Climate change and cardiovascular diseases: a review of systemic challenges, policies, and management strategies

Climate change threatens cardiovascular health, yet health-system responses remain underexamined. This scoping review maps pathways linking climate change to cardiovascular diseases (CVDs), identifies health-system challenges, and synthesises global, regional, and national policies addressing climate-related cardiovascular risks. Following Arksey and O’Malley and PRISMA-ScR guidance, we searched PubMed, Scopus, Web of Science, Embase, Cochrane Library, Google Scholar, and grey literature (2011–2024). Studies examining climate impacts on CVDs and evaluating management strategies, health-system responses, or policy frameworks were included. Twenty-one sources met inclusion criteria. Data underwent qualitative thematic analysis combining deductive and inductive approaches. Five themes emerged: climate-related cardiovascular impacts, health-system challenges, digital health solutions, policy/management strategies, and cross-cutting equity/governance considerations. Climate change exacerbates CVD risk through heat, air pollution, extreme weather, nutritional insecurity, and psychosocial stress. Health-system vulnerabilities include infrastructure fragility, disrupted chronic care, inadequate disaster preparedness, and supply-chain weaknesses disproportionately affecting vulnerable populations. International frameworks (WHO Operational Framework, Paris Agreement, Sendai Framework, SDGs) integrate health and climate priorities, yet non-communicable diseases remain underrepresented in adaptation plans. Emerging strategies include climate-resilient infrastructure, telemedicine, early warning systems, and provider education. Policy co-benefits linking air quality, sustainable nutrition, and walkable urban design offer dual advantages for climate and cardiovascular outcomes. The climate-CVD nexus requires integrated, equity-driven strategies embedding chronic disease management into climate policies. Given heterogeneous evidence, findings constitute broad mapping rather than causal conclusions. Urgent investment in health-system resilience, targeted research in under-studied regions, and sustained political commitment are essential to protect cardiovascular health while advancing climate objectives.