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Conventional treatments have limitations in addressing complex pathological mechanisms. This review highlights the roles of gut microbiota and phytochemicals in the prevention and treatment of CVDs, systematically summarizing recent research progress. Dysbiosis of the gut microbiota is closely associated with CVDs, and its metabolic products play a crucial role in regulating CVDs progression. Phytochemicals such as Higenamine, Paeoniflorin, Ginsenoside Rb1, Tanshinone IIA, Emodin, Irisin, and Quercetin demonstrate unique preventive and therapeutic potential against CVDs (including heart failure, diabetic cardiomyopathy, myocardial ischemia\u2013reperfusion injury, and cardiac hypertrophy) by reshaping gut microbiota composition and modulating metabolic profiles. For example, Ginsenoside Rb1 can regulate gut microbiota abundance to alleviate myocardial fibrosis, while Paeoniflorin improves gut microbiota structure and cardiac function in mice with diabetic cardiomyopathy. Despite significant advances, challenges remain in clinical translation, long\u2010term safety assessment, and elucidation of mechanisms. Future research should focus on clinical cohort validation, in\u2010depth mechanistic studies integrating multi\u2010omics technologies, and the development of innovative treatment strategies targeting the gut microbiota. These efforts hold promise for advancing precision medicine in the management of CVDs.<\/jats:p>","DOI":"10.1002\/ptr.70183","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T08:25:56Z","timestamp":1767860756000},"page":"765-782","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Phytochemicals\u2010Mediated Gut Microbiota Regulation: A Comprehensive Review of Therapeutic Strategies for Cardiovascular Diseases"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1184-8758","authenticated-orcid":false,"given":"Jianxia","family":"Wen","sequence":"first","affiliation":[{"name":"School of Food and Bioengineering, Food Microbiology Key Laboratory of Sichuan Province, Chongqing Key Laboratory of Sichuan Chongqing Joint Construction of Specialty Food Xihua University  Chengdu 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