Linking Dosha Imbalance to Cardiovascular Disease: Insights from Biochemical and Molecular Pathways—A Narrative Review

Cardiovascular diseases (CVDs) are the leading cause of death globally. Recent estimates from the 2025 heart disease & Stroke Statistics Update indicate about 19.41 million global deaths due to CVD. Key mechanisms include oxidative stress–mediated endothelial injury, chronic low-grade vascular inflammation, and systemic metabolic dysregulation, which together accelerate atherogenesis, and plaque instability. Contemporary biomedical research highlights that chronic stress activates the sympathetic nervous system and hypothalamic– pituitary–adrenal axis. Inflammatory mediators accelerate vascular damage, while obesity, insulin resistance, and dyslipidaemia contribute to atherogenesis. In Ayurveda complementary framework in which disease is attributed to the imbalance of the three doshas—Vata, Pitta, and Kapha. Aim: To correlate biochemical pathways with Doṣha imbalance for an integrative understanding of cardiovascular disease (CVD) Objectives: To review key biochemical mechanisms in CVD pathogenesis., to integrate modern biomarkers with Ayurvedic concepts for CVD risk assessment. Methods: The methodology for this review involved a comprehensive literature from multiple databases, including PubMed, J-Gate, Google Scholar through MeSH term cardiovascular disease risk and biomarkers and from classical texts. Results: The search retrieved approximately 16,700 articles from Google Scholar, of which 16 were found relevant and included for review; 1,757 articles from PubMed, of which 12 were reviewed; and 1,669 articles from J-Gate, of which 15 were reviewed and Relevant descriptions of Sthaulya, Medoroga, Hṛdroga, Dhamanīpraticaya, and Santarpanajanya Vyadhi were also reviewed. Discussion: Vata aggravation by chronic psychological stress such as Shoka, Bhabya, corresponds with sympathetic overactivity, resulting in vascular injury. Pitta aggravation reflects inflammatory processes, aligning with cytokine-driven vascular inflammation. Kapha aggravation as metabolic sluggishness analogous to obesity, hyperlipidaemia, and insulin resistance. Conclusion: CVD arises from psychological, inflammatory, and metabolic disturbances that parallel Vata, Pitta, and Kapha imbalances. Integrating both perspectives offers a holistic framework for prevention and management.