Pathogenesis of Atherosclerosis and Coronary Heart Disease: Epidemiology, Diagnostic Biomarkers and Prevention by Nutraceuticals, Functional Foods, and Plant-Derived Therapies

Atherosclerosis is characterized by hardening/narrowing of arteries and reduction of blood flow to vital organs. Animal models and human research show that endothelial dysfunction and plaque development precede the pathogenesis of atherosclerosis, and related coronary heart disease, neurological, and renal disorders. Cardiac CT-scans are used to detect atherosclerosis. Early diagnosis of atherosclerosis reduces mortality, morbidity, and healthcare expenditures. Biomarkers like C-reactive protein, IL-6, IL-8, phospholipase A2, cardiac troponin, MicroRNA, miR-21, and other endothelial inflammation biomarkers are novel targets for monitoring atherosclerosisrelated cardiovascular disorders. Anti-platelet and anti-cholesterol drugs are used in the treatment of atherogenesis and blood vessel clots. However, cholesterol-lowering drugs may cause serious adverse effects. Thus, safe and cost-effective non-pharmacological anti-atherogenic and anticoagulant therapies are urgently needed. Nutraceuticals, functional foods, plant-derived therapies, antioxidant/anti-inflammation, foods/fruits/vegetables, and lifestyle changes (e.g., physical activity, less alcohol, smoking cessation) reduce atherogenesis, diabetes mellitus, obesity, hypertension, LDL, and C-reactive protein in all age groups, especially younger people. Overwhelming evidence suggests that regular physical activity (30 min/day), cessation of cigarette smoking, and consumption of antioxidant nutraceuticals rich in flavonoids and retinoids, fresh vegetables and fruits, omega-3 PUFA, culinary spices, probiotics, Mediterranean-type diet, and “DASH DIET” lower the risk of atherogenesis and cardiovascular diseases. This review summarizes current advances in the diagnosis and management of atherosclerosis and related cardiovascular illnesses with plant-based and wholesome diets, including the Mediterranean diet, DASH DIET, and lifestyle changes. New preventative measures and alternative therapies, including dietary interventions and plant-based foods may be the most cost-effective ways to manage atherosclerosis and cardiovascular illnesses.

Keywords: Coronary heart disease, Culinary spices, DASH diet, Diagnostic biomarkers, Healthful foods, Mediterranean diet, Nutraceuticals, Pathophysiology of atherosclerosis, Stroke.