NAD+ and cardiovascular diseases

• NAD + plays pivotal roles in controlling many biological processes in the organism. • NAD + and NAD + -related enzymes participate in several key processes in cardiovascular diseases. • Maintaining the level of NAD + is a best way to treat and prevent cardiovascular diseases. Nicotinamide adenine dinucleotide (NAD) plays pivotal roles in controlling many biochemical processes. ‘NAD’ refers to the chemical backbone irrespective of charge, whereas ‘NAD + ’ and ‘NADH’ refers to oxidized and reduced forms, respectively. NAD + /NADH ratio is essential for maintaining cellular reduction–oxidation (redox) homeostasis and for modulating energy metabolism. As a sensing or consuming enzyme of the poly (ADP-ribose) polymerase 1 (PARP1), the cyclic ADP-ribose (cADPR) synthases (CD38 and CD157), and sirtuin protein deacetylases (sirtuins, SIRTs), NAD + participates in several key processes in cardiovascular disease. For example, NAD + protects against metabolic syndrome, heart failure, ischemia–reperfusion (IR) injury, arrhythmia and hypertension. Accordingly, the subsequent loss of NAD + in aging or during stress results in altered metabolic status and potentially increased disease susceptibility. Therefore, it is essential to maintain NAD + or reduce loss in the heart. This review focuses on the involvement of NAD + in the pathogenesis of cardiovascular disease and explores the effects of NAD + boosting strategies in cardiovascular health.