The multifaceted role of lactate in cardiovascular health: from metabolism to signaling and epigenetics

Abstract

Lactate, long regarded as a metabolic byproduct of anaerobic glycolysis, has emerged as a key regulator of cardiovascular health. Its roles extend beyond energy metabolism and include cell signaling through hydroxycarboxylic acid receptor 1 (HCAR1/GPR81) and epigenetic regulation via lactylation. These interconnected mechanisms influence diverse processes in the cardiovascular system such as energy production, angiogenesis, inflammation, and fibrosis. In this review we provide a chronological exploration of lactate’s functions, focusing on its role in cardiovascular physiology and with a particular emphasis on its role in epigenetics, highlighting the connecting points among these mechanisms and proposing areas for future research.