Abstract

Telomere length has been hypothesized as a putative biomarker for cardiovascular disease. However, the findings are mixed and shared confounding factors may explain these associations. The current review aims to summarize the recent literature on the role of telomere length in cardiovascular disease and give directions for future potential as a predictive biomarker. In this review, we outline the biology of telomeres as a biomarker of aging through its shortening capacity across the life course. Recent epidemiological evidence for its associations with cardiovascular risk factors and disease is discussed. Then we highlight the possible causal role of telomeres in coronary heart disease and summarize the potential biological mechanisms and pathways known. The current research and results presented on telomere length may implicate that short telomeres are causal risk factors for cardiovascular disease, partially through insulin-mediated pathways. Nevertheless, further studies with refined quantification methods and larger populations are needed to clarify the added role of telomere length in predicting future risks of cardiovascular disease on top of existing risk biomarkers, and whether it may be amenable for intervention.

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