Siddha Medicine in Cardiovascular Care: Clinical Evidence and Pharmacological Perspectives for Integrative Management-An Integrative Review

Cardiovascular Diseases (CVDs) are leading causes of mortality globally and in India, contributing substantially to the burden of noncommunicable diseases. The Siddha system of medicine recommends several internal formulations for cardiovascular care; however, the consolidation of scientific evidence supporting these therapies is necessary to strengthen their role in integrative healthcare. The objective was to compile and analyze available preclinical, toxicity, and clinical evidence on Siddha internal medicines recommended for the management of cardiovascular diseases. This descriptive evidence-based review included preclinical studies, acute and chronic toxicity studies, clinical trials (case reports, case series, pilot studies, and randomized controlled trials), and postgraduate and doctoral theses related to Siddha formulations indicated for CVD treatment. Molecular docking studies and literature reviews of individual ingredients were excluded. A comprehensive search was conducted in PubMed, Embase, Web of Science, Science Direct, the Cochrane Library, and Google Scholar via relevant keywords with Boolean operators. The data were compiled and analyzed systematically. Thirty-four Siddha internal formulations recommended for cardiovascular diseases were identified. Among these compounds, 17 demonstrated antioxidant activity, 8 exhibited anti-inflammatory effects, 2 exhibited cardioprotective properties, 2 exhibited antihypertensive activity, 4 exhibited hypolipidemic effects, and 1 exhibited antiatherogenic action. Several formulations have also shown antidiabetic, Hepatoprotective, and immunomodulatory activities relevant to CVD comorbidities. Toxicity studies conducted on selected formulations indicated acceptable safety profiles under experimental conditions. Limited clinical evidence suggests improvements in lipid parameters and cardiovascular health indicators. Siddha internal medicines exhibit pharmacological activities relevant to cardiovascular disease management. While preclinical evidence is substantial, robust, large-scale clinical trials are warranted to validate efficacy and ensure safe integration into evidence-based cardiovascular care.