Stroke and acute myocardial infarction are leading causes of mortality worldwide. The latter accounts for approximately 9 million deaths annually. In turn, ischemic stroke is a significant contributor to adult physical disability globally. While reperfusion is crucial for tissue recovery, it can paradoxically exacerbate damage through oxidative stress (OS), inflammation, and cell death. Therefore, it is imperative to explore diverse approaches aimed at minimizing ischemia/reperfusion injury to enhance clinical outcomes. OS primarily arises from an excessive generation of reactive oxygen species (ROS) and/or decreased endogenous antioxidant potential. Natural antioxidant compounds can counteract the injury mechanisms linked to ROS. While promising preclinical results, based on monotherapies, account for protective effects against tissue injury by ROS, translating these models into human applications has yielded controversial evidence. However, since the wide spectrum of antioxidants having diverse chemical characteristics offers varied biological actions on cell signaling pathways, multitherapy has emerged as a valuable therapeutic resource. Moreover, the combination of antioxidants in multitherapy holds significant potential for synergistic effects. This study was designed with the aim of providing an updated overview of natural antioxidants suitable for preventing myocardial and cerebral ischemia/reperfusion injuries.

Stroke is a major contributor to global mortality and disability. While reperfusion is essential for preventing neuronal death in the penumbra, it also triggers cerebral ischemia-reperfusion injury, a paradoxical injury primarily caused by oxidative stress, inflammation, and blood–brain barrier disruption. An oxidative burst inflicts marked cellular damage, ranging from alterations in mitochondrial function to lipid peroxidation and the activation of intricate signalling pathways that can even lead to cell death. Thus, given the pivotal role of oxidative stress in the mechanisms of cerebral ischemia-reperfusion injury, the reinforcement of the antioxidant defence system has been proposed as a protective approach. Although this strategy has proven to be successful in experimental models, its translation into clinical practice has yielded inconsistent results. However, it should be considered that the availability of numerous antioxidant molecules with a wide range of chemical properties can affect the extent of injury; several groups of antioxidant molecules, including polyphenols, carotenoids, and vitamins, among other antioxidant compounds, can mitigate this damage by intervening in multiple signalling pathways at various stages. Multiple clinical trials have previously been conducted to evaluate these properties using melatonin, acetyl-L-carnitine, chrysanthemum extract, edaravone dexborneol, saffron, coenzyme Q10, and oleoylethanolamide, among other treatments. Therefore, multi-antioxidant therapy emerges as a promising novel therapeutic option due to the potential synergistic effect provided by the simultaneous roles of the individual compounds.

Cardiovascular disease (CVD) remains a leading cause of death and disability worldwide, including Chile. While mortality rates from CVD are well-documented, the associated burden of disability-adjusted life years (DALYs) and the impact of key modifiable risk factors have yet to be fully explored. This study aims to describe the temporal trends of CVD-related DALYs in Chile, stratified by gender, and to identify the primary risk factors contributing to this burden. An ecological study was conducted using data from the Global Burden of Disease Study 2021. We analysed age-standardised DALYs rates for overall and specific CVDs in Chile from 1990 to 2021. For the year 2021, we calculated the percentage distribution of DALYs by CVD type. Where applicable, CVDs were examined in relation to behavioural, metabolic, and environmental risk factors, and relative changes in DALYs over time. Over the last three decades, the overall CVD DALYs rate in Chile decreased substantially. Ischaemic heart disease and stroke accounted for most of the CVD burden, with gender differences observed. Stroke predominated in females and ischaemic heart disease in males. Metabolic risk factors, particularly high systolic blood pressure (SBP), were the most significant contributors to CVD DALYs, followed by behavioural and environmental risk factors. Although the rates of CVD DALYs have declined significantly in Chile during the past three decades, the burden remains substantial and with gender-specific differences. Metabolic risk factors, especially high SBP, followed by behavioural and environmental factors, remain key contributors to CVD, highlighting the need for continued public health efforts focused on multi-level interventions to reduce the impact of these risk factors on cardiovascular health, such as adopting lower blood pressure goals among older people.