**1. Introduction**

There is an urgent need to implement intervention measures and health policies to reduce mortality associated to cardiovascular disease (CVD), which will result in more adequate, healthy, and sustainable development per each country. CVD has caused 6.2 million deaths worldwide in people aged 30–70 years in 2019 [1].

Regarding cardiovascular health, there are certain modifiable risk factors that can be intervened upon to improve health. These factors include: hypertension, elevated fasting plasma glucose, elevated low-density lipoprotein (LDL) or cholesterol, and alterations in renal function. Environmental factors such as air and household pollution, smoking, low physical activity, and overweight and obesity are also included. In addition, in the case of women, the consumption of oral contraceptives and the presence of polycystic ovaries syndrome increase the risk of suffering CVD [2].

There are numerous studies linking diet and health, and this is most evident in the case of cardiovascular risk. Both dietary patterns, such as a diet rich in antioxidants, fiber (from vegetables, whole grains, fruits, nuts, pulses) fish, poor in processed foods (with high content in sugar or animal fats), together with the food intake containing specific bioactive substances or nutrients can modulate the risk factors [3, 4]. Therefore, changes in lifestyle and diet can prevent these diseases [5].

CVD is linked to the development of atherosclerosis and is directly related with an inflammatory response. This response is prompted by bad diet habits, sedentary lifestyle, obesity, and stress [6].

Herbal measurements are used to develop new drugs with higher potency and fewer adverse effects targeting the modulation of biological activities.

Ginger (*Zingiber officinale*) is among the medicinal plants with beneficial health effects that has been widely used in pharmaceutical products and food. Its crude extract is cardioprotective due to its antihypertensive, antiplatelet, and cardiotonic effects [7].

The term nutraceutical is used for any food or ingredient with a beneficial effect on health beyond the traditional nutritional effects; further, it has a positive impact on health, physical or cognitive state [8]. Numerous nutraceuticals are used for the prevention of CVDs, including ginger (see **Table 1**).

Apart from its cardioprotective effects, ginger has numerous properties such as antimicrobial, antioxidant, anti-inflammatory, anti-carcinogenic, and neurodegenerative diseases prevention. It prevents chemotherapy-induced emesis, nausea, and respiratory disorders [9, 10].

Ginger's flavor and aroma come from its volatile oils (∼1–3% of the weight of fresh ginger) and nonvolatile pungent oleoresins. Further, the pharmacological properties are due to its oleoresin's composition, rich in zingerone (ZGR), gingerols (6/8/10-gingerols), and shogaols (6/8/10-shogaols and 6-hydroshogaol). The spiciness character of dried ginger rhizome comes from the gingerols, especially 6-gingerol. During drying, gingerols transform into ZGR, reducing pungency and providing a spicy-sweet aroma, and shogaols concentration increases [11].

Ginger inhibits lipid peroxidation through its antioxidant effect. 6-Gingerol increases Beclin1 expression to promote autophagy in human endothelial cells and inhibits *PI3K*/*AKT*/*mTOR* pathway signaling not affecting the cell cycle [12].

Ginger could prevent atherosclerosis, since consumption of a ginger extract has been observed to improve lipoprotein results in hamsters thanks to an increased activity of the liver enzyme CYP7A1 and decreased mRNA levels of intestinal cholesterol absorption proteins such as MTP, ACAT2, and NPC1L1 [13].


#### **Table 1.**

*Nutraceuticals in the prevention of cardiovascular diseases [9].*

*Ginger in the Prevention of Cardiovascular Diseases DOI: http://dx.doi.org/10.5772/intechopen.103970*

6-Gingerol regulates lipogenesis, fatty acid oxidation, mitochondrial dysfunction, and oxidative stress of aging rats. Several authors observed that 8-gingerol due to its antioxidant properties could inhibit melanogenesis in murine melanoma cells. In addition, it increases the activity of the antioxidant enzyme superoxide dismutase (SOD) and decreases the levels of malondialdehyde (MDA), a marker of lipid peroxidation, in a concentration-dependent manner [14, 15].

Inflammation associated with CVD induces an increase in proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6). Several authors have observed that ginger significantly reduces TNF-α values, and 6-gingerol reduces the levels of inducible nitric oxide (NO) synthase enzyme and inflammatory factors [16].

Ginger can also be used in moderate obesity, a cardiovascular risk factor. Ginger increases lipolysis and thermogenesis and inhibits lipogenesis; therefore, it could be used to prevent obesity [17].

In summary, ginger consumption in the diet could improve cardiovascular health by lowering blood pressure, improving lipid profile, preventing obesity, improving glycemic control, and vascular health. The benefits of ginger on cardiovascular risk factors are mediated by transcription factors such as adenosine-monophosphateactivated protein kinase, peroxisome proliferator-activated receptors, peroxisome proliferator-activated protein kinase, and nuclear factor kappa B (NF-κB) [8, 18]. Having that in mind, the purpose of the present review chapter is to summarize the effects of bioactive compounds in ginger on CVD.
