This literature review updates what is known about ketone metabolism and its role in cardiovascular health and disease. It describes preclinical and early-phase clinical evidence for ketone salts, ketone esters and the ketogenic diet in conditions such as heart failure, acute cardiac injury, diabetic cardiomyopathy, atherosclerosis, hypertension and aortic aneurysm. It also covers beta-hydroxybutyrylation as a molecular mechanism, therapeutic challenges, ketone levels as possible biomarkers, and gender- and age-specific differences in ketone treatment.
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