Alkaloids and Their Mechanisms of Action in Cardiovascular Diseases

Cardiovascular diseases (CVDs) remain a leading cause of death globally, particularly in low- and middle-income regions, with heart failure (HF), arrhythmia, hypertension, myocardial infarction (MI), and myocardial fibrosis among the most prominent conditions. Current therapeutic strategies focus on chemical treatments targeting neurohumoral systems like the renin-angiotensin-aldosterone system (RAAS) and employing combination therapies such as β‍-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and newer agents like Sodium-glucose cotransporter-2 (SGLT-2) inhibitors. However, alkaloids—naturally occurring compounds with nitrogen atoms—are emerging as promising agents in CVD treatment. Alkaloids are found in various natural sources and exhibit cardioprotective, anti-inflammatory, and anti-arrhythmic properties. This review highlights the mechanisms of action of several key alkaloids in heart failure, arrhythmia, hypertension, myocardial infarction, and fibrosis.