Cardiovascular disease (CVD) continues to dominate as the primary cause of mortality and morbidity worldwide, constituting a pressing global health concern. In contrast to Western medicine, traditional Chinese medicine (TCM) offers a holistic, side-effect-minimizing, and highly efficacious approach to tackling CVD challenges. Among the myriad herbs utilized in TCM, Huangqi (HQ), particularly in the realm of cardiovascular therapeutics, has enjoyed an esteemed status spanning millennia. Astragaloside IV (AS-IV), a saponin derivative meticulously extracted from the roots of the renowned Chinese medicinal plant Astragalus membranaceus, has garnered significant attention for its multifaceted cardioprotective capabilities. These encompass antioxidant stress mitigation, anti-inflammatory actions, anti-apoptotic effects, inhibition of cardiomyocyte hypertrophy, and attenuation of myocardial fibrosis, among others. Consequently, pharmacokinetic and toxicological evaluations underscore AS-IV’s low bioavailability yet commendable safety profile, with a notable caveat of prudence when administering to pregnant individuals. The present article delves into the most recent advancements in understanding the therapeutic impacts and underlying mechanisms of AS-IV in the context of cardiovascular diseases. By consolidating these cutting-edge findings, we aspire to establish a robust theoretical foundation that can propel the development of AS-IV as an innovative therapeutic agent for the treatment of CVDs, thereby contributing to the global endeavor to combat this pervasive health burden.
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