Plant Terpenoids in Cardioprotection: An Overview of Their Therapeutic Potential

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, making the search for new therapeutic strategies to prevent or mitigate cardiac damage mandatory. Essential oils, long used in traditional medicine, contain terpenoids as their most prominent constituents, and these molecules have emerged as promising cardioprotective agents. The review compiles 45 articles investigating the effects of plant-derived terpenoids on cardiovascular health. Evidence shows that their therapeutic properties rely on their antioxidant, anti-inflammatory, anti-apoptotic, anti-remodeling, antiarrhythmic, antihypertensive, anti-atherosclerotic, antidiabetic and antimicrobial actions. These effects result from the modulation of molecular pathways altered during cardiovascular diseases, resulting in oxidative stress, inflammation, cell death, fibrosis, ion channel dysregulation, alteration of lipid metabolism and glucose homeostasis. Key mechanisms of terpenes healing properties include activation of endogenous antioxidant defense-mainly via Nrf2-, inhibition of NLRP3 inflammosome-mediated pyroptosis and reduction in lipid oxidation involved in atherosclerotic plaque formation. Their therapeutic potential is reinforced by low toxicity profiles and broad botanical availability. However, challenges related to their translation to therapeutic practice remain unresolved, such as low bioavailability, limited yield and scarce results in human in vitro models. Future research should focus on nano- and micro-delivery systems, biotechnological production strategies and the use of human induced pluripotent stem cell-derived cardiomyocytes. Despite these limitations, terpenes represent valuable templates for developing more potent and clinically viable therapeutic agents. Further studies of this family are encouraged due to its promising ability to treat cardiovascular disorders.