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date: 18 March 2019

Abstract and Keywords

Cardiovascular (CV) disease is the leading killer of our species. Various evolutionary lenses can be applied to better understand human vulnerability to CV disorders. The evolutionary origins of a healthy human heart—its myocardial, electrophysiologic, valvular and vascular systems—offers a history of the selective pressures, trade-offs and adaptations leading to the normal mammalian CV systems. Beyond these evolutionary-developmental perspectives, the application of a framework based on Tinbergen’s four questions offers a novel evolutionary lens for understanding our species’ vulnerability to CV pathology. This is done by a consideration of comparative information about non-human animals who spontaneously develop the same CV diseases. This phylogenetic information can then be used to develop trade-off-based adaptive hypotheses to explain the nature and origins of vulnerability to a range of CV pathologies including atherosclerosis, heart failure, valvular heart disease and arrhythmias.

Keywords: cardiovascular, heart, Tinbergen, atherosclerosis, heart failure, aortic stenosis, atrial fibrillation, multicellularity, triploblasty, evolutionary medicine

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