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Review
. 2023 Dec 7;12(12):2088.
doi: 10.3390/antiox12122088.

Natural Substances vs. Approved Drugs in the Treatment of Main Cardiovascular Disorders-Is There a Breakthrough?

Jelica Grujić-Milanović  1 , Jovana Rajković  2 , Sladjan Milanović  3 , Vesna Jaćević  4   5   6 , Zoran Miloradović  1 , Lana Nežić  7 , Radmila Novaković  8
Affiliations
Review

Natural Substances vs. Approved Drugs in the Treatment of Main Cardiovascular Disorders-Is There a Breakthrough?

Jelica Grujić-Milanović et al. Antioxidants (Basel). .

Abstract

Cardiovascular diseases (CVDs) are a group of diseases with a very high rate of morbidity and mortality. The clinical presentation of CVDs can vary from asymptomatic to classic symptoms such as chest pain in patients with myocardial infarction. Current therapeutics for CVDs mainly target disease symptoms. The most common CVDs are coronary artery disease, acute myocardial infarction, atrial fibrillation, chronic heart failure, arterial hypertension, and valvular heart disease. In their treatment, conventional therapies and pharmacological therapies are used. However, the use of herbal medicines in the therapy of these diseases has also been reported in the literature, resulting in a need for critical evaluation of advances related to their use. Therefore, we carried out a narrative review of pharmacological and herbal therapeutic effects reported for these diseases. Data for this comprehensive review were obtained from electronic databases such as MedLine, PubMed, Web of Science, Scopus, and Google Scholar. Conventional therapy requires an individual approach to the patients, as when patients do not respond well, this often causes allergic effects or various other unwanted effects. Nowadays, medicinal plants as therapeutics are frequently used in different parts of the world. Preclinical/clinical pharmacology studies have confirmed that some bioactive compounds may have beneficial therapeutic effects in some common CVDs. The natural products analyzed in this review are promising phytochemicals for adjuvant and complementary drug candidates in CVDs pharmacotherapy, and some of them have already been approved by the FDA. There are insufficient clinical studies to compare the effectiveness of natural products compared to approved therapeutics for the treatment of CVDs. Further long-term studies are needed to accelerate the potential of using natural products for these diseases. Despite this undoubted beneficence on CVDs, there are no strong breakthroughs supporting the implementation of natural products in clinical practice. Nevertheless, they are promising agents in the supplementation and co-therapy of CVDs.

Keywords: antioxidants; cardiovascular diseases; natural products; oxidative stress.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pathophysiology of cardiovascular disease. LDL—low-density cholesterol; TG—triglycerides; ROS—reactive oxygen species; RNS—reactive nitrogen species.
Figure 2
Figure 2
Treatment of coronary artery disease. TXA-2—Thromboxane A2; UA—uric acid; HMG-CoA—(3-hydroxy-3-methylglutaryl-coenzyme A) reductase; APO5—apolipoprotein A5; MDA—malondialdehyde; CH—cholesterol; LDL—low-density cholesterol; TG—triglyceride; SOD—superoxide dismutase; GSH—glutathione; GSH—glutathione peroxidase.
Figure 3
Figure 3
Treatment of acute myocardial infarction and atrial fibrillation with approved drugs or natural products.
Figure 4
Figure 4
Treatment of heart failure with naturally derived astragaloside IV.
Figure 5
Figure 5
Treatment of arterial hypertension with approved drugs or natural products.
See this image and copyright information in PMC

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