Climate change and cardiovascular risk factors management: emerging challenges and strategies for prevention and adaptation

Climate change represents an escalating global health crisis that profoundly influences the risk factors for cardiovascular disease (CVD). Human-driven alterations in climate-including rising ambient temperatures, more frequent and severe heatwaves, air pollution, and extreme weather events-directly and indirectly exacerbate hypertension, diabetes, hyperlipidaemia, and physical inactivity. Exposure to high temperatures and pollution promotes vascular dysfunction, inflammation, and oxidative stress, leading to worsened blood pressure control, dysglycaemia, and disrupted lipid metabolism. Extreme weather events, floods, and wildfires trigger acute spikes in cardiovascular events through dehydration, myocardial ischaemia, and arrhythmias, while also disrupting healthcare delivery and medication adherence. Moreover, climate-driven changes in food systems and nutritional quality exacerbate unhealthy dietary behaviours, further amplifying cardiometabolic risk. Vulnerable populations-including older adults, racial and ethnic minorities, and those of lower socioeconomic status-bear a disproportionate burden of these effects. Mitigating the cardiovascular consequences of climate change requires integrated approaches that incorporate climate-sensitive risk stratification, targeted education of patients and clinicians, and adaptive health system responses. Primary care physicians play a central role in delivering anticipatory guidance and equitable care to at-risk individuals. This review synthesizes evidence linking climate change with CVD risk profiles. It outlines clinical and public health strategies to strengthen climate resilience in cardiovascular medicine.