<![CDATA[Atherosclerosis develops through interconnected disturbances in lipid metabolism, vascular inflammation, and immune responses, with visceral adipose tissue dysfunction, interleukin-1 beta (IL-1B)-mediated inflammation, and macrophage-derived foam cell formation playing important roles. This review aimed to evaluate the potential role of purple butterfly pea (Clitoria ternatea L.) in modulating visceral adiposity, IL-1B-mediated inflammation, and foam cell formation associated with atherosclerosis. A literature review was conducted using PubMed/MEDLINE, Scopus, and Google Scholar, supplemented by manual reference screening. Studies addressing Clitoria ternatea, visceral fat or obesity, IL-1B or NLRP3 signaling, and foam cells or atherosclerosis were narratively synthesized.The evidence indicates that visceral adipose tissue dysfunction can promote oxidative stress and inflammation, even without substantial increases in fat mass. NLRP3-driven IL-1B production may suppress the GPR109a–ABCA1 pathway, impair macrophage cholesterol efflux, and enhance foam cell formation. Clitoria ternatea, which is rich in anthocyanins, flavonoids, and phenolic compounds, has demonstrated antioxidant, anti-inflammatory, lipid-lowering, and metabolic effects in animal and human studies. However, its effects on IL-1B regulation remain context-dependent, and direct inhibition of foam cell formation has not yet been confirmed. Therefore, Clitoria ternatea may function as a multi-target modulator of atherogenic pathways; however, integrated experimental studies examining inflammasome signaling, cholesterol transport, histopathological changes, and dose-response relationships are required to rigorously establish its antiatherosclerotic efficacy in future research.]]>
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