Nutritional Status and Cardiovascular Disease in Older Adults: Clinical Perspectives from Mechanisms to Management

Nutritional status is a pivotal determinant of health and longevity in ageing populations. Malnutrition, overnutrition, and sarcopenic obesity are increasingly recognised as key modifiers of CV risk in older adults. Beyond caloric imbalance, age-related metabolic, hormonal, and inflammatory changes profoundly influence CV structure and function. Both nutrient deficiency and excess contribute to endothelial dysfunction, oxidative stress, and chronic inflammation, core mechanisms underlying atherosclerosis, heart failure, and frailty. This review analyses the complex interplay between nutrition and cardiovascular diseases in older adults, outlining physiological mechanisms, diagnostic tools for nutritional assessment, and evidence-based dietary strategies aimed at prevention and management. Particular attention is given to the challenges of multimorbidity, polypharmacy, and altered body composition that shape nutritional care in geriatric cardiology.