Research progress on the molecular mechanisms of tanshinone IIA in the treatment of cardiovascular and cerebrovascular diseases (Review)

Cardiovascular and cerebrovascular diseases (CCVDs) have become prominent global health threats, presenting substantial challenges due to their intricate pathological mechanisms and diverse clinical manifestations. Tanshinone IIA (TSA), an active compound derived from the traditional Chinese medicinal herb Salvia miltiorrhiza, exhibits notable therapeutic potential in these diseases due to its multifaceted mechanism of action. TSA protects the cardiovascular and cerebrovascular systems by inhibiting inflammation, reducing oxidative stress, preventing apoptosis and fibrosis, and modulating key signaling pathways, including toll‑like receptor 4/NF‑κB, PI3K/AKT and nuclear factor erythroid 2‑related factor 2/heme oxygenase‑1. Notably, considerable progress has been made in applying TSA to conditions such as atherosclerosis, myocardial infarction, heart failure and hypertension. The present review synthesizes current research on the molecular mechanisms of TSA in treating CCVDs and highlights innovations in nanodelivery systems (for example, rHDL, TPP‑TPGS/LPNs and CBSA‑PEG‑TSA‑NPs) that enhance its therapeutic efficacy by improving solubility, prolonging its half‑life and enhancing targeting capabilities. These advancements not only establish a foundation for the broader clinical application of TSA in CCVDs but also offer valuable insights for the development of new therapeutic agents.