Exploring the Cardiovascular Benefits of Extra Virgin Olive Oil: Insights into Mechanisms and Therapeutic Potential

Overview

Journal Biomolecules

Publisher MDPI

Specialties Biochemistry
Molecular Biology

Date 2025 Feb 26

PMID 40001586

Authors

Esposito Milena

Mandala Maurizio

Affiliations

Soon will be listed here.

Abstract

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, driven by complex interactions among genetic, environmental, and lifestyle factors, with diet playing a pivotal role. Extra Virgin Olive Oil (EVOO), a cornerstone of the Mediterranean diet (MedDiet), is a plant-based fat that has garnered attention for its robust cardiovascular benefits, which are attributed to its unique composition of monounsaturated fatty acids (MUFAs), particularly oleic acid (OA); and bioactive polyphenols, such as Hydroxytyrosol (HT) and oleocanthal. These compounds collectively exert antioxidant, anti-inflammatory, vasodilatory, and lipid-modulating effects. Numerous clinical and preclinical studies have demonstrated that EVOO's properties reduce major modifiable cardiovascular risk factors, including hypertension, dyslipidemia, obesity, and type 2 diabetes. EVOO also promotes endothelial function by increasing nitric oxide (NO) bioavailability, thus favoring vasodilation, lowering blood pressure (BP), and supporting vascular integrity. Furthermore, it modulates biomarkers of cardiovascular health, such as C-reactive protein, low-density lipoprotein (LDL) cholesterol, and NT-proBNP, aligning with improved hemostatic balance and reduced arterial vulnerability. Emerging evidence highlights its interaction with gut microbiota, further augmenting its cardioprotective effects. This review synthesizes current evidence, elucidating EVOO's multifaceted mechanisms of action and therapeutic potential. Future directions emphasize the need for advanced extraction techniques, nutraceutical formulations, and personalized dietary recommendations to maximize its health benefits. EVOO represents a valuable addition to dietary strategies aimed at reducing the global burden of cardiovascular diseases.

References

Niskanen L, Schwab U, Sarkkinen E, Krusius T, Vahtera E, Uusitupa M . Effects of dietary fat modification on fibrinogen, factor VII, and plasminogen activator inhibitor-1 activity in subjects with impaired glucose tolerance. Metabolism. 1997; 46(6):666-72. DOI: 10.1016/s0026-0495(97)90011-1. View

Fewkes J, Kellow N, Cowan S, Williamson G, Dordevic A . A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis. Am J Clin Nutr. 2022; 116(3):699-729. PMC: 9437993. DOI: 10.1093/ajcn/nqac153. View

El Sabbagh A, Prasad M, Zack C, Widmer R, Karon B, Lerman A . High-Sensitivity Troponin in Patients With Coronary Artery Endothelial Dysfunction. J Invasive Cardiol. 2018; 30(11):406-410. View

Schwedhelm E, Bartling A, Lenzen H, Tsikas D, Maas R, Brummer J . Urinary 8-iso-prostaglandin F2alpha as a risk marker in patients with coronary heart disease: a matched case-control study. Circulation. 2004; 109(7):843-8. DOI: 10.1161/01.CIR.0000116761.93647.30. View

Guasch-Ferre M, Hu F, Martinez-Gonzalez M, Fito M, Bullo M, Estruch R . Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study. BMC Med. 2014; 12:78. PMC: 4030221. DOI: 10.1186/1741-7015-12-78. View

Ewid M, Sherif H, Allihimy A, Alharbi S, Aldrewesh D, Alkuraydis S . AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction. BMC Res Notes. 2020; 13(1):178. PMC: 7092498. DOI: 10.1186/s13104-020-05031-3. View

Lerman-Garber I, Zamora-Gonzalez J, Cardoso-Saldana G, Posadas-Romero C . Effect of a high-monounsaturated fat diet enriched with avocado in NIDDM patients. Diabetes Care. 1994; 17(4):311-5. DOI: 10.2337/diacare.17.4.311. View

Vasan R . Biomarkers of cardiovascular disease: molecular basis and practical considerations. Circulation. 2006; 113(19):2335-62. DOI: 10.1161/CIRCULATIONAHA.104.482570. View

Hajar R . Framingham Contribution to Cardiovascular Disease. Heart Views. 2016; 17(2):78-81. PMC: 4966216. DOI: 10.4103/1995-705X.185130. View

10.

Dahlof B . Cardiovascular disease risk factors: epidemiology and risk assessment. Am J Cardiol. 2010; 105(1 Suppl):3A-9A. DOI: 10.1016/j.amjcard.2009.10.007. View

11.

Trifiletti A, Scamardi R, Gaudio A, Lasco A, Frisina N . Hemostatic effects of diets containing olive or soy oil in hypertensive patients. J Thromb Haemost. 2005; 3(1):179-80. DOI: 10.1111/j.1538-7836.2004.01095.x. View

12.

Nigam P, Bhatt S, Misra A, Chadha D, Vaidya M, Dasgupta J . Effect of a 6-month intervention with cooking oils containing a high concentration of monounsaturated fatty acids (olive and canola oils) compared with control oil in male Asian Indians with nonalcoholic fatty liver disease. Diabetes Technol Ther. 2014; 16(4):255-61. DOI: 10.1089/dia.2013.0178. View

13.

Freese R, Mutanen M, Valsta L, Salminen I . Comparison of the effects of two diets rich in monounsaturated fatty acids differing in their linoleic/alpha-linolenic acid ratio on platelet aggregation. Thromb Haemost. 1994; 71(1):73-7. View

14.

Violi F, Loffredo L, Pignatelli P, Angelico F, Bartimoccia S, Nocella C . Extra virgin olive oil use is associated with improved post-prandial blood glucose and LDL cholesterol in healthy subjects. Nutr Diabetes. 2015; 5:e172. PMC: 4521177. DOI: 10.1038/nutd.2015.23. View

15.

Falk R, Alexander K, Liao R, Dorbala S . AL (Light-Chain) Cardiac Amyloidosis: A Review of Diagnosis and Therapy. J Am Coll Cardiol. 2016; 68(12):1323-41. DOI: 10.1016/j.jacc.2016.06.053. View

16.

Blankenberg S, Rupprecht H, Poirier O, Bickel C, Smieja M, Hafner G . Plasma concentrations and genetic variation of matrix metalloproteinase 9 and prognosis of patients with cardiovascular disease. Circulation. 2003; 107(12):1579-85. DOI: 10.1161/01.CIR.0000058700.41738.12. View

17.

Li W, Dong M, Guo P, Liu Y, Jing Y, Chen R . Luteolin-induced coronary arterial relaxation involves activation of the myocyte voltage-gated K channels and inward rectifier K channels. Life Sci. 2019; 221:233-240. DOI: 10.1016/j.lfs.2019.02.028. View

18.

Parillo M, Rivellese A, Ciardullo A, Capaldo B, Giacco A, Genovese S . A high-monounsaturated-fat/low-carbohydrate diet improves peripheral insulin sensitivity in non-insulin-dependent diabetic patients. Metabolism. 1992; 41(12):1373-8. DOI: 10.1016/0026-0495(92)90111-m. View

19.

DellAgli M, Fagnani R, Mitro N, Scurati S, Masciadri M, Mussoni L . Minor components of olive oil modulate proatherogenic adhesion molecules involved in endothelial activation. J Agric Food Chem. 2006; 54(9):3259-64. DOI: 10.1021/jf0529161. View

20.

Jimenez-Torres J, Alcala-Diaz J, Torres-Pena J, Gutierrez-Mariscal F, Leon-Acuna A, Gomez-Luna P . Mediterranean Diet Reduces Atherosclerosis Progression in Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial. Stroke. 2021; 52(11):3440-3449. DOI: 10.1161/STROKEAHA.120.033214. View