Getting enough sleep and regular exercise may directly suppress the expansion of mutant blood-cell clones that contribute to cardiovascular disease, according to a new commentary in Nature Reviews Cardiology highlighting a landmark study from Nature.
The commentary, by Karina Huynh, draws on original research by Gerhardt et al. published in Nature in 2026, which found that sleep regulation and physical activity can limit the growth of clonal haematopoiesis (CH) clones and reduce the atherosclerosis they drive.
Clonal haematopoiesis is an age-related condition in which blood stem cells carrying certain mutations begin to outcompete normal cells, creating a growing population of mutant blood cells. It affects roughly 10% of people over 70 and is now recognized as an independent risk factor for cardiovascular disease.
What they found
The original Nature study demonstrated that lifestyle interventions, specifically improvements in sleep and exercise, reduced the expansion of CH clones in a mutation-dependent manner. Different CH driver mutations responded differently to sleep and exercise interventions, suggesting that personalised lifestyle recommendations may be needed to target specific clone types.
By limiting clone expansion, the same interventions also attenuated the atherosclerosis associated with CH, opening a non-pharmacological avenue for reducing cardiovascular risk in this vulnerable population.
Why it matters
Until now, clonal haematopoiesis has been viewed largely through a genetic and pharmacological lens. The finding that modifiable behaviours, sleep and exercise, can influence clone dynamics represents a conceptual shift. It suggests that lifestyle factors may modify not only traditional cardiovascular risk but also the expansion of premalignant blood clones themselves.
For the roughly 10% of older adults carrying CH mutations, this raises the possibility that improving sleep quality and increasing physical activity could directly reduce their cardiovascular risk through a mechanism distinct from cholesterol or blood pressure control.
Limits
The original Nature study is a preclinical model, and the commentary does not provide human clinical trial data. The mutation-dependent responses mean not all individuals with CH would benefit equally. Prospective human studies are needed to confirm these effects and establish specific sleep and exercise targets.
Bottom line
Sleep and exercise may directly counteract the harmful effects of clonal haematopoiesis on blood vessels, offering a non-drug strategy for reducing cardiovascular risk in a substantial portion of the older adult population.
Source
Huynh K. Sleep and exercise can limit clonal haematopoiesis clone expansion and reduce associated atherosclerosis. Nat Rev Cardiol. 2026 Jun 22. doi:10.1038/s41569-026-01318-3. PMID: 42332105.