Aug 2026· Phytotherapy Research· 1 citation· 205 references
Medicine
TL;DR
This review systematically examines the mechanisms of major PDBIs in hypertension, focusing on their regulation of vascular function, renin-angiotensin-aldosterone system and sympathetic nervous system, water-salt homeostasis, and target organ protection.
Abstract
Hypertension remains a major global risk factor for cardiovascular diseases, yet current treatments face challenges such as suboptimal blood pressure control and inadequate organ protection. Plant-derived bioactive ingredients (PDBIs), with their multi-target and multi-pathway properties, offer novel strategies for hypertension management. This review systematically examines the mechanisms of major PDBIs (flavonoids, terpenoids, alkaloids) in hypertension, focusing on their regulation of vascular function, renin-angiotensin-aldosterone system and sympathetic nervous system, water-salt homeostasis, and target organ protection. Key signaling pathways involved (NF-κB, TGF-β, MAPK, PI3K/Akt) are analyzed. Clinical translation challenges, including low bioavailability and response heterogeneity, are discussed. Future research should integrate systems pharmacology, smart delivery systems, and precision medicine to advance PDBIs from traditional use to evidence-based therapy, providing a theoretical basis for developing novel antihypertensive and organ-protective strategies.
This review aimed to critically synthesize current evidence on the role of coumarins in hypertension management, integrating mechanistic insights, preclinical findings, pharmacokinetic considerations, and available clinical data.
Although several nutraceuticals show promising blood-pressure-lowering effects, variations in dosage, formulation, bioavailability, and clinical study quality remain important limitations and further standardized, large-scale clinical trials are required to establish their long-term efficacy and safety.
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