or alternative treatments to help prevent and treat a variety of illnesses. Nutraceuticals can have a significant impact on the body's numerous biological functions, preventing diseases and enhancing general health and wellness. Numerous nutraceuticals have been demonstrated to play important roles in immune function and vulnerability to specific disease states. Additionally, oxidative stress-related disease-modifying indications for nutraceuticals include cancer, Alzheimer's disease, cardiovascular disorders, allergies, eye disorders, Parkinson's diseases, and obesity³⁸.

TYPES OF NUTRACEUTICALS:

• Dietary supplements
• Functional Food

Dietary supplements:

Products that contain concentrated bioactive elements from food sources that have been processed into an appropriate dose form are known as dietary supplements. A variety of substances, including vitamins, minerals, essential metabolites, herbs and other botanicals, amino acids, and specific enzymes, may be included in these supplements. Dietary supplements come in a variety of forms, including beverages, candies, energy bars, tablets, capsules, and powders³⁹.

Figure 7: Dietary Tablets

Figure 8: Dietary beverages

Functional Food:

Foods or substances that offer health benefits beyond basic nourishment are referred to as functional foods. This group of foods comprises complete foods as well as fortified, enriched, or enhanced foods that, when routinely ingested as part of a diverse diet, can promote health. Functional food and is available as pasta, cereal, whole grains, yogurt, snacks and more⁴⁰.

Functional foods include:

• Traditional Functional Foods: These are natural, nutrient-dense foods that offer health advantages beyond simple nourishment, such lycopene in tomatoes and omega-3 fatty acids in salmon.
• Non-Traditional Functional Foods: Bioactive ingredients are added to artificial foods to improve health and wellbeing. Examples include iron-enriched cereal, wheat with extra folic acid, and fortified nutritional products like juice with added calcium. Recombinant nutraceuticals, or foods that produce energy through biotechnology, such as bread, yogurt, cheese, and vinegar, can also be considered modified functional food.

 

 

 

Figure 9: Functional Food

Figure 10: Example of Functional food

 

Herbal-based bioactive agents:

The term "herbal bioactive ingredients" describes the naturally occurring substances that may have health benefits that are present in herbs and plant-based goods.These ingredients are recognized to have therapeutic qualities and can be very helpful in both preventing and curing a number of illnesses. Over time, therapeutic plants and herbs have attracted a lot of attention because of their wide range of flavors and scents, which make them useful complements to the fields of medicine and cooking⁴¹. The nutraceutical industry relies heavily on herbal bioactive components, which include compounds such as carotenoids, coumarins, favonoids, lignans, phthalides, plant sterols, polyphenols, saponins, sulphides, and terpenoids.These ingredients have a dual function in raising quality of life since they not only improve our food preparations but also act as powerful agents to promote health and fend off illnesses⁴². These bioactive compounds can be classified into two categories based on their sources: those obtained from herbs and those present in dietary supplements (Table 2).

 

Figure 11: Herbal-based bioactive ingredients

 

 

 

Table 2: (Herbal bioactive ingredients with dietary supplements)

Herbal bioactive ingredients	Dietary supplements
Anthraquinones	Carbohydrates
Bitters	Prebiotics
Tannins	Lipids
Alkaloids	Proteins
Carotenoids	Vitamins
Essential oil	Mushroom
Flavonoids	Probiotics

 

Flavonoids:

Alkaloids are a unique class of substances that play essential roles in the biological processes of many different organisms, including microbes, plants, and mammals.These substances, which are classified as nitrogen-containing heterocyclic chemical molecules, have numerous uses in disciplines like pharmacology, medicine, and ecology⁴³.The pharmaceutical industry has largely accepted them as powerful therapeutic agents due to their substantial physiological effects at the cellular and molecular levels [44]. Despite their advantages, alkaloids are known to dissolve in organic solvents and can occasionally be exceedingly poisonous, even in very little doses⁴⁵.Flavonols, flavones, flavanones, isoflavones, flavon-3-ols (sometimes called catechins), and anthocyanins are some of the subclasses of flavonoids. These substances are widely present in tea, red wine, fruits, vegetables, and a variety of herbs. They add to the colour and flavour of these meals as well as their health-promoting qualities. Numerous types of flavonoids exist, each with unique biological structures and functions. One well-known flavanol with anti-inflammatory and antioxidant qualities is quercetin, which is present in apples, berries, and onions⁴⁶.

Figure 12: Cocoa beans 

 

 

Tannins: 

The main characteristics of tannins, which are complex substances, are their phenolic and polyphenolic structures. These chemical components give them the special capacity to function as astringents in the human body, producing tissue constriction and the constricting of structural proteins in the skin and mucosa.However, their function goes beyond this harsh characteristic. They are essential for the body's proactive defense against many forms of oxidative damage.As strong antioxidants that support the preservation of the body's health, they effectively stop lipid peroxidation, a process that can cause cell damage, and aid in the neutralization of superoxides and other free radicals^{47- 48}.

Figure 13: Coffee seeds

Prebiotics:

Prebiotics are indigestible food ingredients that improve health by promoting good bacteria in the gut. These substrates, which were first presented by Glenn Gibson and Marcel Roberfroid in 1995, are beneficial to health because host bacteria selectively use them⁴⁹. Prebiotics are compounds that improve general gut health and immune function in addition to encouraging the growth of good gut bacteria like lactobacilli and bifidobacteria. Inulin, fructosaccharides (FOSs), galactosaccharides (GOSs), resistant starch, and pectin are examples of prebiotic phytoconstituents⁵⁰. Short-chain fatty acids, such as butyrate, propionate, and acetate, are produced when gut microbial fermentation is aided by phytoconstituents. These SCFAs are essential for preserving the integrity of the intestinal barrier, supplying energy, controlling inflammation, and preserving colon health.  Numerous pharmacological actions of prebiotics greatly enhance human health.Numerous pharmacological actions of prebiotics greatly enhance human health. By encouraging a balanced microbiota, preventing the growth of harmful bacteria, enhancing digestion, and lowering the incidence of gastrointestinal illnesses, they improve gut health⁵¹.

 

Figure 14: Fructosaccharides(FOSs)

Figure 15: Coconut oil

Fatty Acid:

Essential lipids known as fatty acids have important pharmacological properties and are involved in many biological processes. The most significant of these are omega-3 and omega-6 fatty acids, which fall under the categories of saturated, monosaturated, and polyunsaturated fatty acids (PUFAs)⁵². In addition to having therapeutic qualities that support health and fend against illness, these fatty acids are necessary for preserving cellular structure and function. The anti-inflammatory properties of omega-3 fatty acids, in particular ALA, EP, and DHA, have been thoroughly investigated. By controlling the synthesis of eicosanoids, which can lower the synthesis of pro-inflammatory mediators and so lessen the symptoms of chronic inflammatory diseases such arthritis and cardiovascular disorders, they control inflammatory processes⁵³.

Figure 16: Chicory roots

NUTRITIOUS FRUITS THAT GUARD AGAINST CVD:

Fruits and other plant-based foods have so far shown promise in the prevention and of CVDs⁵⁴. Clinical research and observational studies have demonstrated that eating fruit reduces the incidence of CVDs, a finding that is partly due to the presence of bioactive chemicals. Twelve Additionally, Willett claimed that a proper diet that included more plant-based foods was crucial in reducing heart disease and other chronic illnesses. A good diet has been shown to maintain human health⁵⁵.Some fruits and their roles given in (table.3) below:

 

 

 

Table 3: (Role of Nutraceutical Fruits)

S.NO.	Fruit	Bioactive Compounds	Role in CVD
1	Berries (e.g.,blueberries, strawberries, blackberries)	Anthocyanins, flavonoids, polyphenols	Improve endothelial function, reduce blood pressure, lower LDL, and enhance antioxidant status.
2	Pomegranate	Punicalagins, ellagic acid, polyphenols	Reduce arterial stiffness, improve lipid profile, and decrease oxidative stress and inflammation.
3	Citrus fruits (e.g., oranges, lemons, grapefruits)	Vitamin C,  hesperidin, naringenin	Lower blood pressure, improves endothelial function, and reduces cholesterol.
4	Apples	Quercetin, fiber (pectin), polyphenols	Reduce LDL cholesterol, improve vascular health, and decrease inflammation.
5	Grapes (especially red/purple)	Resveratrol,  flavonoids, polyphenols	Improve HDL cholesterol, inhibit platelet aggregation, and protect against oxidative stress.
6	Avocado	Monounsaturated  fats, phytosterols, fiber	Lower LDL & triglycerides, increase HDL, and reduce inflammation.
7	Tomatoes (botanically a fruit)	Lycopene, beta-carotene, vitamin C	Control Blood pressure, and improve vascular function.

 

Figure 17: Nutritious Fruits

VARIOUS DISEASE OF CARDIOVASCULAR DISEASE:

A collection of illnesses that impact your heart and blood vessels is known as cardiovascular disease. Your heart and/or blood vessels may be affected in one or more areas by these conditions⁵⁶.Some disease of CVD are described in (table: 4) below:

Table 4: Diseases of CVD with their description and symptoms

S.NO.	Disease	Description	Symptoms
1	Coronary Artery Disease (CAD)	Narrowing or blockage of coronary arteries, usually due to atherosclerosis.	Chest pain (angina), shortness of breath, heart attack.
2	Stroke	Reduced blood supply to the brain (ischemic or hemorrhagic).	Weakness, paralysis, difficulty speaking, vision problems.
3	Peripheral Artery Disease (PAD)	Narrowing of arteries in limbs, usually the legs.	Leg pain when walking (claudication), sores, numbness.
4	Congenital Heart Disease	Structural heart defects present at birth.	Cyanosis (blue skin), poor growth, fatigue.
5	Heart Failure (HF)	Narrowing of arteries in limbs, usually the legs.	Fatigue, fluid retention, shortness of breath, swelling.
6	Hypertensive Heart Disease	Damage to the heart due to high blood pressure over time.	Often asymptomatic initially, may lead to HF or CAD.
7	Arrhythmias	Abnormal heart rhythm (too fast, too slow, or irregular).	Palpitations, dizziness, fainting.

 

 

Figure 18: Various Diseases of CVD

 

 

Reasons and Risk Factors of CVD:

Heart failure and myocardial infarction are linked to between one-third and one-fifth of cases of cardiovascular disease (CVD). Smoking, stress, and conditions including diabetes, atherosclerosis, and hypertension are a few risk factors for CVDs. Because current medications for CVDs have adverse effects, using herbal medicines is being studied because they are less expensive and have less side effects. Herbal remedies offer anti-inflammatory, immune-regulating, and antioxidant qualities that help prevent CVDs⁵⁷.Some risk factors of CVD are as (table:5).

 

 

Table 5: Risk factor of CVD

S.NO.	Reason/Risk Factor	Explanation
1	Smoking	Damages blood vessels and increases clot risk.
2	Alcohol	Raises blood pressure and damages the heart muscle.
3	High blood pressure (hypertension)	Puts extra strain on heart and arteries.
4	High cholesterol	Contributes to plaque buildup in arteries.
5	Obesity and overweight	increases strain on the heart and leads to other risk factors.
6	Diabetes	Damages blood vessels and nerves controlling the heart.
7	Unhealthy Diet	High in saturated fats, trans fats, salt, and sugar.
8	Family history	Genetic predisposition to heart disease.
9	Age	Risk increases with age.
10	Stress	Raise your heart rate, increase blood pressure.

 

 

Figure 19: Risk factors of CVD

 

CLINICAL EVIDENCE:

Nutraceuticals have emerged as promising adjuncts in the prevention and treatment of cardiovascular diseases (CVD) owing to their bioactive properties that target multiple cardiovascular risk factors. Clinical trials provide substantial evidence for their efficacy in improving lipid profiles, endothelial function, oxidative stress, and inflammation, which are key mechanisms in CVD pathogenesis. Omega-3 fatty acids have demonstrated significant benefits, reducing triglyceride levels, cardiovascular mortality, and major adverse cardiovascular events, as evidenced by the GISSI-Prevenzione and REDUCE-IT trials. Plant sterols and stanols lower LDL-cholesterol by approximately 7–10%, thereby contributing to CVD risk reduction. Coenzyme Q10, as shown in the Q-SYMBIO trial, improves symptoms and outcomes in patients with chronic heart failure. Dietary fibre has been associated with reductions in LDL-cholesterol and improved glycaemic control, while polyphenols, highlighted in the PREDIMED study, enhance vascular health and reduce cardiovascular events through antioxidant and anti-inflammatory effects. Additionally, L-carnitine has demonstrated reductions in mortality and arrhythmias in post-myocardial infarction patients, and garlic supplementation has shown modest benefits in lowering blood pressure and cholesterol levels. These findings suggest that nutraceuticals, as part of a comprehensive lifestyle and therapeutic approach, may play a supportive role in the management and prevention of CVD. However, further large-scale, long-term trials are warranted to establish optimal doses and confirm their clinical benefits.

CONCLUSION:

Nutraceuticals have emerged as valuable adjuncts in the prevention and management of cardiovascular diseases by targeting multiple risk factors through their antioxidant, anti-inflammatory, lipid-lowering, and endothelial-protective properties. Evidence from clinical and epidemiological studies supports the beneficial roles of omega-3 fatty acids, polyphenols, plant sterols, Coenzyme Q10, vitamins, probiotics, and herbal bioactive in reducing cardiovascular morbidity and mortality. Incorporation of nutraceuticals, particularly when combined with balanced dietary patterns such as the Mediterranean or DASH diets, provides a safe, cost-effective, and holistic approach to cardiovascular health. However, challenges remain, including limited bioavailability, variability in product quality, and the lack of universal guidelines for standardized dosing. Future research should focus on large-scale, long-term clinical trials, precision nutrition strategies, and advanced delivery systems to optimize their therapeutic potential. Overall, nutraceuticals represent a promising era in cardiovascular prevention and treatment, complementing conventional therapies while empowering individuals toward healthier lifestyles and improved quality of life.

Conflict of Interest: The authors declare no potential conflict of interest concerning the contents, authorship, and/or publication of this article.

Author Contributions: All authors have equal contributions in the preparation of the manuscript and compilation.

Source of Support: Nil

Funding: The authors declared that this study has received no financial support.

Informed Consent Statement: Not applicable. 

Data Availability Statement: The data supporting this paper are available in the cited references.

Ethical approval: Not applicable. 

REFERENCES:

1. Zuraini NZ, Sekar M, Wu YS, Gan SH, Bonam SR, Mat Rani NN, Begum MY, Lum PT, Subramaniyan V, Fuloria NK, Fuloria S. Promising nutritional fruits against cardiovascular diseases: An overview of experimental evidence and understanding their mechanisms of action. Vascular health and risk management. 2021 Nov 23:739-69. https://doi.org/10.2147/VHRM.S328096 PMid:34858028 PMCid:PMC8631183

2. Fleenor BS, Carlini NA, Martens CR. Nutraceuticals in the prevention and therapeutic of cardiovascular and cerebrovascular disease. Journal of Cardiopulmonary Rehabilitation and Prevention. 2023 May 1;43(3):162-9. https://doi.org/10.1097/HCR.0000000000000773 PMid:36656154

3. Santos CY, Snyder PJ, Wu WC, Zhang M, Echeverria A, Alber J. Pathophysiologic relationship between Alzheimer's disease, cerebrovascular disease, and cardiovascular risk: a review and synthesis. Alzheimers Dement (Amst). 2017; 7:69-87. https://doi.org/10.1016/j.dadm.2017.01.005 PMid:28275702 PMCid:PMC5328683

4. Chirinos JA, Segers P, Hughes T, Townsend R. Large-artery stiffness in health and disease: JACC state-of-the-art review. J Am Coll Cardiol. 2019;74(9):1237-1263. https://doi.org/10.1016/j.jacc.2019.07.012 PMid:31466622 PMCid:PMC6719727

5. Sharma M, Vidhya CS, Ojha K, Yashwanth BS, Singh B, Gupta S, Pandey SK. The role of functional foods and nutraceuticals in disease prevention and health promotion. Eur. J. Nutr. Food Saf. 2024 Feb 19;16:61-83. https://doi.org/10.9734/ejnfs/2024/v16i21388

6. DeFelice SL. The nutraceutical revolution: Its impact on food industry R&D. Trends in Food Science & Technology. 1995;59:59- 61. https://doi.org/10.1016/S0924-2244(00)88944-X

7. Diab A, Dastmalchi LN, Gulati M, Michos ED. A heart-healthy diet for cardiovascular disease prevention: where are we now?. Vascular health and risk management. 2023 Dec 31:237-53. https://doi.org/10.2147/VHRM.S379874 PMid:37113563 PMCid:PMC10128075

8. Woodruff RC, Tong X, Loustalot FV, Khan SS, Shah NS, Jackson SL, Vaughan AS. rdiovascular Disease Mortality Trends, 2010-2022: An Update with Final Data. Am J Prev Med. 2025 Feb;68(2):391-395. https://doi.org/10.1016/j.amepre.2024.09.014 PMid:39321995

9. Hu B, Feng J, Wang Y, Fan Y, Hou L. Global, regional and national temporal trends in prevalence for cardiovascular diseases in women of childbearing age, from 1990 to 2019: An age-period-cohort analysis. Heliyon. 2024 Mar 25;10(7):e28526. https://doi.org/10.1016/j.heliyon.2024.e28526 PMid:38601535 PMCid:PMC11004743

10. Banerjee S, Chaudhry M, Brewer J, Chen Y, Khasiyev F, Soudagar Turkey M. Unprovoked Atypical Absence Status Epilepticus in a Patient With Allogeneic Stem Cell Transplantation. Cureus. 2024 Jul 18;16(7):e64842. PMID: 39156368; PMCID: PMC11330277. https://doi.org/10.7759/cureus.64842

11. Kodali NK, Bhat LD, Phillip NE, Koya SF. Prevalence and associated factors of cardiovascular diseases among men and women aged 45 years and above: Analysis of the longitudinal ageing study in India, 2017-2019. Indian Heart J. 2023 Jan-Feb;75(1):31-35. https://doi.org/10.1016/j.ihj.2022.12.003 PMid:36549638 PMCid:PMC9986734

12. Conrad N, Molenberghs G, Verbeke G, Zaccardi F, Lawson C, Friday JM, Su H, Jhund PS, Sattar N, Rahimi K, Cleland JG, Khunti K, Budts W, McMurray JJV. Trends in cardiovascular disease incidence among 22 million people in the UK over 20 years: population based study. BMJ. 2024 Jun 26;385:e078523. doi: 10.1136/bmj-2023-078523. Erratum in: BMJ. 2024 Oct 28;387:q2381. https://doi.org/10.1136/bmj.q2381 PMid:39467586 PMCid:PMC11514953

13. Joseph P, Kutty VR, Mohan V, Kumar R, Mony P, Vijayakumar K, Islam S, Iqbal R, Kazmi K, Rahman O, Yusuf R, Anjana RM, Mohan I, Rangarajan S, Gupta R, Yusuf S. Cardiovascular disease, mortality, and their associations with modifiable risk factors in a multi-national South Asia cohort: a PURE substudy. Eur Heart J. 2022 Aug 7;43(30):2831-2840. https://doi.org/10.1093/eurheartj/ehac249 PMid:35731159

14. Okobi OE, Nwogwugwu E, Ihezie CO, Olasupo OO, Emovon CI, Wambai-Sani H, Ezie OB, Afolabi AR, Erinne OC, O'dare RA. Cardiovascular Disease Patterns, Mortality, and Hospitalization Trends in Adults Over 18: Insights From the Behavioral Risk Factor Surveillance System Database. Cureus. 2024 Aug 10;16(8):e66604. https://doi.org/10.7759/cureus.66604

15. Sawarni S, Ranjan S, Kumar S. Nutraceuticals: A comprehensive review on its application in Neurological, Cardiovascular and Gastrointestinal disorder. Front Multidiscip Res Stud 2024; 1 (2): 109. https://doi.org/10.31531/fmrs.1000109

16. Fleenor BS, Berrones AJ. Arterial Stiffness: Implications and Interventions: Cham, Switzerland: Springer; 2015. https://doi.org/10.1007/978-3-319-24844-8

17. Fleenor BS, Carlini NA, Martens CR. Nutraceuticals in the prevention and therapeutic treatment of cardiovascular and cerebrovascular disease. Journal of Cardiopulmonary Rehabilitation and Prevention. 2023 May 1;43(3):162-9. https://doi.org/10.1097/HCR.0000000000000773 PMid:36656154

18. Srijan G, Sagarika M, Piyasee P, Dipjyoti D, Sankalan D. Nutraceutical and Functional Foods in Disease Prevention; 2019. 403-431

19. Adetuyi BO, OdineGO,Olajide PA, Adetuyi OA, Atanda OO, Oloke JK. Nutraceuticals: role in metabolic disease, prevention and treatment. World News of Natural Sciences. 2022;42:1-2.

20. Maxwell J, Smith D, Brewster M, Eggleton S. Food as pharma as wellness products evolve, the distinction between food and medicine blurs. R&C Worlds Express. 2012.

21. Biotech for wellness: driving successful R&D and licensing in nutraceuticals through new business models and collaboration, research and markets. 2010.

22. Kumar P, Kumar N, Tushar O. Nutraceuticals- critical supplement for building a healthy India. World J Pharm Pharma Sci. 2016;5(3):579-594.

23. Olaiya CO, Soetan KO, Esan A. e role of nutraceuticals, functional foods and value added food products in the prevention and treatment of chronic diseases. African J Food Sci. 2016;10(10):185-193. https://doi.org/10.5897/AJFS2015.1402

24. Sosnowska B, Penson P, Banach M. e role of nutraceuticals in the prevention of cardiovascular disease. CardiovascDiagner. 2017;7(1):S21-S31. https://doi.org/10.21037/cdt.2017.03.20 PMid:28529919 PMCid:PMC5418215

25. Macfarlane S, Macfarlane G, Cummings H. Review article: prebiotics in the gastrointestinal tract. Alimentary Pharmacology and Therapeutics 2006, 24: 701-714 https://doi.org/10.1111/j.1365-2036.2006.03042.x PMid:16918875

26. Ahirwar NK, Singh R. An overview of nutraceuticals and their role in health applications. J Nutraceuticals Heal. 2023;1(1). https://doi.org/10.61577/jnh.2023.100003

27. Escott-Stump E, Mahan L. Krause's food, nutrition and diet therapy. 10. Philadelphia: WB Saunders Company; 2000, 553-565.

28. Cummings J. The effect of dietary fiber on fecal weight and composition. In: Spiller G, editor. Dietary fiber in human nutrition 2001, 183-252. https://doi.org/10.1201/9781420038514.ch4.4

29. Food and Agricultural Org World Health Org. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria; 2001.

30. Hord G. Eukaryotic macrobiotic crosstalk: potential mechanisms for health benefits of prebiotics and probiotics. Annual Review Nutrition 2008, 28: 215-231. https://doi.org/10.1146/annurev.nutr.28.061807.155402 PMid:18489258

31. Devi M, Verma KK, Kumar I. Roles of Herbals in Paracetamol Induced Hepatotoxicty. Journal of Drug Delivery & Therapeutics. 2023 Sep 1;13(9):160-9. https://doi.org/10.22270/jddt.v13i9.5961

32. Moghadamtousi SZ, Kadir HA, Hassandarvish P, Tajik H, Abubakar S, Keivan K. A review on antibacterial, antiviral, and antifungal activity of curcumin. Biomed Res Intl. (2014) 2014:186864. https://doi.org/10.1155/2014/186864 PMid:24877064 PMCid:PMC4022204

33. Zhong Y, Ma C, Shahidi F. Antioxidant and antiviral activities of lipophilic epigallocatechingallate (EGCG) derivatives. J Funct Foods. (2011) 4:87- 93. https://doi.org/10.1016/j.jff.2011.08.003 PMid:32288792 PMCid:PMC7105014

34. Abba Y, Hassim H, Hamzah H, Noordin MM. Antiviral activity of resveratrol against human and animal viruses. AdvVirol. (2015) 184241:1- 7. https://doi.org/10.1155/2015/184241 PMid:26693226 PMCid:PMC4676993

35. Singh S, Kola P, Kaur D, Singla G, Mishra V, Panesar PS, Mallikarjunan K, Krishania M. Therapeutic potential of nutraceuticals and dietary supplements in the prevention of viral diseases: A review. Frontiers in Nutrition. 2021 Sep 17;8:679312. https://doi.org/10.3389/fnut.2021.679312 PMid:34604272 PMCid:PMC8484310

36. Shirodkar S, Khanchey F, Babre N. Role of functional foods and nutraceuticals in nutrition and health. Academia Nutrition and Dietetics 2025;2. https://doi.org/10.20935/AcadNutr7676

37. Aziz T, Hussain N, Hameed Z, Lin L. Elucidating the role of diet in maintaining gut health to reduce the risk of obesity, cardiovascular and other age-related inflammatory diseases: recent challenges and future recommendations. Gut Microbes. 2024;16(1):2297864. https://doi.org/10.1080/19490976.2023.2297864 PMid:38174551 PMCid:PMC10773664

38. Adetuyi BO, OdineGO,Olajide PA, Adetuyi OA, Atanda OO, Oloke JK. Nutraceuticals: role in metabolic disease, prevention and treatment. World News of Natural Sciences. 2022;42:1-2.

39. Nwosu O, Ubaoji I. Nutraceutical: history, classification and market demand. In: Egbuna C, DableTupas G, eds. Functional Foods and Nutraceuticals. Springer International Publishing 2020, 13-22. https://doi.org/10.1007/978-3-030-42319-3_2

40. Adetuyi BO, OdineGO,Olajide PA, Adetuyi OA, Atanda OO, Oloke JK. Nutraceuticals: role in metabolic disease, prevention and treatment. World News of Natural Sciences. 2022;42:1-27.

41. Kapoor VK, Dureja J, Chadha R. Herbals in the control of ageing. Drug Discov Today. 2009;14(19-20):992-998 https://doi.org/10.1016/j.drudis.2009.06.014 PMid:19596462

42. Roy A, Jauhari N, Bharadvaja N. Medicinal plants as a potential source of chemopreventive agents. anticancer plants: natural products and biotechnological implements; Springer, 2018;2:109-139. https://doi.org/10.1007/978-981-10-8064-7_6

43. Debnath B, Singh WS, Das M, Goswami S, Singh MK, Maiti D, et al. Role of plant alkaloids on human health: a review of biological activities. Mater Today Chem. 2018;9:56-72. https://doi.org/10.1016/j.mtchem.2018.05.001

44. Sottor¬ I, Künzel S, Wiese J, Lipfert M, Preuke N, Sonnichsen FD, et al. Antitumor anthraquinones from an easter island sea anemone: animal or bacterial origin. Mar Drugs. 2019;17(3):154 https://doi.org/10.3390/md17030154 PMid:30841562 PMCid:PMC6471592

45. Prasad R, Prasad SB. A review on the chemistry and biological properties of rutin, a promising nutraceutical agent. Asian J Pharm Sci. 2019;5(S1):1-20 https://doi.org/10.31024/ajpp.2019.5.s1.1

46. Panche AN, Diwan AD, Chandra SR. Flavonoids: An overview. J Nutr Sci. 2016;5:e47. https://doi.org/10.1017/jns.2016.41 PMid:28620474 PMCid:PMC5465813

47. Ying W, Sevigny MB, Chen Y, Swanson RA. Poly (ADP ribose) glycohydrolase mediates oxidative and excitotoxic neuronal death. ProcNatlAcadSci USA. 2001;98(21):12227-12232. https://doi.org/10.1073/pnas.211202598 PMid:11593040 PMCid:PMC59796

48. Bors W, Michel C. Chemistry of the antioxidant e¬ect of polyphenols. Ann N Y Acad Sci. 2002;957(1):57-69. https://doi.org/10.1111/j.1749-6632.2002.tb02905.x PMid:12074961

49. Hutkins RW, Krumbeck JA, Bindels LB, Cani PD, Fahey G, Goh YJ, et al. Prebiotics: Why definitions matter. CurrOpinBiotechnol. 2016;37:1-7. https://doi.org/10.1016/j.copbio.2015.09.001 PMid:26431716 PMCid:PMC4744122

50. Gibson GR, Hutkins R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev GastroenterolHepatol. 2017;14(8):491- 502. https://doi.org/10.1038/nrgastro.2017.75 PMid:28611480

51. Liu C, Ma N, Feng Y, Zhou M, Li H, Zhang X, et al. From probiotics to postbiotics Concepts and applications. In: Animal Research and One Health. Hoboken (NJ): John Wiley & Sons Inc; 2023. Volume 1, p. 92-114. https://doi.org/10.1002/aro2.7

52. Siram K, HabiburRahman SM, Balakumar K, Duganath N, Chandrasekar R, Hariprasad R. Pharmaceutical nanotechnology: A brief perspective on lipid drug delivery and its current scenario. In: Biomedical Applications of Nanoparticles. Amsterdam: Elsevier; 2019. p. 91-115. https://doi.org/10.1016/B978-0-12-816506-5.00005-X

53. Djuricic I, Calder PC. Beneficial Outcomes of Omega-6 and Omega-3 Polyunsaturated Fatty Acids on Human Health: An Update for 2021. Nutrients. 2021;13(7):2421. https://doi.org/10.3390/nu13072421 PMid:34371930 PMCid:PMC8308533

54. NurZulaikhaAzwaZuraini, MahendranSekar, Yuan Seng Wu, SiewHuaGan, Srinivasa Reddy Bonam, NurNajihahIzzati Mat Rani, M Yasmin Begum, Pei TengLum, VetriselvanSubramaniyan, Neeraj Kumar Fuloria&ShivkanyaFuloria (2021) Promising Nutritional Fruits Against Cardiovascular Diseases: An Overview of Experimental Evidence and Understanding Their Mechanisms of Action, Vascular Health and Risk Management, , 739-769, https://doi.org/10.2147/VHRM.S328096 PMid:34858028 PMCid:PMC8631183

55. Sharifi-Rad J, Rodrigues CF, Sharopov F, et al. Diet, lifestyle and cardiovascular diseases: linking pathophysiology to cardioprotective effects of natural bioactive compounds. Int J Environ Res Public Health. 2020;17(7):2326. https://doi.org/10.3390/ijerph17072326 PMid:32235611 PMCid:PMC7177934

56. Sawarni S, Ranjan S, Kumar S. Nutraceuticals: A comprehensive review on its application in Neurological, Cardiovascular and Gastrointestinal disorder. Front Multidiscip Res Stud 2024; 1 (2): 109. https://doi.org/10.31531/fmrs.1000109

57. Mohammadabadi T, Jain R. Cinnamon: a nutraceutical supplement for the cardiovascular system. Archives of Medical sciences. Atherosclerotic Diseases. 2024 Mar 30;9:e72. https://doi.org/10.5114/amsad/184245 PMid:38846056 PMCid:PMC11155465