Extreme heat is increasingly linked to cardiovascular disease (CVD) mortality, with growing evidence showing that heat exposure increases the risk of CVD-related deaths. This review summarizes recent epidemiological studies on the association between heat and CVD mortality, highlighting the impact of heat on different populations, including the elderly, people with preexisting conditions, and socioeconomically disadvantaged groups. The risk is higher in vulnerable subgroups, and the effects of heat on CVD mortality are influenced by factors such as temperature, humidity, air pollution, and other environmental conditions. The review also discusses the biological mechanisms through which heat affects CVD, including thermoregulation, dehydration, and changes in blood flow and cardiac output. The review notes that while the overall risk of CVD mortality due to heat is significant, there is a lack of evidence from low- and middle-income countries (LMICs), where the burden of heat-related CVD mortality is likely higher due to limited resources and infrastructure. The study also highlights the need for more research on the long-term effects of heat on CVD mortality, as well as the potential interactions between heat and other environmental factors. The review emphasizes the importance of understanding the temporal trends in heat-related CVD mortality, as well as the impact of heat on different age groups and sexes. It also discusses the role of air pollution in exacerbating the effects of heat on CVD mortality and the need for further research on the biological pathways involved. The review concludes that more research is needed, particularly in LMICs and among vulnerable populations, to better understand the impact of heat on CVD mortality and to develop effective mitigation and adaptation strategies. The findings underscore the need for targeted public health interventions to reduce the risk of CVD mortality from heat, especially in vulnerable groups. The review also highlights the importance of improving data collection and exposure modeling to better assess the health impacts of heat and to inform policy decisions.Extreme heat is increasingly linked to cardiovascular disease (CVD) mortality, with growing evidence showing that heat exposure increases the risk of CVD-related deaths. This review summarizes recent epidemiological studies on the association between heat and CVD mortality, highlighting the impact of heat on different populations, including the elderly, people with preexisting conditions, and socioeconomically disadvantaged groups. The risk is higher in vulnerable subgroups, and the effects of heat on CVD mortality are influenced by factors such as temperature, humidity, air pollution, and other environmental conditions. The review also discusses the biological mechanisms through which heat affects CVD, including thermoregulation, dehydration, and changes in blood flow and cardiac output. The review notes that while the overall risk of CVD mortality due to heat is significant, there is a lack of evidence from low- and middle-income countries (LMICs), where the burden of heat-related CVD mortality is likely higher due to limited resources and infrastructure. The study also highlights the need for more research on the long-term effects of heat on CVD mortality, as well as the potential interactions between heat and other environmental factors. The review emphasizes the importance of understanding the temporal trends in heat-related CVD mortality, as well as the impact of heat on different age groups and sexes. It also discusses the role of air pollution in exacerbating the effects of heat on CVD mortality and the need for further research on the biological pathways involved. The review concludes that more research is needed, particularly in LMICs and among vulnerable populations, to better understand the impact of heat on CVD mortality and to develop effective mitigation and adaptation strategies. The findings underscore the need for targeted public health interventions to reduce the risk of CVD mortality from heat, especially in vulnerable groups. The review also highlights the importance of improving data collection and exposure modeling to better assess the health impacts of heat and to inform policy decisions.