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Flavonols and cardiovascular disease
Abstract
Flavonols, and specially quercetin, are widely distributed in plants and are present in considerable amounts in fruits and vegetables. In addition to their anti-oxidant effect, flavonols interfere with a large number of biochemical signaling pathways and, therefore, physiological and pathological processes. There is solid evidence that, in vitro, quercetin and related flavonols exert endothelium-independent vasodilator effects, protective effect on nitric oxide and endothelial function under conditions of oxidative stress, platelet antiaggregant effects, inhibition of LDL oxidation, reduction of adhesion molecules and other inflammatory markers and prevention of neuronal oxidative and inflammatory damage. The metabolites of quercetin show partial protective effects on endothelial function and LDL oxidation. Quercetin produces undisputed antihypertensive and antiatherogenic effects, prevents endothelial dysfunction and protects the myocardium from ischemic damage. It has no clear effects on serum lipid profile and on insulin resistance. Human intervention trials with isolated flavonols demonstrate an antihypertensive effect. The meta-analysis of epidemiological studies show an inverse association between flavonol (together with flavone) intake and coronary heart disease and stroke. Therefore, although there is no solid proof yet, a substantial body of evidence suggests that quercetin may prevent the most common forms of cardiovascular disease contributing to the protective effects afforded by fruits and vegetables.
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“The results of our 7 d study, the 10 d study described above (20) and a 15 d study by Vanhatalo et al. (34) suggest that HN vegetables do not induce tolerance, which is a potential advantage over the therapeutic use of organic nitrates (26) .”
From High-nitrate vegetable diet increases plasma nitrate and nitrite concentrations and reduces blood pressure in healthy women (2015) · cites this paper as [34]
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“Some observational studies evaluating total or selected dietary flavonoids observe lower risk of cardiometabolic events;299, 300 no long-term clinical trials have been performed.”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [299]
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“with flavonol intakes, others have not, and results from human studies are less consistent than those from in vitro studies.(24,25) However, a recent systematic review and meta-analysis of 7 randomized controlled trials (587 patients) found that quercetin supplementation of greater than 500 mg/d was effective in reduc…”
ResultTranscriptome and metabolome analysis of flavonol synthesis in apricot fruits
Han, X., Wang, J., Wang, G., Dong, F., Nie, P., & Xue, X. (2023) · Frontiers in Plant Science · doi:10.3389/fpls.2023.1187551 · Cited by 7
Interaction between bioactive carbonyl compounds and asparagine and impact on acrylamide
Hamzalıoğlu, A., & Gökmen, V. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-99119-3.00008-4 · Cited by 7
de Oliveira, A. C., Cruz, J. M. D. A., Mar, J. M., Corrêa, R. F., Rodrigues, J. V. D. S., Mendes, T. A. D. O., Aguiar, J. P. L., Souza, F. D. C. D. A., Neves, K. D. O. G., Santos, A. D. D. C., et al. (2025) · Food Research International · doi:10.1016/j.foodres.2025.115984 · Cited by 10
Dmello, J. R., Chandekar, L. P., Bavadekar, T. A., Buttar, H. S., & Kaur, G. (2023) · Advances in biochemistry in health and disease · doi:10.1007/978-3-031-14952-8_23 · Cited by 7
Cranberry Polyphenols: Effects on Cardiovascular Risk Factors
Khoo, C., Falk, M., & Zhang, J. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-813008-7.00009-6 · Cited by 7
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“have vascular protective effect under oxidative stress conditions.[32]”
BackgroundChapter 81 – Cranberry Polyphenols: Effects on Cardiovascular Risk Factors
Khoo, C., & Falk, M. L. (2014) · Polyphenols in Human Health and Disease · Cited by 7
Morimoto, J. M., Marchioni, D. M. L., César, C. L. G., & Fisberg, R. M. (2012) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2012.07.003 · Cited by 6
Structure assignment and H/D-exchange behavior of several glycosylated polyphenols
Franz, A. H., Serebnitskaya, I., Gudial, G., & Wallis, C. M. (2014) · ARKIVOC · doi:10.3998/ark.5550190.p008.583 · Cited by 6
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Basalekou, M., Καλλιθράκα, Σ., & Kyraleou, M. (2023) · Elsevier eBooks · doi:10.1016/b978-0-12-823811-0.00008-0 · Cited by 6
Phenolic Compounds from a Sex‐Gender Perspective
Campesi, I., Romani, A., Marino, M., & Franconi, F. (2014) · Wiley eBooks · doi:10.1002/9781118329634.ch10 · Cited by 7
Development of the Transgenic Rice Accumulating Flavonoids in Seed by Metabolic Engineering
Ogo, Y., & Takaiwa, F. (2017) · doi:10.1002/9781119079972.ch13 · Cited by 6
Li, X., Xu, R., & Ni, T. (2023) · Journal of Molecular Structure · doi:10.1016/j.molstruc.2023.135614 · Cited by 5
Bioactive Compounds of the PVPP Brewery Waste Stream and their Pharmacological Effects
Pérez-Manríquez, J., Escalona, N., & Pérez‐Correa, J. R. (2019) · Mini-Reviews in Organic Chemistry · doi:10.2174/1570193x16666190723112623 · Cited by 5
Jiang, D., Qian, J., Chen, K., Zhang, B., & Li, X. (2025) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.5c06227 · Cited by 4
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Effects of Onion Peel Water Extract on the Blood Lipid Profiles in Mice Fed a High-Fat Diet
Lee, H. A., Han, S. J., Hong, S., & Kim, O. J. (2014) · Korean Journal of Medicinal Crop Science · doi:10.7783/kjmcs.2014.22.3.203 · Cited by 4
Thermodynamic Studies on Protonation Constant of Quercetin at Different Ionic Strengths
Yazdanshenas, R., & Gharib, F. (2016) · Journal of Solution Chemistry · doi:10.1007/s10953-016-0506-6 · Cited by 4
Efficient Preparation of Various O -Methylquercetins by Selective Demethylation
Kimura, Y., Kato, R., Oyama, K., Kondo, T., & Yoshida, K. (2016) · Natural Product Communications · doi:10.1177/1934578x1601100722 · Cited by 4
Sajjadi‐Ghotbabadi, H., Javanshir, S., Rostami‐Charati, F., & Sayyed-Alangi, S. Z. (2018) · Chemistry of Heterocyclic Compounds · doi:10.1007/s10593-018-2297-8 · Cited by 4
Antioxidant, Anti-inflammatory and Hypolipidemic Properties of Apple Flavonols
Sekhon-Loodu, S. (2012) · Library and Archives Canada (Government of Canada) · Cited by 4
Joshi, K., Pant, N. C., Kumar, V. A., & Kumar, A. (2017) · Annals of Phytomedicine An International Journal · doi:10.21276/ap.2017.6.2.14 · Cited by 4
Dietary Phytochemicals and Their Potential Effects on Diabetes Mellitus 2
Singh, R., Kazmi, I. A., Afzal, M., Imam, F., & Alharbi, K. S. (2019) · Springer eBooks · doi:10.1007/978-3-030-04408-4_4 · Cited by 4
Anthocyanins and Flavonols: Therapeutic Implications of Natural Compounds on Cancer
Assmann, C. E., Weis, G. C. C., da Rosa, J. R., Bonadiman, B. D. S. R., Alves, A. D. O., Borsoi, F. T., & Bagatini, M. D. (2021) · Springer eBooks · doi:10.1007/978-981-15-4501-6_139-1 · Cited by 4
Metadata
- Authors
- Perez-Vizcaino, F., & Duarte, J.
- Affiliations
- Universidad de Granada (ES)
- ORCID
- Duarte, Juan
- Venue
- Molecular Aspects of Medicine
- Publisher
- Elsevier BV
- Published
- 2010-12
- Volume
- 31
- Issue
- 6
- Pages
- 478-494
- ISSN
- 0098-2997 (ISSN-L)
- OpenAlex
- W2088383365
- Cited by
- 393
- References
- 164
- Citations by year
- 2026: 11 · 2025: 23 · 2024: 23 · 2023: 21 · 2022: 33 · 2021: 26 · 2020: 18 · 2019: 20 · 2018: 29 · 2017: 16 · 2016: 32 · 2015: 34 · 2014: 30 · 2013: 30 · 2012: 31
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Molecular Aspects of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Spanish Ministerio de Ciencia y Tecnología (AGL2007-66108, SAF2008-03948, Red HERACLES RD06/0009)
- Junta de Andalucía (P06-CTS-01555)
- Topics
- Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
- Health Sciences › Medicine › Pharmacology (medical) › Flavonoids in Medical Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- flavonols, quercetin, cardiovascular disease, endothelial function, nitric oxide, oxidative stress, platelet aggregation, LDL oxidation, inflammation, antihypertensive effect, atherosclerosis, coronary artery disease, stroke, flavonoid metabolites, fruits and vegetables, antioxidant activity
- MeSH terms
- Animals, Antioxidants, Cardiovascular Diseases, Endothelium, Vascular, Humans, Muscle, Smooth, Vascular, Quercetin, Oxidative Stress, Flavonols
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