Exercise modulates redox homeostasis in cardiovascular and metabolic diseases: from bench to clinic

Cardiovascular and metabolic diseases remain the leading causes of global morbidity and mortality, underscoring the critical need for effective preventive and therapeutic strategies. Exercise training is a pivotal component of a healthy lifestyle and an effective non-pharmacological therapeutic strategy for delaying or even reversing disease progression. Growing evidence indicates that disrupted redox homeostasis is a central pathogenic mechanism underlying cardiovascular and metabolic disorders. Exercise exerts multifaceted benefits on redox balance by enhancing endogenous antioxidant capacity, attenuating oxidative stress and inflammation, and promoting mitochondrial biogenesis and metabolic remodeling. Additionally, exercise-induced exerkines modulate redox signaling and homeostasis, enhancing cellular stress response. This review integrates mechanistic insights from preclinical models with evidence from human observational and interventional studies to elucidate how exercise modulates redox homeostasis across molecular, cellular, and systemic levels. A deeper understanding of exercise-redox interactions will not only advance knowledge of disease pathogenesis but also facilitate the development of precision exercise prescriptions to restore redox balance and improve cardiovascular and metabolic health.