Capsaicinoids and Piperine in Cardiovascular Physiology: Autonomic, Endothelial, and Myocardial Pathways
DOI:
https://doi.org/10.64149/J.Ver.8.3.181-189Keywords:
Capsicum; Piperine; Capsaicin; Volatile oils; TRPV1; Cardiovascular physiology; Chest pain; Coronary vasospasm; Cardioprotection; Pepper-induced cardiac effects; Atypical cardiac pain; Phytochemicals; Autonomic modulation; Ischemic preconditioning; Cardiovascular risk..Abstract
Pepper-derived phytochemicals, particularly volatile terpenoids and pungent alkaloids from Capsicum and Piper species, have attracted increasing attention for their complex cardiovascular effects. Bioactive constituents such as capsaicinoids and piperine interact with transient receptor potential vanilloid 1 (TRPV1) channels, autonomic regulatory circuits, endothelial function, and myocardial signalling pathways, suggesting both cardioprotective potential and cardiovascular risk. This review critically synthesises current experimental, clinical, and epidemiological evidence concerning the cardiovascular actions of pepper-related volatile oils, with particular emphasis on their role in typical and atypical cardiac pain.
Preclinical studies consistently demonstrate TRPV1-mediated mechanisms that may promote cardioprotection, including improved endothelial function, modulation of ischemic injury, and attenuation of adverse myocardial remodelling. In contrast, concentrated or non-dietary exposures have been associated with adverse cardiovascular effects, such as sympathetic activation, coronary vasospasm, and arrhythmogenic potential. Human evidence remains inconclusive. Case reports describe acute cardiac events following high-dose exposure to capsaicinoids or piperine-containing products, whereas population-based studies generally associate habitual dietary intake of peppers with favourable cardiovascular outcomes. Despite limited clinical validation, piperine has emerged as a promising candidate due to its anti-inflammatory, antioxidant, and metabolic effects observed in experimental models.
By integrating mechanistic, translational, and clinical findings, this review highlights critical gaps in current knowledge, including the scarcity of controlled human trials, incomplete pharmacokinetic and pharmacodynamic characterisation, and the absence of systematic surveillance of adverse cardiovascular events. Finally, key priorities for future research are proposed to clarify the therapeutic potential and safety profile of pepper-derived phytochemicals in cardiovascular health and disease.
