Understanding the Role of p ‐Coumaric Acid in Diabetes and Cardiovascular Complications

PCA, a natural phenolic acid, shows promise against diabetic cardiovascular disease (CVD) pathology, but its clinical translation faces significant hurdles, as highlighted by this review. We systematically reviewed over 250 publications (1990–2025) from six databases (Web of Science, PubMed, SciFinder, ScienceDirect, Google Scholar, and EKB), focusing on p ‐coumaric acid (PCA)’s molecular effects, particularly on NF‐Қβ and AMPK pathways, and excluding general antioxidant or non‐peer‐reviewed studies lacking mechanistic depth. Crucially, this review moves beyond simple compilation to address two critical translational gaps: (1) the controversy over the mechanistic specificity (non‐specific antioxidant vs. targeted signaling molecule) and (2) the profound limitation posed by PCA's poor oral bioavailability and its limited clinical validation. By altering endothelial function, reducing NF‐κβ ‐mediated inflammation, and triggering the Nrf‐2 antioxidant defense pathway, it is proved that PCA and its derivatives have cardioprotective and anti‐diabetic effects. We map the various dietary sources and talk about chemical changes intended to increase its inherent activity. Preclinical evidence strongly supports the therapeutic potential of PCA for diabetic CVD, but its clinical translation is limited by poor pharmacokinetics and lack of high‐quality human trials; a strategic roadmap is needed to understand its mechanism and secure targeted clinical validation.