An Exploratory Narrative Review of Environmental, Socioeconomic, and Occupational Determinants of Cardiovascular Risk

Cardiovascular disease (CVD) is the most important contributor to global mortality and disability, and its aetiology extends well beyond the classical behavioural and metabolic risk factors. This exploratory narrative review examines selected international evidence on air and water pollution, geological and urban exposures, socioeconomic disadvantage, and working conditions in mining, metallurgy, automotive manufacturing, agriculture and sedentary or psychosocially demanding occupations. Central and Eastern Europe, including Romania, is considered as a contextual example rather than a separately studied population. We also sought to describe the mechanisms through which specific risk factors trigger harmful pathophysiological responses. Associations differ by exposure definition, outcome, study design and source population. The review identifies prevention and research priorities while acknowledging its purposive evidence selection, heterogeneous populations and lack of a systematic search or new pooled analysis. Population-specific longitudinal and intervention studies are needed to quantify joint effects and the cardiovascular benefits of structural prevention.