Systematic Review: The Effectiveness of Olive Oil on Oxidative Stress Process in the Development of Atherosclerosis
Main Article Content
Abstract
This study aims to analyze the antioxidant effects of olive oil, particularly extra virgin olive oil (EVOO), in inhibiting oxidative stress and its role in the development of atherosclerosis. This study employed a systematic review approach by analyzing scientific articles published between 2020 and 2026 from databases such as PubMed, Scopus, Sinta, and Google Scholar. Selected studies examined the effects of olive oil and its bioactive compounds on oxidative stress, inflammation, and cardiovascular risk factors. The findings indicate that EVOO, especially its polyphenol content, plays a significant role in reducing reactive oxygen species (ROS), preventing LDL oxidation, improving endothelial function, and enhancing antioxidant enzyme activity. However, some studies reported inconsistent results depending on dosage, duration, and subject characteristics. Overall, EVOO demonstrates strong potential as a nutritional intervention to prevent and slow the progression of atherosclerosis through antioxidant, anti-inflammatory, and lipid-regulating mechanisms.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Ajoolabady, A., Pratico, D., Lin, L., Mantzoros, C. S., Bahijri, S., Tuomilehto, J., & Ren, J. (2024). Inflammation in atherosclerosis: pathophysiology and mechanisms. Cell death & disease, 15(11), 817.
Bentzon, J. F., Otsuka, F., Virmani, R., & Falk, E. (2014). Mechanisms of plaque formation and rupture. Circulation research, 114(12), 1852-1866. https://doi.org/10.1161/CIRCRESAHA.114.302721
Björkegren, J. L., & Lusis, A. J. (2022). Atherosclerosis: recent developments. Cell, 185(10), 1630-1645.
Boumezough, K., Alami, M., Fulop, T., Zoubdane, N., Salih, I., Ramchoun, M., ... & Berrougui, H. (2025). Biological Activities Underlying the Cardiovascular Benefits of Olive Oil Polyphenols: Focus on Antioxidant, Anti-Inflammatory, and Anti-Atherogenic Effects. International Journal of Molecular Sciences, 26(22), 11165. https://doi.org/10.3390/ijms262211165
Bucciantini, M., Leri, M., Nardiello, P., Casamenti, F., & Stefani, M. (2021). Olive polyphenols: Antioxidant and anti-inflammatory properties. Antioxidants, 10(7), 1044. https://doi.org/10.3390/antiox10071044
Casas, R., Estruch, R., & Sacanella, E. (2018). The protective effects of extra virgin olive oil on immune-mediated inflammatory responses. Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets-Immune, Endocrine & Metabolic Disorders), 18(1), 23-35. https://doi.org/10.2174/1871530317666171114115632
Davezac, M., Buscato, M., Zahreddine, R., Lacolley, P., Henrion, D., Lenfant, F., ... & Fontaine, C. (2021). Estrogen receptor and vascular aging. Frontiers in aging, 2, 727380. https://doi.org/10.3389/fragi.2021.727380
Della Corte, V., Todaro, F., Cataldi, M., & Tuttolomondo, A. (2023). Atherosclerosis and its related laboratory biomarkers. International Journal of Molecular Sciences, 24(21), 15546. https://doi.org/10.3390/ijms242115546
Dri, E., Lampas, E., Lazaros, G., Lazarou, E., Theofilis, P., Tsioufis, C., & Tousoulis, D. (2023). Inflammatory mediators of endothelial dysfunction. Life, 13(6), 1420. https://doi.org/10.3390/life13061420
Frąk, W., Wojtasińska, A., Lisińska, W., Młynarska, E., Franczyk, B., & Rysz, J. (2022). Pathophysiology of cardiovascular diseases: new insights into molecular mechanisms of atherosclerosis, arterial hypertension, and coronary artery disease. Biomedicines, 10(8), 1938. https://doi.org/10.3390/biomedicines10081938
Fularski, P., Czarnik, W., Dąbek, B., Lisińska, W., Radzioch, E., Witkowska, A., ... & Franczyk, B. (2024). Broader perspective on atherosclerosis—selected risk factors, biomarkers, and therapeutic approach. International journal of molecular sciences, 25(10), 5212. https://doi.org/10.3390/ijms25105212
George, J. (2015). Pathophysiology of coronary artery disease. Interventional Cardiology Imaging: An Essential Guide, 29-46. https://doi.org/10.1007/978-1-4471-5239-2_3
Ginsberg, H. N., Packard, C. J., Chapman, M. J., Borén, J., Aguilar-Salinas, C. A., Averna, M., ... & Catapano, A. L. (2021). Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies—a consensus statement from the European Atherosclerosis Society. European heart journal, 42(47), 4791-4806. https://doi.org/10.1093/eurheartj/ehab551
Gonzalez, A. M., Townsend, J. R., Pinzone, A. G., & Hoffman, J. R. (2023). Supplementation with nitric oxide precursors for strength performance: a review of the current literature. Nutrients, 15(3), 660. https://doi.org/10.3390/nu15030660
Gusev, E., & Sarapultsev, A. (2023). Atherosclerosis and inflammation: insights from the theory of general pathological processes. International Journal of Molecular Sciences, 24(9), 7910. https://doi.org/10.3390/ijms24097910
Immanuel, J., & Yun, S. (2023). Vascular inflammatory diseases and endothelial phenotypes. Cells, 12(12), 1640. https://doi.org/10.3390/cells12121640
Jimenez-Torres, J., Alcalá-Diaz, J. F., Torres-Peña, J. D., Gutierrez-Mariscal, F. M., Leon-Acuña, A., Gómez-Luna, P., ... & Lopez-Miranda, J. (2021). Mediterranean diet reduces atherosclerosis progression in coronary heart disease: an analysis of the CORDIOPREV randomized controlled trial. Stroke. https://doi.org/10.1161/STROKEAHA.120.033214
Jo, S. H. (2025). Triglycerides, triglyceride-rich lipoproteins, and remnant cholesterol in atherosclerotic cardiovascular disease. Journal of Lipid and Atherosclerosis, 14(3), 247. https://doi.org/10.12997/jla.2025.14.3.247
Korkmaz, A., Unsal, V., Yıldız, R., Oner, E., & Atasoy, A. F. (2025). Chemical evaluation of arbequina extra virgin olive oil with in silico analysis of its key phenolic compounds targeting LDL metabolism. Scientific Reports, 15(1), 33536.
Kotlyarov, S. (2021). Diversity of lipid function in atherogenesis: a focus on endothelial mechanobiology. International Journal of Molecular Sciences, 22(21), 11545. https://doi.org/10.3390/ijms222111545
Kourek, C., Makaris, E., Magiatis, P., Zouganeli, V., Benetou, V., Briasoulis, A., ... & Orfanos, P. (2025). Effects of High-Phenolic Extra Virgin Olive Oil (EVOO) on the Lipid Profile of Patients with Hyperlipidemia: A Randomized Clinical Trial. Nutrients, 17(15), 2543. https://doi.org/10.3390/nu17152543
Kwaifa, I. K., Bahari, H., Yong, Y. K., & Noor, S. M. (2020). Endothelial dysfunction in obesity-induced inflammation: molecular mechanisms and clinical implications. Biomolecules, 10(2), 291. https://doi.org/10.3390/biom10020291
Lama, A., Pirozzi, C., Mollica, M. P., Trinchese, G., Di Guida, F., Cavaliere, G., ... & Meli, R. (2017). Polyphenol‐rich virgin olive oil reduces insulin resistance and liver inflammation and improves mitochondrial dysfunction in high‐fat diet fed rats. Molecular nutrition & food research, 61(3), 1600418. https://doi.org/10.1002/mnfr.201600418
Luisi, M. L. E., Lucarini, L., Biffi, B., Rafanelli, E., Pietramellara, G., Durante, M., ... & Ceccherini, M. T. (2019). Effect of Mediterranean diet enriched in high quality extra virgin olive oil on oxidative stress, inflammation and gut microbiota in obese and normal weight adult subjects. Frontiers in pharmacology, 10, 1366. https://doi.org/10.3389/fphar.2019.01366
Martínez-Beamonte, R., Barranquero, C., Gascón, S., Mariño, J., Arnal, C., Estopañán, G., ... & Navarro, M. Á. (2024). Effect of virgin olive oil as spreadable preparation on atherosclerosis compared to dairy butter in Apoe-deficient mice. Journal of Physiology and Biochemistry, 80(3), 671-683. https://doi.org/10.1007/s13105-024-01029-8
Milena, E., & Maurizio, M. (2025). Exploring the cardiovascular benefits of extra Virgin Olive oil: insights into mechanisms and therapeutic potential. Biomolecules, 15(2), 284. https://doi.org/10.3390/biom15020284
Młynarska, E., Czarnik, W., Fularski, P., Hajdys, J., Majchrowicz, G., Stabrawa, M., ... & Franczyk, B. (2024). From atherosclerotic plaque to myocardial infarction—The leading cause of coronary artery occlusion. International Journal of Molecular Sciences, 25(13), 7295. https://doi.org/10.3390/ijms25137295
Nuotio, K., Ijäs, P., Heikkilä, H. M., Koskinen, S. M., Saksi, J., Vikatmaa, P., ... & Lindsberg, P. J. (2018). Morphology and histology of silent and symptom-causing atherosclerotic carotid plaques–Rationale and design of the Helsinki Carotid Endarterectomy Study 2 (the HeCES2). Annals of Medicine, 50(6), 501-510. https://doi.org/10.1080/07853890.2018.1494851
Pacinella, G., Ciaccio, A. M., & Tuttolomondo, A. (2022). Endothelial dysfunction and chronic inflammation: the cornerstones of vascular alterations in age-related diseases. International journal of molecular sciences, 23(24), 15722. https://doi.org/10.3390/ijms232415722
Popa-Fotea, N. M., Ferdoschi, C. E., & Micheu, M. M. (2023). Molecular and cellular mechanisms of inflammation in atherosclerosis. Frontiers in Cardiovascular Medicine, 10, 1200341. https://doi.org/10.3389/fcvm.2023.1200341
Prabakaran, S., Schwartz, A., & Lundberg, G. (2021). Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use. Therapeutic Advances in Endocrinology and Metabolism, 12, 20420188211013917. https://doi.org/10.1177/20420188211013917
Raggi, P., Genest, J., Giles, J. T., Rayner, K. J., Dwivedi, G., Beanlands, R. S., & Gupta, M. (2018). Role of inflammation in the pathogenesis of atherosclerosis and therapeutic interventions. Atherosclerosis, 276, 98-108. https://doi.org/10.1016/j.atherosclerosis.2018.07.014
Salazar, H. M., de Deus Mendonça, R., Laclaustra, M., Moreno-Franco, B., Åkesson, A., Guallar-Castillón, P., & Donat-Vargas, C. (2022). The intake of flavonoids, stilbenes, and tyrosols, mainly consumed through red wine and virgin olive oil, is associated with lower carotid and femoral subclinical atherosclerosis and coronary calcium. European Journal of Nutrition, 61(5), 2697-2709. https://doi.org/10.1007/s00394-022-02823-0
Sandesara, P. B., Virani, S. S., Fazio, S., & Shapiro, M. D. (2019). The forgotten lipids: triglycerides, remnant cholesterol, and atherosclerotic cardiovascular disease risk. Endocrine reviews, 40(2), 537-557. https://doi.org/10.1210/er.2018-00184
Santangelo, C., Vari, R., Scazzocchio, B., De Sanctis, P., Giovannini, C., D'Archivio, M., & Masella, R. (2018). Anti-inflammatory activity of extra virgin olive oil polyphenols: which role in the prevention and treatment of immune-mediated inflammatory diseases?. Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets-Immune, Endocrine & Metabolic Disorders), 18(1), 36-50. https://doi.org/10.2174/1871530317666171114114321
Serreli, G., Boronat, A., De la Torre, R., Rodriguez-Moratò, J., & Deiana, M. (2024). Cardiovascular and metabolic benefits of extra virgin olive oil phenolic compounds: Mechanistic insights from in vivo studies. Cells, 13(18), 1555. https://doi.org/10.3390/cells13181555
Shahidi, S., Ramezani-Aliakbari, K., Sarihi, A., Heshmati, A., Shiri, E., Nosrati, S., ... & Ramezani-Aliakbari, F. (2024). Olive oil protects against cardiac hypertrophy in D-galactose induced aging rats. BMC Cardiovascular Disorders, 24(1), 626. https://doi.org/10.1186/s12872-024-04278-z
Somani, Y. B., Pawelczyk, J. A., De Souza, M. J., Kris-Etherton, P. M., & Proctor, D. N. (2019). Aging women and their endothelium: probing the relative role of estrogen on vasodilator function. American Journal of Physiology-Heart and Circulatory Physiology, 317(2), H395-H404. https://doi.org/10.1152/ajpheart.00430.2018
Souilhol, C., Serbanovic-Canic, J., Fragiadaki, M., Chico, T. J., Ridger, V., Roddie, H., & Evans, P. C. (2020). Endothelial responses to shear stress in atherosclerosis: a novel role for developmental genes. Nature Reviews Cardiology, 17(1), 52-63. https://doi.org/10.1038/s41569-019-0239-5
Summerhill, V., Karagodin, V., Grechko, A., Myasoedova, V., & Orekhov, A. (2018). Vasculoprotective role of olive oil compounds via modulation of oxidative stress in atherosclerosis. Frontiers in cardiovascular medicine, 5, 188. https://doi.org/10.3389/fcvm.2018.00188
Tibaut, M., Mekis, D., & Petrovic, D. (2016). Pathophysiology of myocardial infarction and acute management strategies. Cardiovascular & Hematological Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Cardiovascular & Hematological Agents), 14(3), 150-159.
Wang, C., Fu, H., Xu, H., Yang, H., Min, X., Wu, W., ... & Chen, J. (2025). Non-traditional lipid biomarkers in atherosclerotic cardiovascular disease: pathophysiological mechanisms and strategies to address residual risk. Frontiers in Endocrinology, 16, 1576602. https://doi.org/10.3389/fendo.2025.1576602
Warboys, C. M., & Weinberg, P. D. (2021). S1P in the development of atherosclerosis: roles of hemodynamic wall shear stress and endothelial permeability. Tissue Barriers, 9(4), 1959243. https://doi.org/10.1080/21688370.2021.1959243
Williams, K. J. (2024). Eradicating atherosclerotic events by targeting early subclinical disease: it is time to retire the therapeutic paradigm of too much, too late. Arteriosclerosis, Thrombosis, and Vascular Biology, 44(1), 48-64. https://doi.org/10.1161/ATVBAHA.123.320065
Zimmer, A., Otrante, A., Zoubdane, N., Nguyen, M., Fülöp, T., & Khalil, A. (2023). The immunomodulatory effects of a 6-month extra virgin olive oil intervention on monocyte cytokine secretion and plasma cytokine levels in dyslipidemic and post-infarct patients: a Clinical Pilot Study. Nutrients, 15(17), 3819. https://doi.org/10.3390/nu15173819