The role of ginseng and ginsenosides in ROS and cardiovascular disease

An imbalance in reactive oxygen species (ROS) can lead to severe tissue damage and ultimately result in cell death. While ROS plays a crucial role in cellular signaling, excessive ROS production disrupts intracellular homeostasis, causing oxidative stress, which is a contributing factor to cardiac diseases. Ginseng and its ginsenosides have demonstrated potent antioxidant and cardioprotective properties, and their effectiveness in combating oxidative stress which is closely associated with cardiac health has been thoroughly documented. This review summarizes the cardioprotective roles and molecular mechanisms through which ginseng and its key and rare ginsenosides regulate excess ROS production, restore antioxidant enzyme function, and ameliorate cardiac damage. Key ginsenosides such as Rg1, Rg3, Rb1, and notoginsenoside R1, along with rare forms like Rh1, Rh4, F₂, Mc-1, and TP1 exhibit anti-oxidative property and promote cardiac recovery through both well-established and novel signaling pathways. Recent advances and emerging clinical trial data suggest potential benefits in conditions such as hypertension, ischemia, cardiotoxicity and vascular dysfunction. Collectively, these findings highlight the significance of ginseng and its ginsenoside as valuable adjunct therapy in modern cardiovascular treatment. Further clinical exploration could help translate these preclinical findings into effective cardiac therapies.