From Heart to Brain: How Cardiovascular Disease Drives Neurodegeneration via Blood–Brain Barrier Disruption

Cardiovascular diseases (CVDs) contribute to neurodegenerative disease (NDD) progression through vascular inflammation, oxidative stress, and apolipoprotein E (apoE) dysregulation, all of which disrupt the blood-brain barrier (BBB). The disruption of the BBB is a key link between CVD and BBB weakening. CVD conditions such as hypertension and genetic predisposition lead to BBB-compromise through inflammation and cerebral microbleeds. These weaken the BBB integrity, allowing for harmful toxins to enter the brain, leading to neuronal harm and accelerated neurodegeneration. While some possible therapeutic strategies are being studied using CVD medications, potential methods directly restoring the BBB--such as mitochondrial-targeted interventions or immune modulation-- work by reducing inflammation and repairing barrier structure to reestablish barrier permeability. Restoring BBB integrity may slow or even halt neurodegeneration, making early intervention along the heart-brain axis essential to preventing or delaying NDDs.