From Earth to orbit: cardiovascular innovation diffusion to space medicine - an updated review incorporating a novel predictive modeling framework

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Extraterrestrial environments have an impact on cardiac output, vascular integrity, and endothelial function. This Update Review aims to integrate multi-domain cardiovascular preventive strategies through advanced biomedical and lifestyle interventions in long-duration spaceflight, as well as assessing the adoption of such innovations using Rogers’s Diffusion of Innovations (DOI) theory among spaceflight stakeholders. To conduct this Update Review, we restricted the inclusion criteria to conceptual and interdisciplinary literature in English related to spaceflight in the PubMed, Scopus, and Google Scholar datasets. Articles aligned with the study scope and the relevant keywords about spaceflight, cardiovascular health, and DOI were included. Thematic synthesis was used to integrate the results with the DOI theory and advanced prevention approach on cardiovascular health, with potential benefits in space medicine. Our assessment of current literature suggests that a combined, multi-domain framework for cardiovascular protection in extraterrestrial environments, incorporating lifestyle strategies with complementary biomedical approaches, would be most useful in the pre-Moon or Mars phase. This review underscores how strategic adoption of protective innovations, coupled with a communication model like DOI, can target late adopters and accelerate effective prevention strategies across the aerospace healthcare ecosystem.