Iron Dysregulation and Vascular Diseases: A Contemporary Review

Iron is essential for the cardiovascular system to maintain its function. Disruption of iron balance, in the form of either iron deficiency or overload, has been increasingly recognized to be linked to the pathogenesis of cardiovascular disease. The consequences of iron dysregulation in specific vascular cell types, such as endothelial cells, vascular smooth muscle cells, and macrophages, contribute to critical processes, including inflammation, oxidative stress, and vascular remodeling. In this review, we focus on the role of iron imbalance in the pathogenesis of vascular diseases, in particular atherosclerosis and aortic aneurysm. We provide an overview of cellular and systemic iron homeostasis, explore the impact of iron dysregulation on vascular cell biology, and discuss mechanistic insights into iron imbalance-induced vascular pathology. We also summarize potential therapeutic approaches targeting iron metabolism, review ongoing clinical trials, and outline future research directions needed to translate these findings into clinical interventions for vascular disease.