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NAD⁺metabolism in cardiovascular diseases

WEN Zhao-Zhi¹, YANG Yi-Hang¹, LIU Dong^1,2, SHI Chong-Xu^1,*

¹Nantong Laboratory of Development and Diseases, School of Life Science, Nantong University, Nantong 226000, Chi；²Co-Innovation Center of Neuroregeneration, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong 226000, China

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Nicotinamide adenine dinucleotide (NAD+) is acentral and pleiotropic metabolite involved in multiple cellular energy metabolism, such as cell signaling, DNA repair, protein modifications,and so on. Evidence suggests that NAD+ levels decline with age, obesity, and hypertension, which are all significant CVDrisk factors. In addition, the therapeutic elevation of NAD+ levels reduces chronic low-grade inflammation, reactivates autophagy andmitochondrial biogenesis, and enhances antioxidation and metabolism in vascular cells of humans with vascular disorders. In preclinicalanimal models, NAD+ boosting also extends the health span, prevents metabolic syndrome, and decreases blood pressure. Moreover,NAD+ storage by genetic, pharmacological, or natural dietary NAD+-increasing strategies has recently been shown to be effectivein improving the pathophysiology of cardiac and vascular health in different animal models and humans. Here, we discuss NAD+-related mechanisms pivotal for vascular health and summarize recent research on NAD+ and its association with vascular health anddisease, including hypertension, atherosclerosis, and coronary artery disease. This review also assesses various NAD+ precursors fortheir clinical efficacy and the efficiency of NAD+ elevation in the prevention or treatment of major CVDs, potentially guiding newtherapeutic strategies.

Key words: nicotinamide adenine dinucleotide; cardiovascular diseases; inflammation; vascular healt

Received: 　　Accepted:

Corresponding author: 施冲旭　　E-mail:

DOI: 10.13294/j.aps.2025.0034

Citing This Article：

WEN Zhao-Zhi, YANG Yi-Hang, LIU Dong, SHI Chong-Xu. NAD⁺metabolism in cardiovascular diseases. Acta Physiol Sin 2025; 77 (2): 345-360 (in Chinese with English abstract).