ReviewNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
The bidirectional mechanistic links between Alzheimer's disease and cardiovascular disease.
Review in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlzheimer's disease (AD) and cardiovascular disease (CVD) are two significant chronic diseases that have a profound impact on the health of the elderly globally. In recent years, an increasing body of research has suggested a potentially intimate association between the two. This review aims to comprehensively summarize the bidirectional pathological mechanisms between AD and CVD and explore their implications for clinical intervention and comorbidity management.
methodsThis review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. English-language literature published between 1985 and 2025 was searched in the databases of Pubmed, Web of Science, Google Scholar, Embase, and Scopus. A total of 4,434 articles were initially identified, and 4,293 studies that did not meet the inclusion criteria were excluded. Eventually, 149 eligible articles were subjected to mechanism integration and a narrative review.
resultsThis review elucidates that ischemia-hypoxia, lipid metabolism disorders, systemic inflammatory responses, and blood-brain barrier dysfunction caused by chronic cerebral hypoperfusion constitute the four core pathways through which CVD promotes the incidence and exacerbation of AD. Conversely, mechanisms such as autonomic nervous system dysfunction, spillover of central inflammation to the periphery, adverse lifestyle changes, and cardiovascular side effects of therapeutic drugs are the main reasons why AD increases the risk of CVD.
conclusionThe findings of this review suggest that AD is not merely a central nervous system disorder but also has a close bidirectional association with CVD through multiple mechanisms. Therefore, a thorough understanding of this "cardio-cerebral axis" mechanism is conducive to identifying early risks in the comorbid population, expanding intervention targets, and facilitating the translation and application of combined management strategies for AD and CVD in clinical practice.
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Registered trials
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