Introduction Cardiovascular diseases (CVDs) pose a significant threat to the health of middle-aged and elderly people. They are widely recognized as a major public health concern. The sirtuin (SIRT) family comprises seven proteins (SIRT1–SIRT7), all of which contain a highly conserved nicotinamide adenine dinucleotide (NAD+)-binding catalytic domain. Notably, SIRT1 influences the development and progression of CVDs by regulating biological processes such as inflammation, immune responses, oxidative stress, and autophagy.Areas covered This review summarizes the biological functions of SIRT1 and its role in major cardiovascular conditions, with particular attention to cell-type-specific effects. It examines the preclinical efficacy of SIRT1 activators, such as resveratrol and SRT1720, and discusses challenges including dose dependency, specificity, and barriers to clinical translation. A comprehensive literature search (PubMed, Web of Science, Scopus; 2000–April 2026) was conducted to identify studies on SIRT1 in CVDs, with a focus on mechanistic insights and therapeutic relevance.Expert opinion We believe that developing highly specific SIRT1 activators, identifying predictive biomarkers, and elucidating tissue-selective regulatory mechanisms can amplify SIRT1’s protective effects in cardiac diseases. Current and future clinical trials should establish the safety and efficacy of SIRT1-targeted therapies at the earliest possible stage.
Ma et al. (Sun,) studied this question.
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