Table 1.

Benefits of Plant-derived Bioactive Constituents and Lifestyle Changes on Risk Factors in Cardiovascular Diseases.

Cardiovascular Risk Factor	Pathophysiology	Benefit	Ref
sedentary lifestyle	↑ insulin resistance, ↑ obesity, ↑blood glucose levels, ↑plasma lipids, ↑prothrombotic factors	lifestyle changes: physical activity lowers risk for CVDs mortality ↑physical activity, ↓ alcohol consumption, not smoking, ↓ obesity: ↓ risk of incident heart failure in 50% cases	[31] [32]
hypertension	↑arterial hypertension and endothelial growth factor-linked polymorphisms, ↑vascular damage	berberine, green tea, cocoa, lycopene, aged garlic extract, resveratrol, grape seed extract, beetroot juice, olive oil and ascorbic acid: ↓blood pressure. apricot and olive seed protein hydrolysates: ↓ACE Resveratrol: ↑ nitric oxid production, ↑vasodilatation	[36] [37]
smoking	↑oxidative stress, ↑coronary spasm, disorders of coagulation mechanisms, ↑platelet aggregation, fibrinogen growth, disorders of endothelial function ↑ LDLc, ↓ HDL	garlic extract, Angelica gigas, celery, Artemisiae annuae Herba, oat extracts, cinnamon, soy extracts, hibiscus, flaxseed, wolfberry, lycopene, basil, and cocoa ↓atherosclerosis proanthocyanins (bilberries): anti-inflammatory effect, ↓pro-inflammatory cytokines, ↓chemokines (TNFα, IL-1, IL-6, IL-8)	[49] [44]
stress	disturbance of the hypothalamo-pituitary-adrenal axis, ↑serum cortisol due to stress, ↑inflammation of the arterial (endothelial) wall, ↑atherosclerosis, ↑ tone of the sympathetic vegetative nervous system.	L-theanine from green tea: ↑relaxation, ↓post-stress cortisol hyperforin: ↑serotonin in brain, similar to antidepressant drugs ginseng: antistress action, ↓physical and mental fatigue, ↑ power of concentration, ↑memory, ↑work performance	[61] [62]
obesity	↑dyslipidemia, hypercoagulability, platelet dysfunction, ↑insulin resistance and type 2 diabetes, ↑inflammation	polyphenols (grapes, tea, ginseng, red to purple color fruits) benefits: ↓platelet aggregation, ↓vascular inflammation, ↓apoptotis, ↓LDL oxidation EPA and DHA: anti-inflammatory and cardioprotective effects carotenoids: ↑anti-oxidant potential resveratrol: ↓fat deposits, regulate insulin levels, ↓body weight, ↑SIRT 1 protein	[19] [79,80,81] [23]
diabetes	altering arterial walls increasing inflammation at the endothelial level, with the deposition of VLDL and LDL cholesterol particles at this level and the formation of atheroma plaque	mediterranean diet: ↓ risk of diabetes polyphenols, flavonoids, terpenoids, saponins and lignans: antihyperglycemic effect peptides (soybean): prevent T2D onset	[86] [110] [111]
dyslipidemia	increasing of atherogenic effect deposits of atheroma plaques on the internal walls of medium and large arteries, with thickening of the arterial wall and loss of elasticity	phenolic compounds, flavonols: ↓TC, ↓LDLc, ↓TG levels phytosterols: ↓LDLc Soybean components, both proteins and isoflavones: ↓LDLc, ↑HDLc	[119] [120] [121] [127] [128]

Abbreviations: cardiovascular diseases (CVDs), total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), type II diabetes (T2D), interleukin (IL), tumor necrosis factor alpha (TNFα), Angiotensin-converting enzyme (ACE).