Cardiovascular diseases are the leading cause of death globally and in Iran. Climate change has intensified human exposure to extreme temperatures, thermal variability, and bioclimatic indices. The climate exposome framework offers a comprehensive approach to assessing environmental exposures across the lifespan. This narrative review synthesizes evidence on the climate exposome's role in the development of cardiovascular diseases and its biological mechanisms. Epidemiological evidence indicates that exposure to extreme temperatures, temperature variability, climate-related air pollution, and extreme events is significantly associated with increased cardiovascular disease mortality, hospitalizations, myocardial infarction, stroke, and heart failure. These effects follow non-linear patterns with temporal lags and are more pronounced among the elderly, individuals with pre-existing heart disease, and lower socioeconomic groups. Proposed biological mechanisms include thermoregulatory disruption, sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis activation, systemic inflammation, oxidative stress, endothelial dysfunction, coagulation abnormalities, and emerging mechanisms such as epigenetic modifications and gut microbiome dysbiosis. Interactions between climatic factors and air pollution generate synergistic effects. Adopting the climate exposome approach in cardiovascular research provides a comprehensive understanding of cumulative environmental exposures, playing a critical role in designing preventive interventions, shaping health policies, and enhancing health system adaptation to climate-related hazards.

کلیدواژه ها:

Exposome ، Climate change ، Temperature ، Cardiovascular diseases ، Mortality ، Narrative review