While awareness of infection can sometimes cause stress and reduce perceived quality of life, engagement in treatment may promote proactive health behaviors and improve overall wellbeing [43,44]. In contrast, a history of viral infections, particularly when diagnosed later in life, was associated with poorer cardiovascular outcomes, likely due to the cumulative effects of persistent viral activity, vascular damage, and dysregulation of the renin-angiotensin system [11,45]. Here, REN is linked to viral infectious disease.