Natural Antihypertensive Drug Leads from Northeast India’s Biodiversity Hotspots: Molecular Targets, Signaling Pathways, and Safety Profiles: A Review

Hypertension is a major global health concern affecting over one billion people worldwide and is a leading risk factor for cardiovascular diseases, stroke, and kidney failure. Plant-derived bioactive compounds provide promising natural strategies for hypertension management by improving endothelial function, promoting vasorelaxation and diuresis, reducing oxidative stress, and modulating key molecular pathways. This review focuses on some important traditional medicinal plants from Northeast India with potential antihypertensive activity, summarizing their phytochemical constituents, pharmacological evidence, and proposed mechanisms of action. Northeast India lies within the Eastern Himalayas and Indo-Burma biodiversity hotspots and is recognized for its rich plant diversity. We conducted a systematic literature search using PubMed, Google Scholar, ScienceDirect, and Scopus following PRISMA guidelines. We further evaluated identified compounds for ADMET using open-source computational tools. Ten medicinal plants: Clerodendrum colebrookeanum, Moringa oleifera, Garcinia dulcis, Centella asiatica, Terminalia bellirica, Hibiscus sabdariffa, Citrus limon, Passiflora edulis, Garcinia cowa, and Solanum torvum yielded 22 bioactive compounds with notable antihypertensive activity. These compounds exhibited antioxidant, anti-inflammatory, and vasorelaxant effects via nitric oxide synthase activation, MAPK/NF-κB inhibition, ACE inhibition, calcium channel modulation, and reactive oxygen species scavenging. ADMET profiling indicated favorable pharmacokinetics, with vitexin, isovitexin, isoquercetin, and nobiletin showing low predicted toxicity and high stability.