Abstract
Cardiovascular disorders are leading mortality causes worldwide, often with a latent evolution. Vascular health depends on endothelial function, arterial stiffness, and the presence of atherosclerotic plaques. Preventive medicine deserves special attention, focusing on modifiable cardiovascular risk factors, including diet. A diet rich in fruits and vegetables has well-known health benefits, especially due to its polyphenolic components. Anthocyanins, water-soluble flavonoid species, responsible for the red-blue color in plants and commonly found in berries, exert favorable effects on the endothelial function, oxidative stress, inhibit COX-1, and COX-2 enzymes, exert antiatherogenic, antihypertensive, antiglycation, antithrombotic, and anti-inflammatory activity, ameliorate dyslipidemia and arterial stiffness. The present review aims to give a current overview of the mechanisms involved in the vascular protective effect of anthocyanins from the human diet, considering epidemiological data, in vitro and in vivo preclinical research, clinical observational, retrospective, intervention and randomized studies, dietary and biomarker studies, and discussing preventive benefits of anthocyanins and future research directions.
Highlights
Cardiovascular disorders are leading mortality causes worldwide, often with a latent evolution
ACYs were already mentioned to reverse or attenuate metabolic syndrome in rats [36]. Anthocyanins exert their anti-inflammatory effects by activating the nuclear factor 2 pathway (Nrf2), impairing overproduction of inflammatory cytokines in response to oxidative stress and of chemokines in response to inflammation, limiting NF-k beta activation and inhibiting the expression of vascular smooth muscle cell adhesion molecule and COX-2 expression in vascular smooth muscle cells [75]
The majority of Randomized Controlled Trials (RCT) included in this review reported significant improvements in arterial stiffness following acute and chronic consumption of anthocyanin-rich foods, in patients with diverse disorders, body mass index, and age (Table 4)
Summary
Cardiovascular disorders are leading mortality causes worldwide, often with a latent evolution. ACYs undergo dehydroxylation by colonic bacteria, to form hydroxybenzoic acid, followed by conjugation with glycine to form hippuric acid [33] Anthocyanins and their catabolites undergo phase 2 enzymatic metabolism, generating the glucuronidated, sulphated, and methylated forms, which persist in the urine for a long time after their intake, related, probably, to their transport in the bile [27]. Considering that many people prefer natural therapies, the present paper aims to give a current overview of the vascular protective mechanisms attributed to anthocyanins in the diet, considering epidemiological data, in vitro and in vivo preclinical research, clinical observational, retrospective, intervention, and randomized studies, dietary and biomarker studies, and discussing preventive benefits of anthocyanins and future research directions
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