Resveratrol and atherosclerosis: A comprehensive review of its cardioprotective mechanisms and therapeutic potential

Cardiovascular diseases (CVDs) remain a major global health issue, with atherosclerosis being a primary driver of their development. Atherosclerosis is driven by oxidative stress, chronic inflammation, and lipid dysregulation, which ultimately lead to endothelial dysfunction and plaque formation. Resveratrol, a polyphenolic compound found in grapes and red wine, has emerged as a promising therapeutic agent due to its multivalent protective effects against atherosclerosis. This review outlines the role of resveratrol in the inhibition of key pathologic processes, including suppression of pro-inflammatory signaling pathways, enhancement of antioxidant defense mechanisms, and regulation of cholesterol homeostasis. Resveratrol inhibits NF-κB activation, resulting in decreased vascular inflammation and reduced expression of adhesion molecules such as Vascular Cell Adhesion Molecule-1 (VCAM-1) and Intercellular Cell Adhesion Molecule-1 (ICAM-1), thereby preventing infiltration of immune cells into arterial vessels. Additionally, it increases cholesterol efflux by promoting ATP-binding cassette transporters (ABCA1), enhancing high-density lipoprotein (HDL) function, and lowering lipid levels. Evidence from preclinical and clinical studies suggests that resveratrol holds potential as a natural treatment for the prevention of atherosclerosis.