Dear Colleagues,

Evaluation of the risk of cardiovascular disease and its early prevention are essential for reduction of mortality and morbidity in industrialized communities. Age, gender, ethnicity and genetic predisposition are uncontrollable risk factors for cardiovascular disease. Hypertension, dyslipidemia, smoking and diabetes are the four major cardiovascular risk factors, which are correctable through medication therapy as well as improvement of lifestyles. These risk factors accelerate the progression of atherosclerosis, which is the most important pathogenesis of cardiovascular disease. Obesity, especially visceral obesity, is a central cardiovascular risk factor, and the cardiovascular risk is greatly increased in persons with metabolic syndrome, a status of accumulation of these risk factors. Hyperuricemia and chronic kidney disease are directly and indirectly (through other risk factors) associated with cardiovascular disease. In addition to the aforementioned classical risk factors, elevated circulating homocysteine and acute-phase protein concentrations have been shown to be cardiovascular risk factors. It has been an issue of debate whether elevation of acute-phase proteins reflecting chronic inflammation is a cause, consequence or both for the pathogenesis of cardiovascular disorders. The reason for the French paradox, meaning a prominently lower mortality from cardiovascular disease in France among Western countries, also remains to be elucidated, although a high consumption level of red wine in France and the antioxidative action through polyphenols contained in red wine have been proposed as the basis for the French paradox. Low cardiovascular mortality is also known in eastern Asian countries, although the lifestyles including diet in eastern Asian countries are becoming similar to those in western countries. Since 2020, the most important health-related worldwide topic is undoubtedly the pandemic of Covid-19. Cardiovascular risk factors including hypertension, obesity and diabetes are known to be exacerbating factors for the disease stage of Covid-19 infection.

In this special issue, we would like to introduce recent topics on cardiovascular risk factors broadly. Articles focusing not only on epidemiological studies but also on experimental studies are welcome to this issue. We are hoping that this issue will prepare the ground for the development of future strategies for promotion of cardiovascular health and prevention of cardiovascular aging and dysfunction.

Prof. Ichiro Wakabayashi and Prof. Klaus Groschner

Guest Editors