# Trained Immunity and Cardiovascular Risk: An Immunological Perspective

## TL;DR

This paper reviews how trained immunity, a type of innate immune memory, may contribute to cardiovascular disease and how understanding it could lead to better treatments.

## Contribution

The paper provides a novel immunological perspective on how trained immunity links ASCVD risk factors to chronic inflammation.

## Key findings

- Trained immunity is induced by risk factors like hyperglycaemia and hypercholesterolemia.
- It may sustain vascular inflammation and contribute to ASCVD progression.
- Understanding its mechanisms could guide targeted therapies for ASCVD.

## Abstract

Systemic inflammation is a key driver of atherogenesis and its complications. While anti‐inflammatory therapies targeting pathways such as IL‐1β and IL‐6 have shown promise in established atherosclerotic cardiovascular disease (ASCVD), potential systemic effects raise concerns about immune suppression and infection, underscoring the need for more precise immunomodulatory approaches. Trained immunity—a form of innate immune memory—has emerged as a potential contributor linking ASCVD risk factors to chronic inflammation and disease progression. In this review, we discuss the evidence for trained immunity in ASCVD, its induction by several known risk factors (e.g., hyperglycaemia, hypercholesterolemia, diet, chronic stress, inflammatory diseases, and infection), and its potential role in sustaining vascular inflammation. Advancing our understanding of the metabolic and epigenetic mechanisms underlying trained immunity, as well as defining shared and cumulative effects across risk factors, will be critical to guide the development of next‐generation targeted therapies for ASCVD prevention and treatment.