摘要Atherosclerosis(AS)is widely recognized as the principal pathological substrate underlying chronic cardiovascular diseases(CVDs).It is a chronic,progressive,and inflammatory dis-ease characterized by excessive lipid deposition,oxidative stress,inflammatory response,plaque formation and rupture,thrombosis and vascular calcification(VC).Vascular smooth muscle cells(VSMCs)are essential for maintaining the normal structure of blood vessels and play a pivotal role in the pathological process of AS.Their proliferation,migration,differenti-ation,senescence and death processes critically influence the progression of AS.The specific mechanism of VSMCs participating in AS remains a central focus of research in the cardiovas-cular field.In recent years,natural products have garnered considerable attention in the field of AS prevention and treatment,primarily due to their multi-target effects,low toxicity and side effects.However,there is still a lack of systematic review of natural compounds that alle-viate AS by regulating the function of VSMCs.This article focuses on the core role of VSMCs in the progression of AS,and systematically reviews the natural compounds targeting VSMCs metabolism and their molecular regulatory mechanisms.By combing the relevant pharmaco-logical activities and potential targets,the pathological function of VSMCs in AS is further elu-cidated,thereby providing an important theoretical basis for the development of novel and ef-ficient AS treatment strategies.