Minds and hearts: Cardio-neural crosstalk in cardiovascular and neurodegenerative diseases

With increasing life expectancy, the prevalence of age-related cardiovascular diseases—including hypertension, atherosclerosis, atrial fibrillation, and heart failure—and neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease (PD) continues to rise. Emerging evidence indicates that the heart and brain are linked through complex, bidirectional pathways in which cardiovascular pathology can accelerate neurodegeneration, while neurodegenerative processes can precipitate or exacerbate cardiovascular dysfunction. This review critically appraises current knowledge on cardio-neural crosstalk, distinguishing well-established associations (e.g., hypertension and dementia) from more speculative mechanisms (e.g., receptor changes in ischemic PD). We integrate epidemiological findings with mechanistic insights, highlighting inflammation, hypoperfusion, blood–brain barrier disruption, autonomic dysfunction, and amyloid biology as convergent pathways. To enhance clarity, we summarize evidence strength in expanded tables and figures, including epidemiological hazard ratios, mechanistic pathways, and confidence grading. The main contribution of this review is to provide a structured synthesis of robust and emerging evidence on the bidirectional heart–brain axis, identifying gaps that limit causal inference. We emphasize future directions such as longitudinal biomarker studies, interventional trials repurposing cardiovascular therapies for neuroprotection, and systems biology approaches to integrate cardiovascular and neurodegenerative omics data. By consolidating current evidence and outlining actionable research priorities, this review aims to inform both clinical practice and translational research in cardio-neural disease.