Functional hydrogels in cardiovascular therapy: Design, applications and clinical challenges (Review)

Cardiovascular disease (CVD) is the leading cause of mortality worldwide, and conventional treatments (such as pharmacotherapy, stents and bypass surgery) have limited capacity to repair damaged cardiovascular tissue. Hydrogels, as biocompatible three‑dimensional network materials, demonstrate potential for the treatment of CVD. The present review summarizes functional hydrogels for CVD treatment, including their preparation, applications, current challenges and future perspectives. Hydrogel materials comprise natural polymers, synthetic polymers and composite systems, each with distinct advantages and limitations: Natural polymers offer good biocompatibility but exhibit poor mechanical strength; synthetic polymers provide tunable properties but lack inherent bioactivity; composites combine the advantages of both but are more complex to manufacture. Stimuli‑responsive hydrogels respond to environmental cues and enable on‑demand therapeutic delivery. In terms of clinical applications, hydrogels have potential for post‑infarction myocardial repair, vascular regeneration, heart valve repair and regeneration and heart failure management. They serve as scaffolds, as well as cell and drug delivery carriers. Nevertheless, hydrogels face challenges in clinical translation, including safety, long‑term biocompatibility, mechanical and electrical compatibility with host tissue, thrombogenicity, large‑scale manufacturing, integration with standard care and regulatory approval. In the future, hydrogel systems are may evolve toward stimuli‑responsive, self‑regulating, adaptive and personalized designs, integrate with emerging therapeutic strategies (such as gene therapy, cell therapy, and RNA‑based therapeutics) and be used in conjunction with existing medical devices (stents, vascular grafts, pacemakers, and ventricular assist devices), thereby becoming an important platform for cardiovascular regenerative therapy.