The review examines the impact of maternal preeclampsia (PE) on the cardiometabolic and cardiovascular health of offspring. PE, a hypertensive disorder of pregnancy, is responsible for 2 to 8% of pregnancy-related complications. It significantly contributes to adverse outcomes for their infants, affecting the time of birth, the birth weight, and cardiometabolic risk factors such as blood pressure, body mass index (BMI), abdominal obesity, lipid profiles, glucose, and insulin. Exposure to PE in utero predisposes offspring to an increased risk of cardiometabolic diseases (CMD) and cardiovascular diseases (CVD) through mechanisms that are not fully understood. The incidence of CMD and CVD is constantly increasing, whereas CVD is the main cause of morbidity and mortality globally. A complex interplay of genes, environment, and developmental programming is a plausible explanation for the development of endothelial dysfunction, which leads to atherosclerosis and CVD. The underlying molecular mechanisms are angiogenic imbalance, inflammation, alterations in the renin–angiotensin–aldosterone system (RAAS), endothelium-derived components, serotonin dysregulation, oxidative stress, and activation of both the hypothalamic–pituitary–adrenal axis and hypothalamic–pituitary–gonadal axis. Moreover, the potential role of epigenetic factors, such as DNA methylation and microRNAs as mediators of these effects is emphasized, suggesting avenues for future research and therapeutic interventions.

Background: Acute coronary syndrome (ACS) encompasses ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina. While optimal medical therapy (OMT) is central to secondary prevention, lifestyle interventions—particularly dietary modification—remain underutilised despite their potential impact on long-term outcomes. Objective: To review the current evidence regarding dietary interventions post-ACS, their implementation, adherence, and effects on cardiovascular risk factors and clinical outcomes. Methods: A narrative literature review was performed using PubMed, including studies published in English from 2000 onwards. Keywords included “acute coronary syndrome,” “diet,” “cardiovascular disease,” “outcomes,” “adherence,” “wine,” and “intermittent fasting,” combined with Boolean operators AND/OR. Animal studies were excluded. The latest search was conducted in October 2025. Results: Mediterranean-style diets, when combined with OMT and lifestyle interventions (exercise, smoking cessation, alcohol moderation), consistently improve cardiovascular risk factors and reduce recurrent ischemic events and mortality. Clinical trials and cohort studies demonstrate long-term benefits, including reductions in all-cause mortality and major adverse cardiovascular events, particularly in patients adhering to structured dietary programmes within cardiac rehabilitation. Evidence for other dietary modifications, including low-fat diets, increased fibre, antioxidant supplementation, and intermittent fasting, was more limited, often derived from small or short-term studies focusing on surrogate endpoints. Real-world adherence to dietary guidelines remains suboptimal, especially in high-risk and obese populations. Preliminary studies suggest intermittent fasting and moderate red wine consumption may confer additional cardiovascular benefits, though larger, long-term trials are needed. Conclusions: Dietary modification is a key, yet underutilised component of secondary prevention post-ACS. A Mediterranean-style, whole-food diet integrated with OMT and supported by structured cardiac rehabilitation programmes offers the most evidence-based strategy to improve risk factor control and long-term outcomes. Future research should focus on pragmatic, long-term trials assessing hard cardiovascular endpoints and implementation strategies to enhance adherence across diverse populations.

Cardio-oncology has emerged as a critical discipline addressing cardiovascular toxicities from cancer therapies, yet substantial evidence gaps persist for elderly patients, who represent over 60% of new cancer diagnoses. This narrative review synthesizes the current literature on cardio-oncology challenges in older adults (≥65 years), highlighting underrepresentation in clinical trials, compounded risks from frailty, multimorbidity, and polypharmacy, and the paucity of geriatric-specific guidelines. Older adults exhibit heightened susceptibility to cardiotoxicity from antineoplastic therapies due to age-related declines in cardiac reserve and renal function, and baseline atherosclerosis. Comprehensive geriatric assessments (CGA) identify frailty as a key predictor of adverse outcomes, yet their integration into cardio-oncology protocols remains inconsistent, with limited prospective data on risk-stratification tools such as echocardiography and biomarkers. Observational studies underscore disparities in surveillance and management, leading to the undertreatment of cancer and overtreatment of comorbidities. Current cardio-oncology guidelines recognize older age, multimorbidity, frailty, and individualized assessment as important considerations in clinical decision-making. However, validated geriatric-specific thresholds, surveillance strategies, and management algorithms remain limited, particularly for frail older adults and the oldest-old populations. Emerging priorities include multidisciplinary models incorporating geriatricians, randomized trials in frail populations, and real-world evidence on novel agents. This review advocates tailored strategies to optimize shared decision-making, enhance equity, and address current knowledge gaps through CGA-driven research, while proposing a pragmatic age- and frailty-stratified framework to support individualized cardiovascular assessment in elderly cancer patients.