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In the future, preventive cardiology will be crucial in enabling safe space travel. Indeed, future space missions destined to the Moon and from there to Mars will create new challenges to cardiovascular health while limiting medical management. Moreover, commercial spaceflight evolves rapidly such that older persons with cardiovascular risk factors will be exposed to space conditions. This review provides an overview on studies conducted in space and terrestrial models, particularly head-down bedrest studies. These studies showed that weightlessness elicits a fluid shift towards the head, which likely predisposes to the spaceflight-associated neuro-ocular syndrome, neck vein thrombosis, and orthostatic intolerance after return to Earth. Moreover, cardiovascular unloading produces cardiopulmonary deconditioning, which may be associated with cardiac atrophy. In addition to limiting physical performance, the mechanism further worsens orthostatic tolerance after return to Earth. Finally, space conditions may directly affect vascular health; however, the clinical relevance of these findings in terms of morbidity and mortality is unknown. Targeted preventive measures, which are referred to as countermeasures in aerospace medicine, and technologies to identify vascular risks early on will be required to maintain cardiovascular performance and health during future space missions.<\/jats:p>","DOI":"10.1093\/eurjpc\/zwac029","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T15:12:06Z","timestamp":1644246726000},"page":"1399-1411","source":"Crossref","is-referenced-by-count":63,"title":["How spaceflight challenges human cardiovascular health"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6283-4305","authenticated-orcid":false,"given":"Peter","family":"Jirak","sequence":"first","affiliation":[{"name":"University Clinic for Internal Medicine II, Department of Cardiology and Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Mirna","sequence":"additional","affiliation":[{"name":"University Clinic for Internal Medicine II, Department of Cardiology and Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Rezar","sequence":"additional","affiliation":[{"name":"University Clinic for Internal Medicine II, Department of Cardiology and Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas J","family":"Motloch","sequence":"additional","affiliation":[{"name":"University Clinic for Internal Medicine II, Department of Cardiology and Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lichtenauer","sequence":"additional","affiliation":[{"name":"University Clinic for Internal Medicine II, Department of Cardiology and Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University , Salzburg , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Jordan","sequence":"additional","affiliation":[{"name":"Institute of Aerospace Medicine, German Aerospace Medicine (DLR) , Cologne , Germany"},{"name":"Chair of Aerospace Medicine, Medical Faculty, University of Cologne , Cologne , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Binneboessel","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf , Duesseldorf , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Tank","sequence":"additional","affiliation":[{"name":"Institute of Aerospace Medicine, German Aerospace Medicine (DLR) , Cologne , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9927-4180","authenticated-orcid":false,"given":"Ulrich","family":"Limper","sequence":"additional","affiliation":[{"name":"Institute of Aerospace Medicine, German Aerospace Medicine (DLR) , Cologne , Germany"},{"name":"Department of Anaesthesiology and Critical Care Medicine, Merheim Medical Center, Witten\/Herdecke University , Cologne , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf , Duesseldorf , 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