Herbal and Phytochemical Strategies for Cardiovascular and Cancer-related Cardiotoxicity: Benefits, Risks, and Research Gaps

Cardiovascular diseases (CVDs) and cardiotoxicity induced by chemotherapy and radiation remain major contributors to morbidity and premature mortality worldwide. Phytotherapy has emerged as a promising complementary strategy to counteract both CVDs and treatment-related cardiotoxicity, which continue to present significant challenges in oncology. In this narrative review, we conducted a literature search across databases including PubMed, ScienceDirect, and Google Scholar, focusing on herbal extracts and bioactive phytochemicals with reported cardioprotective or preventive effects in interventional studies. Our analysis highlights 11 herbs, including Moringa, turmeric, Dioscorea, licorice, Alpinia, ginseng, silymarin, ginkgo, bitter orange, grapes, and tomatoes, and their major compounds-ranging from phenolics to saponins-such as ginkgolide, lycopene, apigenin, hesperidin, naringenin, dioscin, galangin, ginsenosides, quercetin, resveratrol, glabridin, curcuminoids, kaempferol, and glycyrrhetinic acid. These phytochemicals have demonstrated potential in mitigating cardiovascular damage, including damage associated with chemotherapy and radiation exposure. We further examined their chemical structures, mechanisms of action, and safety profiles. While preclinical evidence suggests substantial therapeutic promise, gaps remain regarding clinical efficacy, optimal dosing, and long-term safety. Our findings emphasize the importance of advancing clinical research to validate these compounds as potential cardioprotective agents and to establish guidelines for their safe integration into clinical practice.