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Open research questions in Cardiovascular Health and Risk Factors

68 unresolved questions extracted from the limitations and future-work sections of 752 Cardiovascular Health and Risk Factors papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Background Hypertension frequently coexists with poor cardiovascular health (CVH), yet whether the inflammatory potential of habitual diet, captured by the Dietary Inflammatory Index (DII), relates to CVH and to subsequent adverse cardiovascular events in this population remains unclear.

    Dietary Inflammatory Index, cardiovascular health, and long-term outcomes in hypertension: external validation in a Chinese percutaneous coronary intervention cohort · 2026 · DOI

  • Previous studies have shown associations between cardiometabolic diseases and fragility fractures; however, the relationship between CMM and hip fractures remains unclear in the Chinese population.

    Cardiometabolic Multimorbidity Increases the Risk of Hip Fracture: A Longitudinal Cohort Study Based on <scp>CHARLS</scp> · 2026 · DOI

  • Due to the modest response rate (13.2%), limited number of respondents (92 HSS) and inclusion of a single private co-educational school, our findings may not be generalizable to other geographical regions, public or non-coeducational schools. In the Jhaukhel- Duwakot Health Demographic Surveillance System among adolescents in two public and seven private schools in Nepal, those studying in private schools had better knowledge, attitude and practice on cardiovascular health than those in public schools. Consequently, our findings should be validated in larger studies with a diverse population of HSS across geographical locations, school types and sociodemographic characteristics. To avoid unmasking the identity of our respondents, information on sex and race/ethnicity were not reported. Therefore, there may be response bias since we do not have information on the characteristics of HSS who did not complete the questionnaire. Due to the descriptive and cross-sectional nature of our study, we are unable to draw causal inferences from our study results. The cut-off levels adopted to categorize poor, moderate, good and excellent performance on our knowledge scale for each question in our study population is arbitrary and may not apply to other populations. Becker et al.

    Knowledge, awareness and perceived risk of heart disease among high school students with and without cardiovascular disease in the family · 2026 · DOI

  • This study has various limitations that need to be acknowledged. First, its cross-sectional design limits the ability to ascertain causal relationships between risk factors and hyperlipidemia. Second, certain data, such as lifestyle factors and family history, depended on self-reported information, which might be affected by recall bias or social desirability bias. Finally, the study was only done in one location and only looked at young adults. This might suggest that the results don't apply to people of other ages or in other places. This study's cross-sectional methodology makes it impossible to prove causal correlations; as a result, the results should guide focused screening and preventive efforts rather than etiologic conclusions regarding the etiology of disease. CONCLUSION This study found that approximately one-third of young adults in Mosul City have hyperlipidemia, with most unaware of their condition. Modifiable risk fac- tors, particularly BMI, physical inactivity, and dietary habits, strongly predicted hyperlipidemia status. These findings emphasize the need for early screening and targeted interventions among young adults in this post-conflict urban setting. Future research should ex- plore longitudinal trends in cardiovascular risk factors among young Iraqi adults, evaluate the effectiveness of targeted screening and intervention programs, and in- vestigate contextual factors unique to post-conflict set- tings that may influence cardiometabolic health. Addi- tionally, qualitative research exploring young adults' knowledge, attitudes, and practices regarding cardio- vascular health could inform more effective prevention strategies. Romanian JouRnal of medical PRactice – Volume 21, no. 1 (108), 2026 Ethical approval Author’s contributions The study protocol was approved by the Ethical Committee of Mosul Medical Technical Institute/North- ern Technical University/Iraq (Approval No: MMTI/ COM/ETHIC/2023-123). Permission was also obtained from the Directorate of Health in Nineveh Governorate. Participation was voluntary, and confidentiality of infor- mation was maintained throughout the study.

    Prevalence and risk factors of hyperlipidemia among young adults · 2026 · DOI

  • Our study has several important strengths. First, it was conducted across all provinces of Türkiye, ensuring broad national representation. The large sample size and inclusion of participants from a wide range of educational and literacy backgrounds enhanced the generalizability of the findings. Notably, the use of face-to-face interviews allowed for the participation of illiterate individuals, improving inclusivity and reducing sampling bias. However, certain limitations must be acknowledged. The questionnaire, although developed by an expert cardiologist with experience in epidemiology and survey methodology, was not subjected to formal validation in an independent population. While it was reviewed for face validity and pilot-tested, the absence of full psychometric validation may affect interpretability and limit its generalizability. In addition, the survey relied on self-reported data for comorbid conditions and lifestyle behaviors, which may be subject to recall or reporting bias. Furthermore, the study did not collect socioeconomic or region-specific data, and awareness of CVD as the leading cause of death in men was not assessed. Therefore, comparisons between male and female awareness levels should be interpreted with caution. Despite these limitations, to the best of our knowledge, this is the first nationwide study in Türkiye to investigate public awareness of CVD as the leading cause of death among women, highlighting a critical gap in national cardiovascular health literacy.

    Awareness of Cardiovascular Disease as the Primary Cause of Mortality in Women: Insights from a Survey of 7,920 Individuals · 2026 · DOI

  • Introduction: Self-rated health (SRH) predicts morbidity and mortality; however, its long-term trajectories and associations with psychological wellbeing (PWB), health behaviors, and cardiovascular risk remain understudied in Central and Eastern Europe.

    Examination of Self-Rated Health, Psychological Well-Being and Cardiovascular Health Risks : 10-Year Follow-Up of the Budakalász Epidemiological Study in Hungary · 2026 · DOI

  • The strength of this study is that it examined the associations among CVD knowledge, risk perception, motivation factors, and CVD-preventive health behavior using the I-Change model to provide both theoretical insights and ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT practical implications. Additionally, to examine the indirect effects of multiple mediators, phantom variables were created, allowing for a more precise estimation of specific indirect pathways. However, several limitations of this study should be considered. First, because data were collected through an online survey, the sample tended to include participants with relatively higher educational attainment, while individuals with limited Internet access may have been underrepresented. This recruitment approach may have introduced selection bias and limited the representativeness of the sample. Although participants were recruited from various regions in South Korea, the degree to which the sample reflects the broader population remains uncertain. Second, the cross-sectional nature of the study restricts the ability to draw causal conclusions among the study variables. Accordingly, the identified associations should be interpreted as correlational rather than causal, and caution is warranted when interpreting the findings. Future research employing longitudinal or experimental designs is recommended to further examine the proposed relationships and underlying mechanisms. Third, the relatively modest sample size may limit the generalizability of the findings. Studies involving larger and more heterogeneous populations are needed to strengthen the external validity of the results. Finally, this study relied on self-reported survey data and lacked objective cardiovascular health indicators, which may limit the model’s comprehensiveness and introduce recall bias. Although additional analyses controlling for age, income, and education level yielded consistent mediation pathways, model fit declined ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT with the inclusion of these covariates. Therefore, the final model was specified without them to maintain parsimony. Future research should incorporate objective cardiovascular health indicators to further validate these findings.

    Path analysis of cardiovascular disease preventive health behavior in postmenopausal Korean women based on the I-Change model · 2026 · DOI

  • Despite current guidelines suggesting an RHR threshold of 80 bpm for heightened risk and potential therapeutic intervention, evidence supporting this cut-off remains inconclusive.

    Diabetes: At what resting heart rate does the risk of cardiovascular events increase? · 2025 · DOI

  • AbstractStudies investigating the association between acetylsalicylic acid (ASA) use and spontaneous subarachnoid haemorrhage (SAH) in the general population have produced conflicting results.

    The association between acetylsalicylic acid and subarachnoid haemorrhage: the Framingham Heart Study · 2023 · DOI

  • Conclusions: Limited and heterogenous literature suggests that the influence of SES on associations between combinations of unhealthy LFs and adverse health could be additive but remains unclear.

    The influence of socioeconomic status on the association between unhealthy lifestyle factors and adverse health outcomes: a systematic review · 2023 · DOI

  • Despite their consequences, depressive symptoms are poorly recognized and undertreated because wide variation in symptom presentation limits clinical identification-particularly among African American (AA) women-an understudied population at an increased risk of health inequity.

    Latent Class Analysis of Depressive Symptom Phenotypes Among Black/African American Mothers · 2022 · DOI

  • Objectives: The roles of cardiorespiratory fitness (CF) in reducing cardiovascular disease (CVD) and all-cause mortality risks are well established; however, little is known about the role of CF in reducing risk of metabolic syndrome (MetS), a cluster of CVD risk factors, particularly in Asian countries.

    The association between cardiorespiratory fitness and metabolic syndrome diagnosis: A cross-sectional study in Indonesian middle-aged and older adults · 2021 · DOI

  • However, factors such as dietary habits and behaviours, physical activity, life stress and smoking habits, although thoroughly discussed, are not well understood and appreciated in the spectrum of secondary ACS prevention.

    Secondary Prevention of Acute Coronary Syndrome. Socio-economic and Lifestyle Determinants: A Literature Review · 2014 · DOI

  • Future research should focus on understanding the relationship between ACB and mortality, and cardiovascular disease and possibly minimising ACB load where feasible.

    Total anticholinergic burden and risk of mortality and cardiovascular disease over 10 years in 21,636 middle-aged and older men and women of EPIC-Norfolk prospective population study · 2014 · DOI

  • In conclusion, we suggest that PSID consider adding important assessments of specific CVD biomarkers and mediating behavioral measures, health, and medications that will ultimately address many of the gaps in the literature regarding the relationship between SEP and cardiovascular health.

    Socioeconomic Position and Inflammatory and Immune Biomarkers of Cardiovascular Disease: Applications to the Panel Study of Income Dynamics · 2009 · DOI

  • However, population-level trends and demographic disparities in related deaths remain insufficiently characterized, necessitating large-scale analyses to better inform prevention, risk stratification, and healthcare planning.

    Patterns and trends of mortality in patients with arrhythmia and cerebrovascular disease in the United States: a nationwide analysis of older adults · 2026 · DOI

  • However, the study lacks data related to urban–rural and racial differences, making it impossible to further analyze the disease burden disparities between urban and rural areas as well as among different races.

    Global and regional burden of cardiovascular diseases due to low physical activity from 1990 to 2021 and projections to 2045: a joinpoint regression and age-period-cohort analysis based on GBD 2021 · 2026 · DOI

  • Background and AimsCardiovascular risk scores guide primary prevention, but their comparative performance remains uncertain.

    Cardiovascular risk scores for primary prevention: head-to-head validation of 16 established and contemporary models · 2026 · DOI

  • Developing innovative strategies for sustained patient engagement, including personalized support systems, community-based programs, and leveraging behavioral economics principles, is necessary.

    Lifestyle Medicine in China: The Fuwai Hospital Lifestyle Medicine Initiative · 2026 · DOI

  • However, the feasibility and utility of applying the Urban HEART tool to smaller jurisdictions has not been tested in Canada.

    Socio-spatial inequities beyond the big city: evaluating the World Health Organization’s Urban HEART tool in a non-metropolitan context · 2018 · DOI

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68 open questions have been extracted from the limitations and future-work passages of 752 Cardiovascular Health and Risk Factors papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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