Cardiovascular Benefits of Salvia miltiorrhiza (Danshen) Supplementation: Bioactive Constituents, Mechanisms, Clinical Evidence and Implications for Nutritional Care

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, creating interest in adjunctive strategies that complement standard care. Salvia miltiorrhiza (Danshen), a traditional Chinese medicinal herb rich in tanshinones and salvianolic acids, has been investigated for multi‐target cardiovascular effects. This narrative review summarizes key phytochemical classes, preclinical mechanisms, human clinical findings, and formulation approaches aimed at improving bioavailability. Preclinical studies consistently report antioxidative, anti‐inflammatory, vasodilatory, antithrombotic, and anti‐fibrotic activities, involving pathways such as endothelial nitric oxide signaling and modulation of NF‐κB/MAPK‐related inflammation. Clinical studies have reported potential benefits in conditions such as coronary artery disease and myocardial ischemia; however, the overall evidence is limited by heterogeneity in preparations and dosing, variable product composition, small sample sizes, and a shortage of rigorously designed trials. Practical translation is further constrained by poor solubility and rapid metabolism of key constituents, though delivery platforms (e.g., liposomes, nanoparticles, and self‐microemulsifying systems) may enhance exposure in experimental settings. Overall, Danshen remains a plausible adjunct candidate, but standardization and high‐quality randomized clinical trials are needed to establish efficacy, safety, and interaction risk with conventional cardiovascular therapies.