Risk Factors for Cardiovascular and Metabolic Disease: Integrating Traditional and Novel Paradigms

ABSTRACT Cardiovascular and metabolic diseases (CVMD), encompassing atherosclerotic cardiovascular disease (ASCVD), heart failure, obesity, type 2 diabetes mellitus (T2DM), and metabolic dysfunction‐associated steatotic liver disease (MASLD), remain the leading global cause of morbidity and mortality. Although traditional risk factors form the cornerstone of risk assessment, a significant proportion of events occur in individuals deemed low or intermediate risk by conventional models. This underscores the critical role of novel risk factors in CVMD. This review synthesizes current knowledge on both established and emerging risk factors for CVMD. We detail the pathophysiology, clinical significance, and interplay of traditional factors (dyslipidemia, hypertension, hyperuricemia, hyperhomocysteinemia, smoking, obesity, physical inactivity, unhealthy diet, and family history) and explore the growing evidence for novel risk factors, including inflammatory biomarker, lipid‐related factor, adipokines, lipid metabolite, air pollution, noise pollution, microplastics, heavy metals, and psychological factor. We discuss the integration of these factors into refined risk prediction models and their implications for personalized prevention and therapeutic strategies. Future research directions focusing on causality, mechanistic insights, and targeted interventions for novel risk markers are highlighted.