Dharshini Jaisankar, Suruthi Ramamoorthy, Jegadeesh Ramasamy
CVDs such as atherosclerosis, hypertension, myocardial infarction, and heart failure, are the top cause of death worldwide. Due to the challenges with traditional therapies, interest in complementary treatments has increased. Research has found that TCM and its herbal constituents, rich in flavonoids, appear to have a positive effect on cardiovascular health due to several underlying mechanisms. This review provides an overview of current clinical and experimental research on flavonoid-rich Chinese medicinal plants. The database includes PubMed, Scopus, Web of Science, and CNKI. Details include various cardiovascular diseases (CVD) types and their mechanism of action (including antioxidant, anti-inflammation, enhancement of endothelial function, and stabilization of mitochondria). It also features studies of several compounds in preclinical models and clinical trials, including quercetin and baicalin as key representatives. Significant portion pathways are PI3K/AKT, NF-κB, Nrf2/HO-1, eNOS and AMPK/mTOR. The comparative table highlights plants, pharmaceutical targets, and the impact of diseases. Evidence suggests that flavonoids from Chinese medicinal plants have a wide-ranging cardio-protective effect, regardless of the CVD model. The compounds possess potent antioxidant, anti-inflammatory, endothelial-enhancing, and lipid-regulatory effects. While recent clinical studies indicate improvements in blood pressure, lipid profiles, myocardial resilience, and endothelial function, results remain inconsistent due to small sample size, differences in extract composition, and variation in trial design. The use of Chinese medicinal herbs enriched in flavonoids can provide effective multi-pathway intervention against complex pathophysiological mechanisms, making them a valuable resource for cardiovascular therapy. Despite the obvious translational potential, shortcomings like poor bioavailability, phytochemical variability, and limited clinical trials are significant. These limitations continue to hinder clinical translation, and addressing them will be critical for broder therapeutic adoption. Future research should focus on improving the formulation, facilitating clinical standardization, and developing systems-level pharmacology to enable evidence-based use of flavonoid therapies in modern cardiovascular medicine.