Abstract: Objective To summarize the current research on Mongolian medicine formulas for hypertensive cardiac injury and provide insights into the mechanisms of Mongolian medicine and future development of drugs with reference to related studies on traditional Chinese medicine. Methods Recent literature on hypertensive cardiac injury and Mongolian medicine formulas was reviewed. Representative Mongolian medicine formulas and related TCM evidence were analyzed in general and key pathological processes in particular, including cardiac hypertrophy, ventricular remodeling, myocardial fibrosis, inflammation, oxidative stress, and metabolic abnormalities. Results Hypertensive cardiac injury involved multiple pathological processes, such as cardiomyocyte hypertrophy, cardiac remodeling, abnormal fibrotic signaling, and metabolic disorders. Current studies suggested that representative Mongolian medicine formulas, such as Anshen Buxin Liuwei pills, Nutmeg-5, and Siwei Tumuxiang powder, might be effective at cardiomyocyte protection, cardiac remodeling, hypertensive myocardial hypertrophy, and metabolic regulation. These formulas might exert cardioprotective effects through anti-oxidative, anti-apoptotic, calcium homeostasis-regulating, mitochondrial protective, and metabolic network-modulating mechanisms. In comparison, studies on TCM formulas and their active components against hypertensive cardiac injury were more full-fledged and might provide useful references for mechanistic studies of Mongolian medicine formulas. Conclusion Mongolian medicine formulas can be potentially used in interventions with hypertensive cardiac injury. However, current evidence remains limited by insufficient direct studies, unclear pharmacodynamic material bases, inadequate validation of core targets, and a lack of high-quality clinical data. More effort should be devoted to multi-omics-based functional validation and high-quality clinical research to shed light on their pharmacodynamic basis and mechanisms of action.

Key words: Hypertension, Hypertensive Cardiac Injury, Anshen Buxin Liuwei Pill, Nutmeg-5, Siwei Tumuxiang Powder, Mongolian Medicinal Formulas