Finding risk before disease: how the Safe Hearts Plan aims to transform prevention

Cardiovascular diseases and type 2 diabetes often develop silently, leaving millions of people unaware of their risk until serious complications occur. The Safe Hearts Plan places early detection and targeted health checks at the centre of prevention, while JACARDI is helping translate this ambition into practical action through common guidance, real-world evidence and pilot initiatives across Europe. Ahead of the EU Screening Week, beginning on 28 September, we explore how screening can turn silent risks into actionable health information, what makes health checks effective pathways to prevention and care, and how JACARDI’s guidance, evidence and pilot projects are informing the European health check protocol under the Safe Hearts Plan.

A health check is only valuable if it changes what happens next. Every day, millions of Europeans go about their lives unaware that they are living with high blood pressure, elevated cholesterol or type 2 diabetes. Around one in five people in the European Union live with hypertension, while more than 45 million adults have diabetes. Yet these and other cardiovascular risk factors often remain silent until they trigger a heart attack, stroke or other serious health event. [1] The challenge facing Europe’s health systems is no longer simply identifying these risks, but ensuring that early detection leads to timely action.

That ambition lies at the heart of the Safe Hearts Plan [2], launched by the European Commission, which aims to shift the focus of healthcare from treating cardiovascular disease to preventing it. One of its flagship initiatives is the development of a European protocol on cardiovascular health checks, designed to support Member States in detecting cardiovascular disease, diabetes and obesity earlier while reducing inequalities in access to prevention.

From policy ambition to effective health checks

But implementing effective health checks is about much more than measuring blood pressure or cholesterol.

According to JACARDI’s response to the Call for Evidence on the proposed Council Recommendation for cardiovascular health checks, countries should begin by understanding their own health challenges. Analysing disease burden, mortality, lifestyle patterns and available health data allows screening programmes to target people who are most likely to benefit, making prevention not only more effective but also a better use of healthcare resources.

Europe is already moving in that direction. JACARDI’s mapping study of cardiovascular screening programmes across 18 countries found that thirteen have already established or are developing national strategies to identify people at increased cardiovascular risk. Yet the study also reveals a significant gap between policy and practice. How countries identify, assess and follow up those at increased risk varies considerably across Europe. In other words, while many countries have a strategy on paper, implementation remains uneven.

As Hanna Tolonen, Director of Research and Development at the Finnish Institute for Health and Welfare (THL) and leader of JACARDI’s Work Package on screening high-risk populations and individuals, explains:

“Cardiovascular health checks are a cornerstone of the Safe Hearts Plan. Hypertension and elevated cholesterol are well-known, preventable risk factors for cardiovascular disease, but they are often ‘silent,’ showing no symptoms for a long time. Health checks serve as a tool to identify asymptomatic individuals who may be at an increased risk of developing cardiovascular disease.”

Making health checks matter

Identifying risk, however, is only the first step. The JACARDI Short Guide to Screening for Individuals at Increased Risk of Developing Cardiovascular Diseases and Type 2 Diabetes [3], developed by experts from across the partnership to support policymakers and public health professionals, emphasises that screening programmes should be practical, evidence-based and integrated into existing healthcare services wherever possible.

Rather than advocating a one-size-fits-all approach, the guide translates the principles of the Safe Hearts Plan into practical recommendations and encourages countries to tailor screening to their own populations while using validated cardiovascular risk assessment tools to support clinical decision-making.

Health checks should include a concise but effective set of measurements, such as blood pressure, lipid profile, blood glucose, body mass index and smoking status. And, crucially, they should not end once those measurements have been taken. Screening programmes need clear referral pathways so that individuals identified at increased risk receive appropriate follow-up, lifestyle support and, when necessary, medical treatment.

This is precisely where JACARDI is helping bridge the gap between European policy and everyday practice. The guide also encourages countries to integrate health checks into existing health services and, where appropriate, community and workplace settings, making screening more accessible and sustainable.

Testing screening approaches in different settings

Across 19 screening pilots under the Work Package on screening, partners are testing different approaches in hospitals, primary care and community settings, reaching diverse population groups through both systematic and opportunistic screening. These pilots are not only evaluating which models are most effective, but also exploring how health checks can increase awareness of cardiovascular risk factors and encourage people to know their numbers before disease develops. This practical experience is helping generate evidence that can support the implementation of the EU protocol on health checks.

“By testing a variety of strategies, such as opportunistic screening in community settings and systematic screening in clinical environments, JACARDI pilots transform these ‘silent’ risks into actionable health information. These pilots also serve as awareness-raising campaigns, educating communities on CVD risk factors and the importance of knowing one’s numbers. Furthermore, it is essential to build integrated care pathways into these procedures to ensure that individuals receive the necessary follow-up, whether that involves lifestyle counseling or medical treatment,” Hanna Tolonen notes.

The diversity of these pilots reflects how European recommendations of the Safe Hearts Plan can be adapted to local realities. In Ukraine, JACARDI is supporting efforts to strengthen cardiovascular prevention by promoting community-based screening approaches, improving health literacy and fostering collaboration between national and international public health institutions [4].

In Calabria, southern Italy, free community health screening initiatives are bringing cardiovascular and diabetes prevention closer to citizens, demonstrating how local engagement can increase participation while identifying people at increased risk before symptoms appear.

Effective health checks reflect real-world needs

For patient organisations, the success of health checks will ultimately be measured not by the number of people screened, but by what happens afterwards.

As Neil Johnson, Founder and Executive Director of Global Heart Hub, explains: “The effectiveness of health checks will depend on more than clinical targets. Patient insights and experiences need to be centrally embedded in their design and delivery so as to reflect real-world needs, barriers and realities. Health checks need to be far more than just tests; they need to lead the pathway to prevention, early detection and equitable access to timely treatment.”

His message echoes one of JACARDI’s central recommendations: screening is only effective when it forms part of an integrated pathway of care. A blood pressure reading or cholesterol measurement, valuable as they are, cannot improve health on their own. They must lead to informed decisions, preventive interventions and long-term support.

As Europe prepares to implement the Safe Hearts Plan, that may be the most important lesson of all. The evidence already exists, practical solutions are being tested across JACARDI’s pilot sites, and Member States are increasingly committed to strengthening prevention. The next challenge is ensuring that every health check becomes more than a test, it becomes the first step towards a healthier future.

Sources:
[1] OECD (2025), The State of Cardiovascular Health in the European Union, OECD Publishing, Paris
[2] Safe Hearts Plan; Directorate-General for Health and Food Safety, European Commission. 16 December 2025.
[3] Leysen, W., Cardinale, A., Alexandra, C., Lampaert, A., Formenti, B., Armocida, B., Marcozzi, B., Angheluta, C., Dima, C., Giacomozzi, C., Rantala, E., Monnet, F., Calcagnini, G., Elonheimo, H., Zaletel, J., Vergauwen, J., Paalanen, L., Palmieri, L., Petrelli, M., Tolonen, H. (2026). Short Guide to Screening Individuals at Increased Risk of Developing CVDs and T2D (Version 1.0.0). Zenodo.
[4] Evaluation of Preparedness and Capacity of Primary Healthcare Facilities in Khmelnytskyi Region to Provide Extended Scope of Services Related To Type 2 Diabetes Prevention, Screening and Control, o High-Risk Groups; Pilot survey report. Nataliia Hryb, Tetiana Ruda, Yuliia Arabska, Maryna Halchenko. Кyiv 2025.

The illustration in this article was created using generative AI under human direction and editorial review.

Smarter screening, stronger prevention: JACARDI at ESC Congress 2026

At the ESC Congress 2026 in Munich, held from 28 to 31 August, Hanna Tolonen and Héctor Bueno brought the JACARDI perspective to the debate on the future of cardiovascular prevention in Europe, highlighting how smarter screening, early detection and better use of data can help turn the Safe Hearts Plan into practical action. These themes take on added relevance ahead of the first EU Screening Week, a European Commission initiative placing prevention and earlier detection of cardiovascular risk in the spotlight.

An estimated 80% of cardiovascular disease is preventable, according to the World Heart Federation [1]. Addressing modifiable risk factors, improving awareness and identifying people at increased risk earlier are therefore central to reducing the burden of cardiovascular disease.

Prevention moves upstream: first EU Screening Week

This focus on prevention and early detection is particularly timely as Europe prepares to mark the first EU Screening Week, taking place from 28 September to 4 October 2026. The initiative, launched by the European Commission, aims to raise awareness of the importance of screening and early detection as part of a stronger approach to prevention and population health. Its timing also provides a timely link to World Heart Day on 29 September and to the objectives of the Safe Hearts Plan.

These issues were at the heart of the ESC TV Connect discussion Safe Hearts, smarter screening: Transforming cardiovascular prevention in Europe, held during the European Society of Cardiology’s annual congress and moderated by Héctor Bueno, cardiologist and Scientific Director of the Cardiovascular Research Area at the i+12 Research Institute, Hospital Universitario 12 de Octubre, in Madrid; co-leader of the JACARDI working group on data availability and quality; and leader of a research group at CNIC.

Hanna Tolonen, Deputy Director General at the Finnish Institute for Health and Welfare (THL) and co-leader of the JACARDI working group on screening, joined Mélodie Bernaux, Policy Officer for Digital Health at the European Commission, to discuss the implementation of the Safe Hearts Plan and the role of smarter screening in strengthening cardiovascular prevention.

Why early detection matters

For Hanna Tolonen, the discussion underlined the need to move further towards prevention. She highlighted JACARDI’s contribution to increasing population awareness of cardiovascular diseases, supporting early detection and screening of people at high risk, and advancing the implementation of integrated care.

Hanna Tolonen described the benefits of early detection at three levels: for individuals, society and healthcare systems. Identifying risk factors early can help prevent disease and improve the health and well-being of individuals and their families. It also benefits society by helping people remain healthy and active, particularly as many develop cardiovascular disease during their prime working years, when they make important contributions to the workforce and their communities.

At the healthcare-system level, Tolonen noted that treating hypertension is considerably more effective and cost-effective than caring for a stroke patient in intensive care and providing subsequent rehabilitation. As Europe’s population ages, she said, reaching people at high risk before they develop cardiovascular disease will become increasingly important.

From European ambition to practical action

The Safe Hearts Plan provides a framework for stronger action on cardiovascular health, including a more coordinated approach to early detection and health checks across Europe. JACARDI is already generating practical knowledge that can contribute to this ambition.

Through its screening work, JACARDI is working on approaches to identify people and population groups at increased risk of cardiovascular diseases and type 2 diabetes. Its activities are testing how risk assessment and screening approaches can be implemented in different real-world settings and adapted to different populations and health systems.

Bringing health checks closer to people

One of the clearest lessons from JACARDI’s work, Tolonen explained, is that health checks need to be brought closer to people rather than relying on them to attend healthcare facilities. Mobile units and drop-in checks in accessible settings such as community centres can help overcome practical and trust-related barriers, making it easier to reach people who might otherwise be excluded from screening.

A key resource from this work is the ‘Short Guide to Screening for Individuals at Increased Risk of Developing Cardiovascular Diseases and Type 2 Diabetes’, published by JACARDI in January 2026. [2] Developed by JACARDI experts, including Hanna Tolonen, the guide provides a practical, evidence-based overview of approaches such as population-level monitoring, individual risk assessment, population segmentation and screening. It also stresses that identifying risk is only one part of the process: when risk identification is used to support earlier diagnosis or prevention, it needs to be linked to appropriate follow-up, diagnosis and intervention.

Data as a foundation for smarter prevention

New technologies, including artificial intelligence (AI), have significant potential to support cardiovascular and wider non-communicable disease prevention. But their effectiveness depends on the quality and representativeness of the data behind them. As Hanna Tolonen pointed out, healthcare data cannot automatically be considered representative population data, and ensuring that datasets adequately reflect different population groups remains a major challenge.

This connects directly with JACARDI’s work on data availability, quality, accessibility and sharing, which focuses on strengthening the foundations for better use of health data. Better data can support a clearer understanding of cardiovascular risk and help researchers, health professionals and policymakers develop and evaluate more effective prevention strategies.

But data alone is not enough: it needs to support action. “Effective screening does not end with a health check. We need follow-up, interventions and monitoring,” Héctor Bueno, who moderated the ESC TV Connect discussion, stressed, also pointing to the importance of data and digital tools in achieving a measurable impact on health.

Mélodie Bernaux also highlighted the role of AI in implementing the Safe Hearts Plan and pointed to the Plan’s dedicated AI incubator for cardiovascular health, which will provide €20 million to test how AI models can be deployed and integrated into clinical workflows. ‘Data and AI today are fundamental when we talk about healthcare’, she said, while stressing the need to carefully address the risks associated with these technologies.

Watch the full ESC TV Connect discussion to hear more about how the Safe Hearts Plan and JACARDI can help translate prevention, early detection, equitable health checks and the responsible use of data and AI into action across Europe.

References:
[1] World Heart Federation, Heart Health
[2] Leysen, W., Cardinale, A., Alexandra, C., Lampaert, A., Formenti, B., Armocida, B., Marcozzi, B., Angheluta, C., Dima, C., Giacomozzi, C., Rantala, E., Monnet, F., Calcagnini, G., Elonheimo, H., Zaletel, J., Vergauwen, J., Paalanen, L., Palmieri, L., Petrelli, M., … Tolonen, H. (2026). Short Guide to Screening Individuals at Increased Risk of Developing CVDs and T2D (Version 1.0.0). Zenodo