Background: Cardiovascular disease (CVD) remains the leading global cause of mortality, accounting for approximately 17.9 million deaths annually. Oxidative stress and chronic inflammation are key contributors to CVD pathogenesis, highlighting dietary antioxidants as promising strategies for cardiovascular prevention.
Objective: This scoping review evaluates the mechanistic basis, clinical evidence, and translational potential of dietary antioxidants in reducing cardiovascular risk.
Methods: A scoping review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library to identify English-language publications from January 2020 to December 2024. Eligible sources included randomized controlled trials, prospective cohort studies, systematic reviews, meta-analyses, and relevant clinical guidelines investigating dietary antioxidants, oxidative stress, and cardiovascular outcomes. Evidence was narratively synthesized to identify key mechanisms, clinical findings, emerging trends, and research gaps.
Results: The reviewed literature indicates that dietary antioxidants, including polyphenols (quercetin, resveratrol, and curcumin), carotenoids, vitamins C and E, and trace minerals such as selenium and zinc, exert cardioprotective effects through activation of the Nrf2/HO-1 pathway, suppression of NF-κB signalling, enhancement of endothelial nitric oxide synthase activity, inhibition of LDL oxidation, and modulation of SIRT1/AMPK signalling. Clinical evidence suggests that polyphenol supplementation modestly reduces systolic blood pressure, improves lipid profiles, and lowers cardiovascular risk. Adherence to the Mediterranean diet has also been associated with a 48% reduction in major adverse cardiovascular events (OR 0.52; 95% CI: 0.32–0.84). However, evidence supporting isolated high-dose supplementation with beta-carotene and vitamin E remains inconsistent.
Conclusion: Dietary antioxidants consumed as part of whole-food dietary patterns provide significant cardiovascular benefits, whereas isolated antioxidant supplementation shows variable efficacy. Future research should prioritize personalized nutrition, improved bioavailability, and pharmacogenomic approaches to optimize antioxidant-based cardiovascular prevention.
