Abstract
Polyphenols, bioactive compounds abundant in plant-based foods, have attracted significant interest for their potential cardiovascular benefits. This narrative review summarizes the current evidence on how polyphenols contained in extra virgin olive oil impact cardiovascular health, including their molecular mechanisms of action and clinical effects. Polyphenols exert antioxidant and anti-inflammatory effects in vascular cells by modulating key signaling pathways (e.g., NF-κB, Nrf2, and PI3K/Akt) and activating endothelial nitric oxide production, which collectively may improve endothelial function and reduce atherosclerotic burden. We review human trials of polyphenol-rich foods (such as berries, cocoa, tea, and wine) and isolated polyphenol supplements, which generally report improvements in blood pressure, vascular function, lipid profiles, and inflammatory markers-though results are not uniform. Limitations of these trials (small sample sizes, short durations) and variability in individual responses are discussed. We also consider the role of polyphenol metabolism and bioavailability, noting that gut microbiota-derived metabolites (e.g., urolithins, equol) likely contribute to the cardioprotective effects. Overall, a diet rich in diverse polyphenols appears to confer cardiovascular benefits, but more personalized research is needed to define optimal types and doses for specific patient profiles. Practical recommendations for incorporating polyphenol-rich foods into cardiovascular prevention strategies are provided.