Cardiovascular diseases as systemic modulators of oncogenesis: Mechanisms and clinical implications

Cardiovascular disease (CVD) and cancer represent two of the major health burdens worldwide, with a significant relationship between the two. Research in cardio-oncology has predominantly focused on how cancer influences CVD. However, it is equally essential to investigate how CVD may influence cancer development, a framework referred to as reverse cardio-oncology. This review consolidates existing evidence, elucidating the commonalities and promoting relationships between CVD and cancer. Both conditions share overlapping etiologies and pathogenesis, including systemic disturbances caused by CVD, such as neurohormonal activation, oxidative stress, inflammation, and immune cell reprogramming, alongside the coordinated secretion of circulating factors that may promote tumor progression. Within the pathophysiological process whereby CVD facilitates cancer progression, signaling molecules like microRNA (miRNA) play a significant role, potentially fostering cancer development by regulating signaling pathways associated with angiogenesis, immune responses, and fibrosis. This article also discusses the dual efficacy of cardiovascular therapeutic agents, highlighting the potential carcinogenic risks associated with various CVD treatments. Furthermore, it reviews recent advancements in reverse tumor cardiology, clarifying the roles of CVD and their therapeutic agents in tumor occurrence and development, while proposing potential targets for interdisciplinary therapeutic development.