Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide, with mitochondrial dysfunction emerging as a central contributor to their pathogenesis. Mitochondria play a pivotal role in cardiac energy metabolism, redox homeostasis and apoptosis regulation. Disruption of mitochondrial dynamics, oxidative phosphorylationand mitochondrial membrane integrity leads to cardiomyocyte injury, particularly during ischemia-reperfusion and heart failure. While pharmacological strategies targeting mitochondrial dysfunction are under investigation, growing evidence highlights the potential of herbal medicines in modulating mitochondrial function and offering cardioprotection. This review explores the molecular mechanisms by which cardioprotective herbsincluding Curcuma longa, Panax ginseng, Salvia miltiorrhiza and Withania somnifera exert their beneficial effects via mitochondrial pathways. Key mechanisms include attenuation of oxidative stress, inhibition of mitochondrial permeability transition pore (mPTP) opening, enhancement of mitochondrial biogenesisand modulation of apoptosis-related signaling. By integrating insights from preclinical and emerging clinical studies, we highlight the promise of herbal medicines as adjunct or alternative strategies in managing mitochondrial dysfunction in CVDs. The review also discusses current challenges, such as variability in herbal formulations and the need for translational research, to pave the way for mitochondria-targeted phytotherapeutics in cardiovascular care.
