The invisible shift that marks a woman’s heart forever 🫀 

Hot flashes, mood changes and sleep disturbances are often associated with menopause. But the real, silent threat may lie deeper: the cardiovascular system. Cardiovascular disease (CVD) remains the leading cause of death among postmenopausal women, yet awareness is still low.

Women typically develop heart disease later than men, thanks to the vascular protection offered by estrogen during their reproductive years. But once this hormonal shield declines, risk rises sharply. Estrogen helps regulate lipids, supports endothelial function, and controls inflammation. Without it, LDL cholesterol increases, arteries stiffen, and insulin resistance becomes more common.

📉 Menopause increases risk factors

As highlighted in research developed in Poland [1], the menopausal period is a critical window for cardiovascular risk acceleration. Several factors emerge or intensify during this time: lipid disorders, type 2 diabetes, obesity, hypertension, and lifestyle issues like smoking and physical inactivity. In simple terms, during menopause the body experiences more “wear and tear” at the cellular level (known as oxidative stress), and the nervous system becomes more active, which can tighten blood vessels. Substances like endothelin also cause blood vessels to narrow. All these changes can irritate the blood vessel walls and make them stiffer over time.

Physiologically, there’s also a rise in oxidative stress, sympathetic nervous activity, and vasoconstrictive agents like endothelin, contributing to vascular inflammation and arterial remodeling.

Hypertension, in particular, is often underdiagnosed and undertreated in women. In developed countries, about 30% of adult women live with it, many unknowingly. Postmenopausal women are twice as likely to develop hypertension compared to premenopausal women, and even borderline cases can cause more vascular damage in women than in men [2].

This hormonal shift doesn’t just mark the end of fertility, it fundamentally rewires the cardiovascular system. A meta-analysis confirmed that women with early menopause (before age 45) face a higher risk of hypertension, likely due to a steeper drop in estrogen and a lower estrogen-to-androgen ratio [3]. Regular monitoring and healthy lifestyle habits, such as exercise and a balanced diet, are crucial to managing these risks and maintaining heart health.

A gap that matters

Despite strong evidence, most cardiovascular risk assessments still overlook menopause as a critical factor. This oversight leaves many women underdiagnosed during a key phase of vulnerability. Menopause must be seen as a cardiovascular checkpoint. Risk models should integrate hormonal status, and clinicians should tailor prevention, screening, and even hormone therapy decisions with heart health in mind.

That’s where JACARDI comes in. One of the core objectives of the joint action is to address gender-specific gaps in cardiovascular care, including the urgent need to improve outcomes for women in midlife. Menopause can no longer be left out of the cardiovascular conversation.

Let’s bridge the gap. Women’s hearts deserve it!

#JACARDI #EU4Health #CardiovascularHealth #WomensHealth #MenopauseAwareness

Sources: 

[1] Ryczkowska K, Adach W, Janikowski K, Banach M, Bielecka-Dabrowa A. Menopause and women’s cardiovascular health: is it really an obvious relationship? Archives of Medical Science. 2023;19(2):458-466. https://doi.org/10.5114/aoms/157308 

[2] Miller, V. M., Lahr, B. D., Bailey, K. R., Heit, J. A., Harman, S. M., & Jayachandran, M. (2015). Longitudinal effects of menopausal hormone treatments on platelet characteristics and cell-derived microvesicles. Platelets, 27(1), 32–42. https://doi.org/10.3109/09537104.2015.1023273 

[3] Anagnostis, P., Theocharis, P., Lallas, K., Konstantis, G., Mastrogiannis, K., Bosdou, J. K., … & Goulis, D. G. (2020). Early menopause is associated with increased risk of arterial hypertension: a systematic review and meta-analysis. Maturitas, 135, 74-79. https://doi.org/10.1016/j.maturitas.2020.03.006

European countries unite in Madrid to tackle health inequalities at the General Assembly of JACARDI

From 14 to 16 October 2025, Madrid hosts the third General Assembly of the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), gathering more than 200 participants from 21 European countries

• Discussions centre on health, equity, gender disparities, monitoring systems, sustainability across all the “patient journey”, and the forthcoming EU Cardiovascular Health Plan.
• High-level institutional representatives, including the European Commission, the WHO Regional Office for Europe and health authorities from Spain, together with key experts and representatives from the scientific and civil society, deliver keynote speeches setting the stage for dialogue with the aim to strengthen collaboration to reduce the burden of non-communicable diseases across Europe

Madrid, Spain – Equity in health remains one of Europe’s most pressing challenges. Differences in access to care, diagnosis, and treatment continue to shape health outcomes across the region. Gender is emerging as a particularly critical dimension, as women in Europe face worse outcomes in cardiovascular disease, from higher mortality after heart attacks to longer delays in receiving treatment. Furthermore, data from the European Society of Cardiology (ESC Atlas of Cardiology) reveals that 40% of women in the EU die from cardiovascular disease.

This challenging reality is at the centre of discussions at the Third General Assembly of the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), taking place in Madrid from 14 to 16 October and hosted at the Spanish Ministry of Health and the Ilustre Colegio Oficial de Médicos de Madrid.

The Assembly brings together more than 200 representatives from 21 European countries, including the European Commission, the WHO Regional Office for Europe, scientific societies, and patient organisations. This year’s programme places gender and equity at the heart of the agenda, alongside sustainability, data monitoring, and the forthcoming EU Cardiovascular Health Plan.

With equal access to prevention and care at the forefront, participants reflect on the progress made during the first two years of JACARDI to highlight lessons learned and barriers tackled while improving care pathways in diverse settings across European health systems. 

“At the heart of JACARDI is the belief that health systems must serve everyone, fairly and equally. That’s why equity and diversity are not side topics in JACARDI, they are central to everything we do. This General Assembly in Madrid is an opportunity to show that together we can accelerate the shift towards a more equitable and healthier future”, adds Dr Benedetta Armocida, JACARDI’s Coordinator.

“Women are more likely to die from a heart attack and yet remain underrepresented in clinical trials, leaving critical knowledge gaps that perpetuate unequal care. Recognising gender differences in cardiovascular disease is not about division, it is about improving care to meet the unique needs of everyone”, says Dr Héctor Bueno, co-leader of JACARDI’s Work Package on data availability and quality and group leader of the Multidisciplinary Translational Cardiovascular Research at the Spanish National Centre for Cardiovascular Research (CNIC).

In the spotlight: The Cardiovascular Health Plan

The meeting takes place at a pivotal moment as the European Commission prepares the Cardiovascular Health Plan. By connecting JACARDI’s insights and pilot experiences to this political momentum, the Assembly intends to strengthen motivation, collaboration, and collective capacity to reduce the burden of non-communicable diseases across Europe. To this end, there is a dedicated roundtable during the event focusing on the EU Cardiovascular Health Plan, featuring representatives from DG SANTE (the European Commission’s Directorate-General for Health and Food Safety), the European Public Health Alliance (EPHA), and scientific societies such as the European Society of Cardiology, the European Heart Network, the European Diabetes Forum and the International Diabetes Federation. 

Contributions from WHO Regional Office for Europe and the JA PreventNCD initiative on monitoring systems and reducing health inequities are included on the agenda as well as pilot experiences from Portugal, Spain, Iceland, Romania, Belgium, Ireland, Italy and Poland, highlighting early results from JACARDI’s 143 pilot projects.

The agenda also explores sustainability and the translation of evidence into policy, ensuring that JACARDI’s pilot actions contribute to long-term change. On October 15 and 16, dedicated sessions explore specific focus areas, such as health literacy, integrated care pathways, data accessibility, and patient self-management. These workshops are designed to facilitate in-depth discussions and promote actionable insights to enhance health outcomes across Europe.

About JACARDI:

JACARDI, a Joint Action of the European Union, is a collaborative initiative aimed at addressing the rising prevalence of cardiovascular diseases and diabetes. Through coordinated efforts among European member states, the program focuses on evidence-based strategies and best practices to prevent and manage non-communicable diseases effectively. JACARDI is conducting 143 pilots to test evidence-based practices for preventing and managing cardiovascular disease and diabetes, with 81 partner institutions across 21 European countries.

Adopting tailored interprofessional protocols in general practice

Scientific publications by JACARDI  

In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.  

We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe. 

Stay informed on how JACARDI turns evidence into action.

Authors: Laurent Desmet, Eva Goossens, Peter Van Bogaert and Katrien Danhieux

Abstract:

Background As the burden of non-communicable diseases continues to rise, general practices in primary care face increasing challenges in delivering high-quality care while managing workload constraints. Interprofessional care models, supported by practice-tailored protocols, offer a promising approach to optimizing task shifting and enhancing care coordination. However, the transition towards protocol-based interprofessional care remains complex and understudied.
Objective This study explores the experiences of general practices in developing and implementing practicetailored protocols to facilitate interprofessional care. Using the Consolidated Framework for Implementation Research (CFIR), we identify key barriers, facilitators and strategies that support this transition.
Method We conducted a qualitative study in Flanders, Belgium, using semi-structured interviews with 33 healthcare providers from 18 general practices. Participants represented various disciplines, including general practitioners, nurses, dietitians and reception staff. A hybrid qualitative analysis was applied, beginning with an inductive analysis based on Braun and Clarke’s thematic approach, followed by a deductive phase guided by the CFIR-framework.
Results The findings highlight several key factors influencing the development and implementation of practicetailored protocols in general practices. Participants emphasized that clear task allocation and communication structures within protocols improved care coordination. External factors, such as financial constraints and high workloads, posed challenges, whereas collaborations with external healthcare providers facilitated interprofessional teamwork. Internal practice dynamics, including a shared vision, mutual trust, and structured team meetings, were identified as crucial enablers. At the individual level, motivation to adopt protocols varies, with some physicians expressing reluctance due to concerns about shifting patient relationships and increasing complexity in their caseloads. The implementation process benefited from a stepwise approach guided by a team leader, clear goal
setting, continuous evaluation and peer learning.

Source: https://link.springer.com/article/10.1186/s12913-025-13424-y

Evaluating the effectiveness of lifestyle education for individuals at increased risk of type 2 diabetes and cardiovascular diseases(Halt2Diabetes)

Scientific publications by JACARDI

In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.  

We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe. 

Stay informed on how JACARDI turns evidence into action. 

Authors: Jorik Vergauwen, Fanny Monnet, Josefien Van Olmen, Edwin Wouters, Katrien Danhieux, Laurent Desmet, Monika Martens, Ruth Verdegem, Justine Vanhaecke, Aurélie Lampaert, Sabine Verstraete, Inge Everaert and William Leysen

Abstract:

Background Halt2Diabetes is a prevention initiative in Flanders, Belgium, targeting the rising prevalence of type 2 diabetes (T2D) and cardiovascular diseases (CVDs). The program uses a two-step approach to identify high-risk individuals and guide them towards healthier lifestyles, reducing T2D and CVD risk factors. Building on evidence that lifestyle interventions can prevent both conditions by addressing modifiable risk factors, this research evaluates the effectiveness of Halt2Diabetes as a scalable real-world intervention and its potential as a blueprint for other contexts.
Methods The Halt2Diabetes program identifies high-risk individuals using the Finnish Diabetes Risk Score (FINDRISC) through an online risk assessment tool. Eligible participants, referred by general practitioners, participate in six groupbased lifestyle guidance sessions led by trained dietitians, focusing on healthy eating, physical activity, and behavior modification. This longitudinal study employs repeated measurements at five time points over 18 months. Primary outcomes include changes in body weight, waist circumference, and hemoglobin A1c (HbA1c) levels. Secondary outcomes encompass blood pressure, cholesterol levels, physical activity, and dietary habits. Data collection involves self-reported questionnaires, biochemical measures, and anthropometric assessments. Analysis will examine longitudinal changes in health and behavioral outcomes among participants.
Discussion This study will provide evidence for the real-world effectiveness of Halt2Diabetes in promoting sustained lifestyle changes and reducing T2D and CVD risk factors. Despite challenges including participation barriers and data integration needs, the program’s scalable, digitalized risk assessment model shows promise for broader application.

Source: https://link.springer.com/article/10.1186/s12889-025-24462-w

More than cancer: The silent epidemic in Europe 

“I almost didn’t see my daughter graduate.” Alice, a 45-year-old mother of two, was the picture of health, or so she thought. Until one day, a sudden heart attack left her in the ICU, fighting for her life. Like many others, Alice was unaware of her cardiovascular risk factors. Her story is a stark reminder of the silent epidemic plaguing Europe: cardiovascular disease (CVD). Historically, CVD has been the leading cause of death in the European Union, claiming over 1.8 million lives annually and affecting more than 60 million people. [1],[2] Recent improvements in cardiovascular care in some countries highlight progress, but the burden of CVD remains unparalleled.

Despite its massive toll, CVD lacks the policy attention it deserves. Rising obesity and diabetes rates, particularly among younger populations, are fueling this crisis, while the decline in mortality rates has slowed alarmingly. Marleen Kestens, Manager of CVD Prevention Policies at the European Heart Network (EHN), underscores this urgency:

“CVD remains the leading cause of death in the EU, surpassing cancer and diabetes, yet it has long lacked the policy attention it urgently requires. The progress achieved through Europe’s Beating Cancer Plan presents a clear opportunity: its lessons, good practices, and even its unimplemented measures on prevention and nutrition can help shape an effective Cardiovascular Health (CVH) Plan. With up to 80% of premature CVD deaths being preventable through public health measures and/or preventative treatment, the time to act is now to make the healthy choice the default choice.” 

A blueprint for action

The success of Europe’s Beating Cancer Plan, reflected in the fact that over 90% of its actions are completed or well underway. Council Recommendations on cancer screening, on vaccine-preventable cancers, and on smoke- and aerosol-free environments provide recommendations to Member States and are extending access to important tools such as cancer screening, Human Papillomavirus and Hepatitis B vaccination, and strengthening protection from cancer risk factors such as tobacco. [3] 

These principles are equally vital for tackling CVD. JACARDI is committed to building on this momentum. By collaborating with organizations like EHN and supporting the European Alliance for Cardiovascular Health (EACH)’s roadmap, JACARDI aims to promote preventative care and education, advocate for evidence-based policy changes, and foster partnerships to enhance cardiovascular health across Europe.

For the Coordination Team of JACARDI, “the current policy momentum presents a pivotal opportunity to advance the development and implementation of a dedicated EU Cardiovascular Health Plan. Building on the achievements and lessons of Europe’s Beating Cancer Plan, such a framework must be tailored to the distinct complexities of cardiovascular disease prevention, early detection, and integrated care. We strongly endorse this strategic direction. We are firmly committed to contributing to and advocating for a comprehensive, equity-driven EU response.”

Central to JACARDI’s mission is the promotion of equity and diversity inclusion, grounded in gender-responsive and context-specific approaches. “We believe that only by embedding these principles at every level of policy and practice can we truly reduce the burden of cardiovascular diseases and diabetes, and ensure that no one is left behind,” explain the members of JACARDI’s Coordination Team.

Aligned with JACARDI’s vision, EACH envisions a future where, by 2030, premature and preventable deaths from CVD are reduced by one-third [4]. This ambitious goal aligns with Sustainable Development Goal Target 3.4 and prioritizes access to high-quality risk assessments, personalized care pathways, and reduction of health inequalities across Europe.

Turning vision into reality

Alice’s story, though fictional, represents the reality faced by millions. CVD is a silent epidemic, but it doesn’t have to remain that way. By learning from the successes of Europe’s Beating Cancer Plan and implementing a robust Cardiovascular Health Plan, fewer lives will be lost to preventable cardiovascular conditions. Together, we can make cardiovascular health a priority across Europe and create a future where the healthy choice becomes the default choice.

About the CVH Plan

The European Commission is currently developing the European Cardiovascular Health Plan (CVH Plan) to address Europe’s leading cause of death. In parallel, the European Alliance for Cardiovascular Health (EACH) has published A European Cardiovascular Health Plan: The Roadmap, which sets out a shared vision and concrete recommendations to reduce premature and preventable cardiovascular deaths by one third by 2030. Together, these efforts aim to ensure universal access to risk assessments, patient-centred care, and comprehensive strategies for prevention, diagnosis, treatment, and rehabilitation. Learn more.

Sources: 

[1] Fighting cardiovascular disease – a blueprint for EU action, June 2020. European Heart Network and the European Society of Cardiology. https://ehnheart.org/about-cvd/eu-action-on-cvd/ 

[2] Samuel Chin Wei Tan, Bin-Bin Zheng, Mae-Ling Tang, Hongyuan Chu, Yun-Tao Zhao, Cuilian Weng, Global Burden of Cardiovascular Diseases and its Risk Factors, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021, QJM: An International Journal of Medicine, 2025; hcaf022, https://doi.org/10.1093/qjmed/hcaf022

[3] Europe’s Beating Cancer Plan: a comprehensive action plan working hand in hand with the Cancer Mission. European Observatory on Health Systems and Policies: Domenico Fiorenza Glanzmann, Vittoria Carraro, Philippe Roux; CC BY-NC-SA 3.0 IGO. 12 March 2025, https://iris.who.int/bitstream/handle/10665/380751/Eurohealth-31-1-6-eng.pdf?sequence=1 

[4] A European Cardiovascular Health Plan: The need and the ambition, May 2022. European Alliance for Cardiovascular Health (EACH). https://www.cardiovascular-alliance.eu/wp-content/uploads/2022/05/EACH-Plan-Final_130522.pdf 

Bridging Borders: promoting public health across cultures

Katarzyna Brukało is an Assistant Professor at the Faculty of Public Health, Medical University of Silesia (SUM) in Katowice, Poland. She is a public health and dietetics specialist with over 15 years of academic and research experience. Her current work focuses on innovative approaches to NCD prevention, health promotion, and evidence-based policy. She is actively involved in EU and WHO projects such as JAHEE, Best Re-MaP, Health4EUkids, JACARDI, and JA PreventNCD.

You lead 15 very diverse pilot projects in JA PreventNCD, all centered around the concept of healthy living environments. Why is working at the local level so important, and what impact do you hope these pilots will have?

Our work package is very broad, because we have 15 pilot projects that are all very different. For example, we are adapting breastfeeding best practices from our Norwegian partners and implementing them in Greece. These are two very different contexts, with different conditions, and we also have pilots that promote drinking tap water, among many other activities.

What’s important is that all of these are implemented at the local level. This means we are close to the communities, close to the citizens, and that’s where we can make the biggest impact. Local governments and local structures have real power, and when we use this effectively, we can build on this work to make an impact on national policies as well. It’s like a puzzle: each pilot is one piece, and together they create the bigger picture.

Looking at the bigger picture, what is your dream result at the end of this project journey?

Our vision is not that Norway should become like Greece, or Greece like Norway. Instead, the real goal is that we learn from one another, build a good professional relationship with the facilitators, understand each other’s barriers, and use this knowledge to build responsible, community-based public health initiatives based on peer learning.

SUM University is also active in JACARDI. How do JACARDI and Prevent NCDs complement each other, and what added value do they bring when combined?

It’s very valuable that we are part of both Joint Actions, which we often call sister actions. JACARDI focuses mainly on cardiovascular diseases and type 2 diabetes, while Prevent NCDs addresses non-communicable diseases more broadly, including cancer.

Together, they allow us to tackle the full spectrum of non-communicable diseases. Only by acting together can we make a real impact, not just at the national level but also internationally.

You are known as an engaging communicator. How would you inspire others to make public health messages resonate?

For me, the key in communicating about public health is to be clear and responsible. We need to stand behind every word we say, because mistakes can lead to misinformation or even fuel fake news.

It’s also important to stay open to discussion, even engage in difficult debates and tough questions. Hard questions mean people are listening, reflecting, and engaging with what we say. That is, after all, why it is called public health, because it is for the public, and it must involve the public. Communication is central to this: raising awareness, building health literacy, and empowering people to understand their options.

About the JACARDI & JA PreventNCD collaboration:

The two projects are part of a broader network of European Union initiatives aimed at tackling non-communicable diseases (NCDs) and promoting public health. They work together to share knowledge, strategies, and resources, thereby amplifying their impact across the EU. By harnessing the synergies of these collaborative efforts, we can enhance the effectiveness of our initiatives, ensuring a more comprehensive approach to NCD prevention-and management, as well as health promotion.Explore more about the work of PreventNCDs here.

New online risk test by the Finnish Diabetes Association garners over 120,000 users in just one month

A groundbreaking new digital health initiative in Finland is empowering individuals to assess their risk of developing some of the country’s most common chronic illnesses, all from the comfort of their homes. This tool has been developed as part of a pilot program within JACARDI’s Work Package on screening by the Finnish Institute for Health and Welfare (THL) and the Finnish Diabetes Association.

The new online risk test has already garnered over 120,000 users in just one month, signaling a widespread public interest. In fact, drawing from extensive population-level health data, the tool estimates a person’s likelihood of developing: type 2 diabetes, cardiovascular diseases, and memory disorders (such as dementia). The risk for type 2 diabetes and heart disease is projected over 10 years, while memory disorders are evaluated over a 20-year timeline.

The test was developed by a team of experts, including Prof. Jaana Lindström, Research Manager at THL and Sari Koski, Director of Diabetes Courses and Knowledge Production at the Finnish Diabetes Association, under JACARDI’s Work Package on Screening, led by Hanna Tolonen from THL. It does not function as a diagnostic tool, yet it offers a general risk assessment based on an individual’s lifestyle and health background, providing valuable insights even before symptoms emerge. It is especially helpful for individuals who may not yet have access to clinical testing or regular medical evaluations.

The test is available online and can be completed in minutes, anonymously and free of charge. It is designed for adults of all ages and is especially relevant for those who are unaware of their risk factors. It can be used independently at home.

Each user receives a personalized summary of their risk, along with science-backed lifestyle suggestions. These include advice in areas, such as diet and nutrition, physical activity, sleep and recovery, and stress management.

By taking the test, individuals are encouraged to make small but impactful changes to their daily habits, changes that could significantly reduce their chances of developing chronic illnesses in the future.

Since its launch in late May 2025, the test has exceeded expectations; the section related to memory disorders has seen particularly high engagement.

This level of adoption underscores a growing interest among the Finnish population in self-directed health promotion and self-care. The success of the initiative also reflects how digital tools can complement traditional healthcare services by raising awareness, prompting early action, and reducing long-term healthcare costs.

Health authorities are enthusiastic about the test’s potential. Prof. Jaana Lindström, from THL, emphasized its preventive power, stating that recognizing risk is key to taking action in time.

Sari Koski, representing the Finnish Diabetes Association, highlighted the importance of modest lifestyle adjustments by saying that even small changes can lead to significant health benefits over time.

This perspective is supported by stark national statistics. Every year in Finland:

• Approximately 23,000 people are diagnosed with type 2 diabetes
• Around 22,000 with coronary artery disease
• About 23,000 begin experiencing memory-related disorders

These figures underline the urgent need for tools that enhance citizens’ awareness of chronic disease risk factors and promote early detection and lifestyle interventions.

For this reason, the launch of this new test quickly gained widespread attention, as the campaign was covered extensively by both major national and local media outlets across Finland. Leading publications highlighted the test’s potential to empower individuals to take control of their health. Regional news platforms played a key role in disseminating the information, ensuring that citizens across the country, from urban centers to rural municipalities, were informed about the tool.

The risk test serves not only as a personal wellness tool but also as a potential model for broader public health efforts. This strategy is not only beneficial for the individual but also contributes to the sustainability of the healthcare system.

Moreover, initiatives like this one are economically sensible: they help curb the rising costs of treating chronic conditions and allow more people to stay healthier and more productive for longer.

Finland’s new online risk test represents a timely and impactful tool for public health promotion. While not a replacement for medical diagnosis, it opens the door to greater personal responsibility and awareness. By bridging digital innovation with health promotion, it empowers citizens to act before illness strikes, and that might just be the key to a healthier future for all.

“There is a positive story to be told here” — what we learned at the DigiCare4You Workshop

In line with HaDEA’s commitment to foster synergies and share knowledge across EU health initiatives, JACARDI actively engages with a wide portfolio of projects – from Joint Actions and EU4Health grants to Horizon-funded interventions. JACARDI team members recently attended the DigiCare4You Capacity Building and Recommendations Development Workshop with International Stakeholders, held in Lisbon during the annual ICIC conference.

The event underscored how ongoing stakeholder engagement is vital to disseminate results, explore upscaling opportunities, develop evidence-based national policies and lay the groundwork for future cross-country collaborations. We invite readers to learn more about this ambitious intervention – running in parallel to our own pilot implementations – which is already demonstrating early results, implementation insights, and an inspiring commitment to meaningful change in health self-management.

A people-centric, digital health solution for preventing and managing diabetes and hypertension

The Horizon2020-funded DigiCare4You project offers a new model for the early prevention and management of type 2 diabetes (T2D) and hypertension (HTN) by engaging schools, communities, and healthcare systems in an intersectoral approach. At its core, the project empowers families and connects health and education sectors, equipping individuals with digital tools to better manage their health.Building on the evidence-based Feel4Diabetes study, DigiCare4You is being implemented in two high-income (Greece, Spain) and two middle-income countries (Albania, Bulgaria), targeting over 10,000 families across socio-economic groups.

Screen, support, empower – the DigiCare4You approach

DigiCare4You applies a two-step screening model leveraging existing child growth monitoring activities in schools and health centers through which parents and caregivers are approached to complete the FINDRISC questionnaire as the first screening step. Adults identified as at risk are then referred for a second screening, which includes anthropometric and clinical assessments to detect conditions such as prediabetes, type 2 diabetes, or hypertension.

Those confirmed at risk are subsequently invited to join the DigiCare4You two-year, mHealth-supported intervention programme, focused on lifestyle change, self-management, and family support. A multilingual mobile app offers access to health data, tracking tools, and educational resources and even recipies. Importantly, the intervention supports healthier behaviors in both adults and children through school and community-based activities.

DigiCare4You combines digital innovation, equity-driven outreach, and participatory research, while integrating into existing systems and investing in health professional training – ensuring sustainable, real-world impact.

Early results revealed: first findings inspire confidence

The Capacity Building and Recommendations Development (CBRD) Workshop gathered international experts at the midpoint of project implementation to review progress and shape the upcoming Roadmap for Scale-Up.Prof. Brian Oldenburg elevated the spirit of the event stating that: “Early findings are promising enough to say that there is a positive story to be told here.” Indeed, early results are compelling:

• Fewer adults with intermediate hyperglycaemia progressed to T2D; many returned to normal glucose levels.
• Participants with T2D improved their HbA1c.
• Adults with obesity experienced weight loss, BMI reduction, and lower cholesterol—without increased medication reliance.

From research to real-world impact

The workshop emphasized the transition from effectiveness to implementation research – examining how interventions work in real-life conditions. Dr Rajesh Vedanthan facilitated a compelling discussion in which implementers candidly shared successes and challenges.

Key takeaways from country implementers:

• Strong consensus: “Yes, we would start and do it again.”
• Motivation stems from seeing behavior change within families—especially when children and caregivers reinforce each other’s progress.
• Burnout among healthcare staff is a concern—but aligning DigiCare4You with existing systems proved an effective strategy.
• Local ownership and trust, especially through primary care systems and schools, were pivotal.
• Participants emphasized the importance of engaging families holistically, with one Bulgarian team member noting how “changing the behavior at home” can be one of the most lasting outcomes.

Additionally, one noted barrier to engagement was previous unsuccessful attempts at weight control, highlighting the need for tailored motivational support.

Cost-effectiveness, scalability, and the road ahead

Preliminary analyses suggest strong cost-effectiveness, especially when targeting adults with intermediate hyperglycaemia in MICs. A Scalability Decision Support Tool was developed to assess implementation readiness across five domains: NCD care context, digital literacy, support systems, screening capacity, and digital integration. These insights inform the forthcoming Roadmap for Scale-Up.

JACARDI Relevance

The presence of experts involved in both JACARDI and DigiCare4You highlights the existence of a vibrant, cross-country network of professionals dedicated to cardiovascular and diabetes care. The workshop featured members of the JACARDI Stakeholder Advisory Board, including a policy advisor from the European Diabetes Federation, epidemiologist and researcher from EUPHA, healthcare professionals involved in the pilot implementation in Portugal, representatives from the industry developing digital tools, and communication experts. Together, these individuals demonstrate the strength of this interconnected community.

Such events provide valuable opportunities to learn, grow and exchange knowledge, and have the potential to shape and enhance the quality of ongoing interventions. Given the different timelines of these projects, the initial findings of the DigiCare4You project can provide valuable insights for the JACARDI teams, given that the implementation of the pilots has only just begun.

Looking ahead

In its final year, DigiCare4You will focus on completing the intervention, finalizing cost-effectiveness studies, and refining its scalability tools. A second CBRD workshop will present final results and a full Roadmap for Scale-Up, providing a concrete guide for policy and replication.

As the burden of type 2 diabetes (T2D) in Europe is expected to reach 72 million people by 2050, DigiCare4You is emerging as a promising prevention model. “We design a programme, and when we start to implement it, we are confronted with the reality on the ground. Reality is revealed, and we act according to people’s needs,” said Prof. Yannis Manios, Project Coordinator. Meeting people where they are – with empathy, innovation and commitment – may be the most powerful intervention of all.

Discover more about the DigiCare4You project here.

JACARDI’s voices on the scientific stage across Europe

The first half of 2025 has been a busy and productive time for JACARDI, with consortium members sharing key findings and pilot implementation highlights at leading scientific conferences across Europe. These contributions, spanning health literacy, integrated care, biomarker-based screening, and health economics, demonstrate the depth and scope of the work underway across multiple work packages.

Spotlight on ICIC25 – Lisbon, Portugal | May 14–16, 2025

JACARDI had a strong presence at the 25th International Conference on Integrated Care (ICIC25) with three distinct contributions representing different work packages:

Irati Erreguerena (Work Package 6 – Health literacy) delivered an oral presentation on a co-designed health literacy program for adolescents in the Basque Country, Spain. Her talk highlighted how WHO’s Health Literacy Development Model, and the Ophelia (Optimising Health Literacy and Access) co-design methodology were applied to empower younger populations with knowledge and tools for chronic disease prevention.

Yhasmine Hamu (Work Package 9 – Integrated care pathways) presented on the implementation of a value-based integrated care model, sharing strategies to address care fragmentation and improve outcomes for people with chronic conditions.

Gergely Varga (Representing both Work Package 9 – Integrated care pathways and Work Package 5 – Methodological framework) contributed a poster that outlined a situational analysis methodology designed to support integrated care.

Faculty of Public Health Summer Scientific Meeting – Dublin, Ireland | May 20–21, 2025

Sonja Moore (Work Package 8 – Screening) presented findings from a scoping literature review on the use of natriuretic peptides in cardiovascular risk stratification and management. Her poster focused on current strategies and approaches for using these biomarkers in patient populations without diagnosed heart failure, a topic gaining traction in preventive cardiology. The review aimed to inform more targeted screening protocols and identify gaps in clinical practice across Europe.

COMET Conference – Poznań, Poland | June 25–27, 2025

Richard Osborne (Work Package 6 – Health Literacy) represented JACARDI at the 23rd International and Interdisciplinary Conference on Communication, Medicine, and Ethics (COMET). His oral presentation focused on scaling up health literacy development as a strategy to prevent and manage non-communicable diseases. The talk stressed the need for strategic investment in communication and co-design at the system level.

1st European Public Health Economics Conference
– Palermo, Italy | June 26–27, 2025

Katie Ellwood (Work Package 8 – Screening) presented a pilot study from JACARDI aiming to establish the most cost-effective threshold for using NT-proBNP blood marker in cardiovascular disease (CVD) risk stratification. The analysis models the impact of different thresholds over a 30-year horizon in a large population cohort. This pioneering work within JACARDI bridges clinical practice with health economics, helping to inform sustainable, evidence-based screening strategies.

These scientific initiatives reflect JACARDI’s commitment to knowledge-sharing, collaboration, and measurable impact. Consortium members not only showcased research but also engaged with policymakers, practitioners, and academics, advancing the mission to improve cardiovascular and diabetes outcomes across Europe. The autumn season offers a variety of relevant conferences, kicking off right at the end of summer with the Congress of the European Society of Cardiology, taking place from 29 August to 1 September.

From evidence to impact: a united call for equity-driven and sustainable action on NCDs

• JACARDI, JA PreventNCD, WHO Europe, OECD and the European Commission’s DG SANTE have published a joint Comment in The Lancet Regional Health, based on the findings of the newly published report ‘Avoidable mortality, risk factors and policies for tackling NCDs: leveraging data for impact’, by WHO Europe.
• The Comment underscores the critical role of cross-national collaboration in translating WHO findings into actionable policies, with a focus on equity, data-driven solutions, and integrated care pathways.
• These organizations call for an accelerated, harmonised and equity-driven European agenda on non-communicable diseases.

Non-communicable diseases (NCDs) remain the leading cause of death and disability in Europe, and recent trends reveal both progress and setbacks. While tobacco use, hypertension prevalence, and alcohol consumption have declined since 2010, obesity and diabetes rates continue to rise alarmingly, and physical inactivity shows no signs of improvement. This mixed picture is compounded by a slowdown in the implementation of vital public health policies since the COVID-19 pandemic.

These findings are discussed in a Comment published in The Lancet Regional Health and developed through a collaborative effort bringing together JACARDI, JA PreventNCD, WHO Europe, OECD (Organisation for Economic Co-operation and Development), and the European Commission’s DG SANTE. The publication summarises the findings of the report Avoidable mortality, risk factors and policies for tackling noncommunicable diseases – leveraging data for impact: monitoring commitments in the WHO European Region ahead of the Fourth United Nations High-Level Meeting, by WHO Europe, reinforcing the urgency of renewed action. It emphasises the need for comprehensive solutions that prioritise strengthening health systems, accelerating the implementation of proven interventions, effective policies, and integrating equity-driven approaches.

The Comment presents key insights taken from the WHO Europe Report on the current state of NCD prevention and management in Europe. It highlights key challenges, such as the decline in the number of countries that have fully implemented NCD surveys, which fell from 28% in 2021 to 19% in 2023, and the reduction in the number of countries with operational multisectoral NCD strategies, which decreased from 60% to 55% during this period.

Despite these challenges, the authors note that 85% of European countries have adopted management guidelines for the four major NCDs: cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases; demonstrating significant foundational progress.

“These figures paint a complex picture. Despite decades of progress in reducing premature mortality from the four major NCDs prioritised by global agenda, currently the region is off track to meet its 2025 targets. Moreover, the rise in obesity and diabetes and the slowdown in policy implementation highlight the urgent need to reinvigorate our efforts”, comments first author Dr Benedetta Armocida, from the Department of Cardiovascular, Endocrine-metabolic Diseases and Aging at Istituto Superiore di Sanità-ISS, Rome (Italy) and Coordinator of JACARDI.

The Scientific Coordinator of JA PreventNCD, Prof Knut-Inge Klepp, concurs and is particularly concerned regarding the slowdown in the implementation of population level policy interventions:

“We know how critical such policies are if we are to succeed in having a significant and lasting impact across population groups in Europe. Inequalities in NCD-related health remain a key challenge across and within European countries”.

Driving change

The European Union’s flagship initiatives under the EU4Health Programme are pivotal in addressing these challenges. JACARDI and JA PreventNCD are at the forefront of strengthening cross-national collaboration and implementing integrated strategies for NCD prevention and management.

JA PreventNCD targets primary prevention by tackling root causes such as unhealthy diets, tobacco and alcohol use, and lack of physical activity. JACARDI, meanwhile, focuses on secondary and tertiary prevention, aiming to enhance outcomes for cardiovascular diseases and diabetes through evidence-based interventions and integrated care pathways. Together, these initiatives exemplify the EU’s commitment to tackling NCDs across the care continuum, supported by a combined budget of €160 million and participation from 27 European countries.

The WHO NCD Global Monitoring Framework, which includes nine global voluntary targets, notably the headline goal of a 25% reduction in premature mortality from NCDs by 2025, is about to expire. That is why the authors provide a clear roadmap for advancing the fight against NCDs, ensuring systematic policy implementation and strengthening data infrastructures to translate commitments into measurable health outcomes.

“There are no more excuses. We have the knowledge and the tools. What remains is the will to implement them swiftly and hold ourselves accountable for delivering real results. This is not just a matter of public health; this is a matter of justice, security, and competitiveness, and a shared future”, says Dr Hans Henri P. Kluge, World Health Organization Regional Director for Europe.

Armocida and Klepp underscore the power of collaboration in achieving meaningful change: “We truly believe this joint effort reflects the strength and unity across Europe, bringing together a diverse group of organisations, initiatives, and stakeholders committed to reducing the burden of NCDs. The collaborative authorship of this Comment itself serves as an example of the collective commitment and shared vision needed to address one of the region’s most pressing public health challenges.”

The Comment calls for an accelerated, harmonised, and equity-driven European agenda on NCDs, particularly in the lead-up to the 2025 UN High-Level Meeting on NCDs.

The JA PreventNCD and JACARDI Joint Actions encourage policymakers, researchers, and public health advocates to explore this vital publication and join in building a healthier, more equitable future for Europe.

JACARDI (Grant Agreement 101126953) and JA PreventNCD (Grant Agreement 101128023) projects have received funding from the EU4Health Programme 2021-2027.

JACARDI featured on Italian national TV: free health screenings raise awareness on diabetes and cardiovascular risks

JACARDI was recently featured on RAI, Italy’s national public broadcaster, highlighting a free public screening campaign aimed at the early detection of diabetes and cardiovascular disease. This broadcast was filmed during a high-profile event in Reggio Calabria tied to the arrival of the Italian Navy’s historic ship Amerigo Vespucci, and it brought national attention to a simple yet powerful tool for screening and prevention: online self-assessment accessible through a QR code.

The JACARDI project, in collaboration with the ASP (Azienda Sanitaria Provinciale, Local Health Authority) of Reggio Calabria, was able to engage with citizens by making them scan a QR code with their smartphone and receive information about preventive health measures. People answered simple questions and received useful lifestyle tips, and those showing health concerns were flagged for follow-up, providing an immediate and accessible method for early diagnosis.

During the broadcast, several key figures were interviewed, including Dr. Lucia Di Furia, Director General of ASP Reggio Calabria, who suggested that prevention begins with daily awareness. Along with Dr. Ernesto Giordano, an endocrinologist and project manager on childhood obesity prevention, Di Furia highlighted how important it is to educate children on food habits to prevent future health issues.

This initiative exemplifies how JACARDI, as part of a broader EU Joint Action, is transforming prevention into practical action. By combining digital innovation with community outreach, the project is not only improving health literacy but also enabling early detection of conditions that often go unnoticed until it’s too late. As one of the 142 pilots under JACARDI, the ASP Reggio Calabria screening demonstrates how EU joint actions can deliver real, measurable benefits to people’s lives, fostering a culture of prevention and improved care that crosses borders and builds healthier futures for all.

The pilot in Calabria is one of 18 pilots within JACARDI’s Work Package 8, which focuses on screening and identifying individuals at increased risk of cardiovascular diseases and diabetes. These conditions can often be prevented or delayed through healthy lifestyle changes and better risk factor management. The pilots collect standardized data on key risk factors across European countries to support more targeted, evidence-based prevention strategies.

For the news broadcast in Italian, click here, and to watch the pilot’s promotional video, click here.

JACARDI takes the floor at OECD policy dialogue on Europe’s Cardiovascular Health

On 5 May 2025, the OECD convened a high-level policy dialogue in Brussels to address one of Europe’s most pressing public health challenges: the growing burden of cardiovascular diseases (CVDs). With the participation of the European Commission and key representatives from national governments, civil society, and international organisations, the event marked an important moment in shaping the OECD’s analytical work on CVD trends, prevention, and care across the EU. Represented by its Coordination Team, JACARDI brought forward lessons from its cross-country collaboration, referencing tools, frameworks, and reflections that align with the OECD’s strategic priorities, particularly around equity, data, and cross-sectoral integration.

Cardiovascular diseases (CVDs) remain the leading cause of mortality and morbidity across Europe, placing immense pressure on health systems, economies, and societies. Addressing this burden demands more than incremental change—it requires a shared, data-driven, and equity-focused vision for action.

The OECD’s policy dialogue, “Burden of Cardiovascular Disease in the EU,” held on 5 May 2025 with the participation of the European Commission, convened key stakeholders to discuss forthcoming OECD work that aims to analyse trends in CVD burden, prevention, and management across the EU.
The event gathered representatives from national governments, civil society, and intergovernmental organisations to ensure that the forthcoming report reflects stakeholder priorities and is rooted in collective insight.

JACARDI—the Joint Action on Cardiovascular Diseases and Diabetes—was represented by its Coordination Team: Benedetta Armocida, Graziano Onder and Beatrice Formenti. During both plenary and roundtable sessions, JACARDI shared reflections on the future of CVD response in Europe, highlighting insights from its ongoing collaboration with countries and stakeholders. The Joint Action welcomed this opportunity to align with OECD’s strategic direction and contribute to a common agenda for strengthening CVD prevention and control.

Six key areas of alignment were highlighted:

1. A shared framework: the Patient Journey
   Echoing the OECD’s analytical framework, JACARDI supports a patient-centred approach that addresses the full continuum of care—from health promotion and early prevention to integrated treatment and long-term management. This patient journey model underpins JACARDI’s operational structure and is currently being implemented through real-world pilots in 18 European countries.
   Notably, JACARDI integrates cardiovascular diseases and diabetes within a unified framework, recognising their clinical, biological, and systemic interlinkages. This convergence reflects a growing consensus: that sustainable improvement in population health requires integrated, system-strengthening, and equity-oriented solutions.
2. Equity as a structural imperative
   JACARDI endorses the OECD’s emphasis on reducing health inequities, particularly among migrants, ethnic minorities, and other underserved groups. Equity is not an add-on but a core pillar of JACARDI’s approach—operationalised through the 4C Equity Framework: Critical reflection, Contextualised data, Co-design, and Clear, inclusive communication.
   This commitment is made tangible through specific tools like capacity-building masterclasses, a dedicated maturity matrix, and pilot initiatives targeting institutional barriers, including racism and discrimination in healthcare. JACARDI advocates for the standardisation and institutionalisation of such equity-driven models across EU health policies and programmes.
3. Putting women’s hearts on the Agenda: gender-sensitive CVD responses
   Despite notable advances in CVD care, gender disparities persist. Women remain underdiagnosed, undertreated, and underrepresented in research—leading to suboptimal outcomes. JACARDI addresses these challenges through a gender-sensitive approach, following The Lancet Commission on Women and Cardiovascular Disease which underscores the need to embed sex- and gender-specific data into every level of policy and practice.
   For example, in Spain, an interactive tool is being developed to map gender-based health disparities regionally. In France, a comprehensive data linkage is underway to examine how gender and social deprivation intersect in influencing disease risk and care pathways. These initiatives represent a shift toward gender-responsive and inclusive health systems.
4. Data for change: building the evidence base
   Fragmented, delayed, and non-comparable data continue to hinder effective CVD policy implementation. There is a pressing need for harmonised, disaggregated, and interoperable health data—especially data disaggregated by sex, ethnicity, and socioeconomic status.
   JACARDI is addressing this gap by developing a conceptual data framework for mapping and improving national and regional datasets. The framework spans risk factors, disease conditions, and modifiers of disease or care across population, outpatient, and hospital settings. The information is also structured by domains (care, results, quality indicators), offering a comprehensive and standardised approach to data mapping.
   This framework will inform a practical consultation tool to support standardised, comparable, and interoperable data collection across Europe. The aim is to enhance research, promote accountability, and strengthen European health information systems in alignment with OECD, WHO, and EC priorities.
5. Screening and early detection
   A key recommendation from JACARDI reported within the dialogue was the creation of a centralised platform to oversee CVD screening—ensuring quality, transparency, and accountability throughout all stages, from design to evaluation. Such a platform would also house validated risk prediction tools tailored to diverse populations.
   JACARDI supports this vision with a suite of tools developed across the Joint Action, including guidance for implementing, monitoring, and evaluating screening programmes; roadmaps for sustainability; and strategies for disease burden surveillance (via WP7). These resources reflect JACARDI’s holistic approach, linking prevention, early detection, and continuous care.
6. Workplace interventions
   CVDs and diabetes significantly impact Europe’s labour market. JACARDI addresses this challenge by promoting workplace interventions that support people living with NCDs in maintaining or returning to employment.
   Strategic recommendations include strengthening occupational health services, fostering inclusive workplace cultures, combating stigma, promoting intersectoral collaboration, and increasing awareness and research investment. By aligning employment policy with health priorities, JACARDI aims to reduce economic strain and improve quality of life.
   
   

From prevention to rehabilitation: closing the gaps

Effective care for CVD and diabetes requires integrated, person-centred pathways that span the full spectrum of need—from early detection to long-term management and reintegration into society. Reducing fragmentation, ensuring timely access to services, and addressing the needs of chronically ill individuals are essential. JACARDI is actively supporting Member States in designing and implementing more cohesive, sustainable care models—bridging current gaps and promoting resilience in national health systems.

Looking ahead: building Europe’s CVD response together

As the OECD-led analytical report continues to evolve, JACARDI remains committed to contributing to this inclusive, co-creative process. Through piloted innovations, practical tools, and sustained cross-border collaboration, the Joint Action seeks to strengthen Europe’s collective response to CVD and diabetes.

JACARDI’s contribution rests on four foundational principles:

1. Equity as structure and substance—addressing the needs of women, migrants, and other underserved groups throughout the policy cycle;
2. High-quality, harmonised, and disaggregated data—to enable effective monitoring, accountability, and action;
3. Cross-sectoral integration—connecting health with education, employment, social protection, and digital transformation;
4. Inclusive, multi-stakeholder engagement—ensuring that patients, professionals, policymakers, and civil society shape the future together.

In closing, JACARDI exemplifies what is possible when countries align around a shared vision. Through collaboration, knowledge exchange, and an unwavering commitment to inclusion, we are not only shaping better health outcomes—we are building a lasting legacy of equity, resilience, and solidarity across Europe.

“JACARDI, together with all key stakeholders, is showing what’s possible when Europe comes together with a shared purpose and vision—turning knowledge into action, and collaboration into a legacy of healthier, fairer societies for all, starting with the urgent challenge of cardiovascular diseases.”

— JACARDI Coordination Team, Benedetta Armocida and Beatrice Formenti