Ginkgo biloba L. in preventing cardiovascular disease: pharmacological effects, mechanism of action, and therapeutic potential.

Cardiovascular diseases (CVDs) involve complex, interrelated pathologies such as oxidative stress, inflammation, endothelial dysfunction, platelet aggregation, and dyslipidemia, for which single-target drugs remain constrained. As a multicomponent herbal medicine, Ginkgo biloba L. (G. biloba) contains diverse bioactive constituents, primarily flavonoids (e.g., quercetin, kaempferol, isorhamnetin, ginkgetin, and isoginkgetin) and ginkgolides (e.g., ginkgolide A, B, C, and J), which are proposed to exert synergistic effects against the multifaceted pathology of CVDs. This review systematically summarizes the pharmacokinetic characteristics and pharmacodynamic mechanisms of the major bioactive components in G. biloba, highlighting distinct mechanistic axes of Nrf2-mediated antioxidant defense, platelet-activating factor (PAF) receptor antagonism, and inflammasome inhibition. These preclinical findings collectively suggest the therapeutic potential of G. biloba extracts (GbE) for atherosclerosis, stable and unstable angina, myocardial infarction, heart failure, obesity-related and diabetic cardiomyopathy, as well as diabetic nephropathy, retinopathy, and non-alcoholic fatty liver disease. However, the clinical evidence remains limited and inconsistent, and G. biloba has not been established as a standard therapy for CVDs. This review evaluates the current clinical evidence and combination therapeutic strategies, aiming to provide a reference for the design of future clinical trials.