Abstract
The global epidemic of obesity and diabetes imposes a significant strain on healthcare systems, substantially elevating the risk of vascular dysfunction and its associated complications. Astragaloside IV (AS-IV) and berberine (BBR) have demonstrated considerable promise in addressing vascular issues linked to these conditions. This review examines the mechanisms driving their vascular protective effects, drawing on evidence from preclinical studies to compare and contrast their modes of action. It explores both the unique and overlapping pathways through which they mitigate the complications of obesity and diabetes. A thorough analysis of their therapeutic potential highlights promising preclinical data and its clinical implications. However, challenges remain, such as enhancing the bioavailability of AS-IV and BBR and translating preclinical findings into robust clinical trials. This synthesis provides critical insights for advancing research and practical approaches in managing vascular dysfunction associated with obesity and diabetes.