Pathophysiological Interplay Between Cardiovascular Diseases and Metabolic Disorders: A Review of Shared Mechanisms and Emerging Therapeutic Approaches

Background and aims: Cardiovascular diseases (CVDs) and metabolic disorders, such as type 2 diabetes mellitus (T2DM), obesity, and metabolic syndrome, frequently coexist and contribute to a substantial global burden of morbidity and mortality. Accordingly, this review was designed to investigate the shared pathophysiological mechanisms underlying CVDs and metabolic disorders and to highlight emerging therapeutic strategies targeting these common pathways. Methods: A structured narrative literature search was performed in PubMed, Scopus, and Web of Science, covering studies published between 2019 and 2025. Keywords related to inflammation, oxidative stress (OS), insulin resistance, endothelial dysfunction, gut microbiota, and cardiometabolic therapies were used for this purpose. Eligible peer-reviewed studies focusing on shared mechanisms or therapeutic implications underwent qualitative analysis. Results: According to recent studies, low-grade inflammation, OS markers, impaired phosphoinositide 3-kinase/protein kinase B insulin signaling, and microbiota-derived metabolites, such as trimethylamine N-oxide (TMAO), are strongly associated with increased cardiometabolic risk. Moreover, clinical studies revealed that patients with T2DM have a 2–4-fold higher risk of CVD, while increased TMAO levels are linked to a 30–60% rise in adverse cardiovascular outcomes. Emerging therapies, including sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, anti-inflammatory agents, and microbiota-targeted interventions, demonstrated measurable reductions in cardiovascular events and improved metabolic control in high-risk patients. Conclusion: Overall, CVDs and metabolic disorders share standard mechanisms that can be increasingly targeted with emerging therapies. Recognizing these pathways helps clinicians and policymakers adopt integrated management strategies, promote earlier intervention in high-risk individuals, and implement evidence-based treatments that address both conditions simultaneously.