Targeting Vascular Calcification: Novel Insights into Molecular Pathways and Clinical Interventions

Vascular calcification (VC), a pathological hallmark of advanced atherosclerosis, exerts a profound impact on arterial stiffness and the incidence of cardiovascular disease. Its development involves not only actively regulated biological processes but also passive mineral deposition and is particularly prevalent in patients with diabetes, chronic kidney disease, and endocrine disorders. Although conventional therapies-such as phosphate binders, calcium channel blockers, bisphosphonates, and endovascular interventions-form the current clinical foundation, they remain inadequate for preventing early VC or reversing established lesions. This review systematically summarizes advances in both standard strategies and emerging therapies. Recent studies have highlighted several breakthrough approaches: nanotechnology-based delivery systems, optimized agents such as SNF472 and GLP-1 receptor agonists, and bioactive constituents from traditional Chinese medicine (e.g., ginsenosides, chelerythrine), all of which target distinct calcification pathways. In addition, dietary interventions and lifestyle modification show preventive value. Progress in multi-omics technologies continues to uncover new molecular mechanisms and therapeutic targets, guiding precision medicine. By integrating mechanistic insights with novel therapeutic paradigms, this review aims to facilitate the development of personalized management strategies and ultimately improve cardiovascular outcomes in high-risk populations.