Anthocyanins and Cardiovascular Disease Mechanisms Benefits and Interventions

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, driving increasing interest in dietary strategies that may reduce its burden. Anthocyanins, a subclass of flavonoids abundant in berries, purple cabbage, cherries, and other plant-based foods, have attracted significant attention due to their antioxidant, anti-inflammatory, and metabolic regulatory properties. This review synthesizes current evidence on the sources, chemical characteristics, mechanisms of action, and health effects of anthocyanins in the context of CVD prevention and management. Data from biochemical, molecular, animal, and human studies indicate that anthocyanins can modulate oxidative stress, lipid metabolism, endothelial function, insulin sensitivity, and inflammatory pathways. These effects are mediated through antioxidant enzyme activation, inhibition of lipid peroxidation, modulation of vascular endothelial growth factor (VEGF) expression, and regulation of gene and microRNA activity involved in vascular homeostasis. The review also highlights the impact of anthocyanins on key cardiovascular biomarkers, including LDL and HDL cholesterol and inflammatory cytokines, as well as emerging evidence on novel formulations designed to enhance stability and bioavailability. While findings strongly support the potential cardiovascular benefits of anthocyanin-rich diets, limitations such as variability in study designs, inconsistent dosages, low bioavailability, and limited long-term data hinder definitive conclusions. Future research should focus on standardized, large-scale, longitudinal clinical trials, advanced metabolomic approaches, and innovative delivery systems to improve efficacy and translational relevance. Overall, anthocyanins represent a promising, naturally occurring class of compounds with considerable potential as part of evidence-based dietary interventions for cardiovascular health promotion.