Targeting Programmed Cell Death as an Innovative Strategy Against Atherosclerosis: Potential of Natural Compound Supplements

Atherosclerosis (AS) is the primary pathological basis of various cardiovascular diseases. Its pathogenesis involves multiple processes, including inflammatory responses, lipid metabolism disorders, and cell death. Recently, programmed cell death (PCD), comprising apoptosis, autophagy, pyroptosis, necroptosis, and ferroptosis, has attracted considerable attention as a potential therapeutic target in AS progression. Furthermore, natural compounds with anti-atherosclerotic properties derived from plants have gained wide interest. These natural products regulate PCD through various mechanisms and demonstrate significant potential for the prevention and treatment of AS. Therefore, this review summarizes the molecular mechanisms of critical PCD pathways involved in AS and discusses the latest findings on natural products, such as flavonoids, polyphenols, saponins, and alkaloids that target PCD to alleviate AS. Based on these findings, this review highlights the importance of natural compounds targeting PCD as a therapeutic strategy against AS, providing novel theoretical insights and translational directions to promote the development of precise anti-atherosclerotic therapies derived from natural products.