| Antioxidants protect the body's organs, but under certain conditions, they may increase oxidative stress and potentially induce organ damage. High-density lipoprotein (HDL) helps prevent cardiovascular disease by reducing oxidative stress and Low-density lipoprotein (LDL) oxidation. Although lipid oxidation contributes to atherosclerosis and antioxidants are generally beneficial, their exact impact remains unclear. A close relationship exists between medicinal plants and antioxidants, as many medicinal plants contain antioxidant compounds that can contribute to the health of the body. Medicinal plants are a class of plants that naturally contain various types of antioxidants. A number of antioxidant compounds have been identified in medicinal plants, including polyphenols, flavonoids, tannins, vitamins C and E. This review updates the recent findings and action mechanisms of antioxidants, focusing on the positive and negative roles of antioxidants in atherosclerosis with the aim of clarifying the knowledge gap. This article reviews the publications from 1991 to 2025 sourced from Google Scholar, PubMed, Web of Science, and Scopus, using terms such as Antioxidants, oxidative stress, free radicals, hyperlipidemia, lipid profile, and inflammation. The study updates the effects of Beta-carotene, Lutein, Quercetin, Silymarin, Betaine, Carotenoids, Lycopene, Flavonoids, Vitamins A, D, E, Selenium, Coenzyme Q10, and Epicatechin on blood lipids. Reactive oxygen species (ROS) contribute to heart diseases and hyperlipidemia. Antioxidants neutralize ROS and reduce oxidative stress, but the circumstances under which they may act as prooxidants should be considered in atherosclerosis therapy. |