Clinical and Preclinical Effectiveness of Traditional Chinese Herbal Medicine in Atherosclerosis: A Critical Review of Current Evidence and Translational Challenges.
Atherosclerosis continues to represent a major global health burden, with morbidity and mortality that remain inadequately addressed by current therapeutic strategies. Traditional Chinese herbal medicines (CHMs) are deeply embedded in cardiovascular practice and increasingly recognized for their capacity to target multiple pathological processes, including inflammation, lipid dysregulation, endothelial dysfunction, and plaque instability.
This review critically evaluates the clinical and mechanistic evidence supporting CHMs in atherosclerosis, with particular attention to translational barriers and their integration into contemporary cardiovascular care.
A structured literature search was conducted across PubMed, Web of Science, and CNKI, prioritizing CHMs with documented clinical efficacy and mechanistic relevance in atherosclerosis.
Key bioactives such as berberine, salvianolic acids, ginsenosides, and astragaloside IV exert pleiotropic effects through NF-κB, PI3K/AKT, mTOR, and ferroptosis-related pathways. Approved CHM formulations such as Tongxinluo Capsule and Danhong Injection have been shown to improve lipid profiles, enhance plaque stability, and reduce inflammatory markers. However, challenges related to bioavailability, trial design, and regulatory cohesion continue to limit their widespread clinical adoption.
Future research is expected to prioritize multicenter trials, standardized protocols, and omics-guided profiling to bridge traditional practice with evidence-based medicine.
This review critically evaluates the clinical and mechanistic evidence supporting CHMs in atherosclerosis, with particular attention to translational barriers and their integration into contemporary cardiovascular care.
A structured literature search was conducted across PubMed, Web of Science, and CNKI, prioritizing CHMs with documented clinical efficacy and mechanistic relevance in atherosclerosis.
Key bioactives such as berberine, salvianolic acids, ginsenosides, and astragaloside IV exert pleiotropic effects through NF-κB, PI3K/AKT, mTOR, and ferroptosis-related pathways. Approved CHM formulations such as Tongxinluo Capsule and Danhong Injection have been shown to improve lipid profiles, enhance plaque stability, and reduce inflammatory markers. However, challenges related to bioavailability, trial design, and regulatory cohesion continue to limit their widespread clinical adoption.
Future research is expected to prioritize multicenter trials, standardized protocols, and omics-guided profiling to bridge traditional practice with evidence-based medicine.