The interplay between osteoarthritis and cardiovascular disease: shared pathophysiological mechanisms

The relationship between osteoarthritis (OA) and cardiovascular disease (CVD) is complex. Epidemiologically, both OA and CVD have displayed rising trends in the last decades, largely attributed to consistent increases in the prevalence of overlapping risk factors. Furthermore, subjects with OA appear to have a greater cardiovascular risk. As a result, these conditions are associated with a significant burden for public health systems. Both OA and CVD have traditionally been studied as distinct conditions, yet growing epidemiological and molecular evidence suggests these two highly prevalent chronic diseases are linked not merely by shared risk factors such as aging, obesity, and sedentary lifestyle, but also by deeply interconnected biological mechanisms. In ensemble, a plethora of pathophysiologic phenomena, such as chronic inflammation, oxidative stress, adipokine dysregulation, endothelial dysfunction, and extracellular matrix remodeling form a complex and overlapping network of processes that can jointly drive both articular degradation and vascular injury. Bridging the gap between musculoskeletal and cardiovascular research offers the promise of innovative therapies and integrated care strategies that can improve both mobility and longevity for millions of patients worldwide by improving clinical outcomes of both OA and CVD. In this narrative review, we revise the pathophysiological interconnections between OA and CVD.