NAD+ and cardiovascular diseases

Clin Chim Acta. 2021 Apr:515:104-110. doi: 10.1016/j.cca.2021.01.012. Epub 2021 Jan 21.


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.

Keywords: Biological processes; Cardiovascular disease; NAD(+); NADH; SIRTs.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases*
  • Energy Metabolism
  • Humans
  • NAD / metabolism
  • Oxidation-Reduction
  • Sirtuins* / metabolism


  • NAD
  • Sirtuins