Background- Cardiovascular diseases, including myocardial infarction, dyslipidaemia and\ncoronary artery pathology, are a major cause of illness and death in Western countries. Therefore,\nidentifying effective therapeutic approaches and their cellular signalling pathways is a challenging\ngoal for medicine. In this regard, several epidemiological studies demonstrate a relationship between\nthe intake of flavonoid-rich foods and the reduction of cardiovascular risk factors and mortality.\nIn particular, flavonoids present in citrus fruits, such as oranges, bergamots, lemons and grapefruit\n(95% from flavanones), are emerging for their considerable nutraceutical value. Methods- In\nthis review an examination of literature was performed while considering both epidemiological,\nclinical and pre-clinical evidence supporting the beneficial role of the flavanone class. We evaluated\nstudies in which citrus fruit juices or single flavanone administration and cardiovascular risk factors\nwere analysed; to identify these studies, an electronic search was conducted in PUBMED for papers\nfulfilling these criteria and written in English. Results- In addition to epidemiological evidence\nand clinical studies demonstrating that fruits in the Citrus genus significantly reduce the incidence\nof cardiovascular disease risk, pre-clinical investigations highlight cellular and subcellular targets\nthat are responsible for these beneficial effects. There has been special attention on evaluating\nintracellular pathways involved in direct cardiovascular and cardiometabolic effects mediated by\nnaringenin, hesperetin and eriodictyol or their glycosylated derivatives. Conclusions- Although some\nmechanisms of action remain unclear and bioavailability problems remain to be solved, the current\nevidence supports the use of a nutraceutical approach with citrus fruits to prevent and cure several\naspects of cardiovascular disease.
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