Table 2.

Mechanism of Action of Nutritional Fruits Against CVDs

Nutritional Fruits	Mechanism of Action	Reference
Apple	Protection of Vascular Endothelial Function •By improving endothelial function Blood Pressure Modulation •By maintaining pulse rate and systolic blood pressure Inflammation Reduction •By lowering CRP level in the body •By decreasing stroke mortality •By decreasing serious stomach aortic calcification Reduction of Cholesterol Levels •By decreasing TC and LDL levels •By increasing HDL levels	Bondonno et al,23 Hodgson et al,22 Ravn-Haren et al,25 Sandoval-Ramírez et al,21 Serra et al,29 Gonzalez et al30
Avocado	Platelet-Inhibiting Functions •By acting as anti-platelet and anti-thrombotic agents Thrombosis Suppression •By increasing coagulation times •By reducing thrombus formation Blood Pressure Modulation •By inducing bradycardia, vasorelaxation and hypotension Inflammation Reduction •By decreasing the levels of high-sensitivity CRP •By preventing the development of metabolic syndrome Reduce Cholesterol Level •By increasing serum HDL-c concentrations •By decreasing TG, VLDL and LDL levels	Carvajal-Zarrabal et al,33 Gouegni and Abubakar,39 Mahmassani et al,32 Park et al,36 Rodriguez-Sanchez et al,38 Dabas et al40
Grapes	Lipid-Metabolism Regulation •By exerting a positive effect on blood lipids •By inhibiting LDL oxidation Protection of Vascular Endothelial Function •By improving endothelial function Platelet-Inhibiting Functions •By inhibiting human platelet aggregation Blood Pressure Modulation •By preventing the production of high blood pressure •By protecting from hypertension Oxidative Stress Reduction •By increasing antioxidant levels Inflammation Reduction •By preventing some inflammatory-mediated diseases	Borde et al,53 Godse et al,54 Leifert and Abeywardena,57 Resende et al,51 Shanmuganayagam et al,45 Quiñones et al,52 Leibowitz et al,49 Luzak et al,50 Quintieri et al,55 Safwen et al44
Mango	Lipid-Metabolism Regulation •By reducing lipid levels in the induced dyslipidaemia model •By reducing the risk factors of hyperglycaemia, HF diet, dyslipidaemia and visceral adiposity •By increasing serum HDL-c in the hyperlipidaemic model Oxidative Stress Reduction •By enhancing antioxidant activity Reduce Cholesterol Level •By preventing the rapid onset of the atherosclerotic process	Fidrianny et al,60 Prabhu et al;61 Lobo et al62
Orange	Lipid-Metabolism Regulation • By inhibiting the production of Fe2+-induced malondialdehyde in a concentration-dependent manner • By enhancing the lipid profile and peroxidation Blood Pressure Modulation • By reducing diastolic and systolic blood pressures Oxidative Stress Reduction • By enhancing antioxidant activity • By preventing oxidative damage Inflammation Reduction • By inhibiting MAO, PDE and ACE activities	Ademosun and Oboh,64 Asgary and Keshvari,65 Castello et al66
Kiwi	Lipid-Metabolism Regulation • By improving plasma lipid levels • By reducing TG levels in the blood • By improving dietary lipid absorptions and reabsorptions, as it also contains soluble fibre Platelet-Inhibiting Functions • By reducing platelet reactivity to collagen and ADP • By inhibiting fibrinolysis activity Blood Pressure Modulation • By inhibiting ACE activity • By decreasing diastolic and systolic blood pressures Thrombosis Suppression • By improving the efficacy of thrombosis prophylaxis Reduction of Cholesterol Levels • By inhibiting HMG-CoA reductase • By improving apolipoprotein B/apolipoprotein A1 ratio • By improving plasma HDL-c and TC/HDL-c ratio • By preventing atherosclerosis	Duttaroy and Jørgensen,73 Iwasawa et al,72 Jung et al,76 Karlsen et al,79 Padmanabhan and Paliyath,78 Stonehouse et al74
Pomegranate	Lipid-Metabolism Regulation • By reducing aortic sinus and coronary artery atherosclerosis • By reducing lipid peroxidation levels Protection of Vascular Endothelial Function • By reducing hypertension, coronary artery disease and peripheral artery disease Blood Pressure Modulation • By reducing ACE activity • By relieving hypertension Ischemic or Reperfusion Reduction • Reducing cellular ATP/ADP ratio in cardiomyocytes Oxidative Stress Reduction • By enhancing phase II enzyme activity in high-fibre diet-induced cardiovascular disorders • By giving strong antioxidant effects • By increasing antioxidant defences Inflammation Reduction • Reducing arrhythmia • By improving mitochondrial function in the paraventricular nucleus • By reducing Ca2+ ATPase levels Reduce Cholesterol Level • By acting as atheroprotective	Al-Jarallah et al,116 Cao et al,85 Haghighian et al,94 Jadeja et al,90 Mohan et al,83 Shao et al,93 Sun et al,89 Hajipour et al87
Papaya	Lipid-Metabolism Regulation • By reducing fat absorption • By treating lipid abnormalities at the prediabetic stage • By preventing prediabetes patients from getting diabetes mellitus type 2 • By improving lipid profile • By reducing triglyceride levels Blood Pressure Modulation • By reducing arterial blood pressure • By having potent anti-hypertensive properties • By inhibiting ACE activity • By reducing cardiac hypertrophy Oxidative Stress Reduction • By ameliorating free radicals-induced damage Inflammation Reduction • By preventing heart attacks and strokes as well as decreasing cholesterol levels • By preventing morbidity and death	Brasil et al,100 Gayosso-García et al,97 Hiraga et al,98 Santana et al,95 Wilson et al96
Pineapple	Platelet-Inhibiting Functions • By performing fibrinolytic activity Ischemic or Reperfusion Reduction • Reducing ischemic conditions in the reperfusion of the skeletal muscles. Oxidative Stress Reduction • By increasing antioxidant activity Thrombosis Suppression • By inhibiting blood platelet aggregation, minimising the risks from having arterial thrombosis and embolism • By reducing coagulation via the interference of fibrinogen and facilitation of a good blood flow through the vessels Inflammation Reduction • By protecting cell membrane integrity • By improving isoproterenol-induced cardiac systolic/diastolic dysfunction • By reducing the degree of myocardial damage Reduce Cholesterol Level • By breaking down cholesterol plaques	Juhasz et al,108 Neumayer et al,153 Saxena and Panjwani,104 Wali102
Watermelon	Lipid-Metabolism Regulation • By reducing body weight, BMI and waist-to-hip ratio Blood Pressure Modulation • By reducing systolic blood pressure • By improving vascular health in hypertensive patients Oxidative Stress Reduction • By increasing total antioxidant capacity Reduce Cholesterol Level • By reducing the levels of TG, LDL and TBARS • By increasing HDL levels	Jumde and Shukla,113 Connolly et al,111 Shanely et al,112 WHO114

Notes: All the abbreviations are available in the main text.