Table 3.

The role of silybin in cardiovascular diseases.

Diseases	Key associated effect	Regulated factors	Reference
Atherosclerosis	↓ Activation of the NF-κB signaling pathway; ↓ expression of downstream pro-inflammatory cytokines; ↓ ADMA levels, endothelial function, ↑ bioavailability of NO; ↑ synergistic anti-inflammatory effect exerted by the Nrf2 antioxidant pathway	↓ NF-κB signaling pathway; ↓ ADMA; ↑ Nrf2 signaling pathway	(55)
	Regulate the gut microbiota-metabolite-host axis;↑ butyrate production and transport, and repair the intestinal barrier	↑ BUT, ↑ MCT1/MCT4	(56)
	When combined with clopidogrel, it alleviates aortic root lesions, inflammation, and endothelial injury in a diabetic atherosclerosis model.		(57)
Hypertension	Bind to and activate the TRPV4 channel, induce calcium influx in endothelial cells, and mediate vasodilation; reduce blood pressure and improve vasodilatory response.	↑ TRPV4 channel, ↑ Ca²+ influx	(15)
Myocardial infarction/ischemia-reperfusion injury/heart failure	↓ HIF-1α expression and nuclear translocation; ↓ key glycolytic regulatory proteins, alleviate myocardial inflammation, fibrosis, and cardiac dysfunction	↓ HIF-1α signaling pathway, ↓ PFKFB3, ↓ GLUT1, ↓ LDHA	(60)

“↑” represents silybin’s promoting effect. “↓” represents silybin’s inhibiting effect.