The initiative aims to improve the early detection of cardiovascular risk factors and diseases, helping reduce preventable illness and premature deaths across Europe.

The new recommendations support Member States in developing and implementing national cardiovascular health check programmes. They encourage actions that help identify risk factors such as high blood pressure, elevated cholesterol, high blood sugar and obesity at an early stage, enabling timely prevention and treatment.

Shared priorities: prevention, equity and early detection

Many of the themes highlighted in the recommendations align closely with JACARDI’s objectives. Throughout the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), experts have worked to strengthen prevention, improve early detection of risk factors and reduce health inequalities across Europe. These perspectives have also been reflected in discussions and expert contributions supporting the development of European policies and recommendations.

“Seeing JACARDI’s work reflected in the proposed recommendations is a significant milestone. It demonstrates how evidence generated through European collaboration can help shape policies that strengthen prevention, improve access to health checks and support better cardiovascular health outcomes across the EU,” says Hanna Tolonen, lead of JACARDI’s Screening Work Package and Deputy Director General of Research, Development and Innovation at the Finnish Institute for Health and Welfare (THL).

The Commission’s proposal stresses that cardiovascular health checks should be accessible to everyone and pay particular attention to people at higher risk and groups that may face barriers to healthcare. It also highlights the importance of health literacy, public awareness and tailored outreach activities that help people understand their cardiovascular risk and access preventive services.

The recommendations additionally recognise the potential of health innovation, including data-driven and artificial intelligence-based tools, to strengthen risk assessment and support prevention when used responsibly and with appropriate human oversight.

For JACARDI, the proposed recommendations represent an important step towards a more preventive, equitable and evidence-informed approach to cardiovascular health across Europe.

Further information:
European Commission press release
EU cardiovascular health recommendations and policy information

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From European policy to national implementation

JACARDI’s Short Guide to Screening provides policymakers and public health professionals with a structured framework and practical recommendations for planning and implementing screening activities. Developed through a major collaborative effort across the JACARDI consortium, the guide brings together the expertise and evidence generated through the Joint Action’s work on screening. With the European Commission’s proposal for a Council Recommendation on cardiovascular health checks published during EU Screening Week, this collective work has now found its way into European policy. The guide is referenced in the proposal, while its practical guidance can help support Member States in translating the new recommendations into local action.

Identifying risk is useful only when clear follow-up actions are in place. Effective screening programmes must reach the right people, use reliable screening methods, and lead to access to appropriate prevention, diagnosis, treatment or support.
JACARDI’s Short Guide for Screening Individuals at Increased Risk of Developing Cardiovascular Diseases and Type 2 Diabetes helps putting these essential elements together, and offers practical guidance for designing and implementing screening programmes adapted to local needs.

Why screening matters

Many of the risks for cardiovascular disease (CVD) and type 2 diabetes (T2D) can develop without noticeable symptoms. Screening programmes use health checks, measurements, or questionnaires to identify people who may be at increased risk or who may already have an undiagnosed condition.

This creates an opportunity to act before health conditions become more severe. When screening is well targeted and linked to appropriate support, it can raise awareness, guide preventive action, enable earlier diagnosis and help health systems direct resources where they can make the greatest difference.

Different goals, different screening approaches

Screening can support prevention in several ways. It can identify people at increased risk before disease develops, detect an existing disease at an earlier stage, or identify co-morbidities among people already living with CVD or T2D. While the guide outlines how screening can contribute at different stages of prevention, its principal focus is identifying increased risk as part of primary prevention.

The same tools used for screening can also support population-level health. The key difference lies in how the information is used. Population-level monitoring helps authorities understand trends and plan public health actions. Screening for individual health outcomes should provide each participant a clear result and, where needed, a route to further assessment, prevention, or care.

Screening is more than a test

A health check should be part of a complete prevention pathway. People need to understand why they are being screened, what their results mean, and what they should do next. At the same time, health services must be prepared to provide further assessment, preventive support, and when needed, diagnosis or treatment.

Without these links, screening risks becoming a measurement without an outcome. To be both effective and ethical, each step should connect seamlessly to the next, guiding people towards appropriate prevention, care, or support.

How JACARDI’s Screening Guide helps

Developed under the guidance of Hanna Tolonen, leader of JACARDI’s Work Package on screening high-risk populations and individuals, the Short Guide to Screening brings together expertise from JACARDI’s work on screening. It provides a structured approach for planning screening activities for CVD and T2D.

The guide outlines the key decisions that need to be made before a programme begins. It covers target population, risk assessment tools, measurement protocols, innovative screening technologies, and programme coordination. It also includes supporting resources and an evaluation template to help decision-makers assess a proposed or existing screening programme.

Making the right decision before screening begins

Screening programmes require time, funding, trained professionals and follow-up capacity. Before investing these resources, decision-makers need to consider whether screening is the most appropriate response to a health problem and whether the expected benefits outweigh the potential costs and harms.

The Short Guide to Screening supports this decision in two stages. First, it examines whether the disease, available evidence, and possible interventions provide a strong rationale for screening. It then considers whether screening is appropriate in a specific country or region, taking into account population needs, health inequalities, available resources, and the organisation of care.

Designing screening around the people it should serve

The impact of a screening programme depends largely on who it reaches. Effective programmes identify the groups most likely to benefit, consider how they can be reached, and address the barriers that may prevent participation.

The guide helps users define the target population and assess whether people living in vulnerable situations may be at risk of being overlooked. This makes equity an integral part of programme design from the beginning, rather than a concern identified only after inequalities emerge in the results.

Selecting the right risk-assessment tool

Many tools are available for estimating the risk of CVD and T2D, but different settings call for different approaches. A tool that performs well in one population may be less accurate in another. Some tools require laboratory results, while others rely on information that can be collected quickly and at a lower cost.

The Short Guide to Screening helps users choose the most appropriate tools by considering the population, intended outcome, regional relevance and available data. JACARDI’s interactive Risk Assessment Toolkit complements this guidance by allowing users to compare existing risk scores and identify those most closely aligned with their needs.

Explore the JACARDI Risk Assessment Toolkit

Creating reliable and comparable data

Screening results are only as reliable as the measurements they are based on. Differences in how blood pressure, blood glucose, cholesterol, or body measurements are taken can affect the accuracy of results and make comparisons between individuals, populations, and programmes more difficult.

The guide summarises recommended measurement protocols and directs readers to recognised technical standards for collecting high-quality data. This helps health systems interpret results, compare programmes, evaluate what works, and make informed decisions about future improvements.

Using innovative devices without compromising quality

As digital health technologies become more widely available, self-measurement tools and other innovative devices may seem an attractive way to make health checks more accessible and convenient. However, before they can be used in screening programmes, there must be sufficient evidence that they are accurate, validated, and suitable for the intended purpose.

Based on the evidence currently available, the Short Guide to Screening does not recommend the use of innovative self-measurement devices for screening. Instead, it highlights the need for further research and emphasises that these devices should not replace clinically validated methods or professional assessment.

Read more about JACARDI’s research on self-measurement tools.

Connecting the pieces through stronger governance

Delivering an effective screening programme requires coordination across many stakeholders, including public health authorities, healthcare professionals, laboratories, data systems, community organisations and the people invited to participate. Without clear governance, these different components can become fragmented, reducing the programme’s ability to translate screening results into timely action.

To address this challenge, JACARDI recommends a central governance structure for CVD and T2D screening. Bringing together evidence, standards, tools, and implementation experience supports more consistent decisions, better use of resources and stronger links between screening, prevention and care.

A timely contribution to European health checks

JACARDI’s Short Guide to Screening was developed alongside the European Commission’s work on its proposal for cardiovascular health checks, as part of the consortium’s wider work on screening. It was a substantial collaborative effort, bringing together 29 contributors from across JACARDI’s European network, representing national public health institutes, universities, regional health authorities and organisations represented on JACARDI’s Advisory Board:

• Finnish Institute for Health and Welfare (THL) leading JACARDI’s Work Package on Screening
• Italian National Institute of Health (ISS), coordinating the Joint Action
• Diabetes Liga, Belgium
• Slovenian National Institute of Public Health (NIJZ)
• Romanian National Institute of Public Health
• WHO Europe
• European Heart Network
• European Association for the Study of Diabetes (EASD)
• Fondazione Policlinico Universitario Agostino Gemelli
• Vrije Universiteit Brussel
• University of Antwerp
• Regione MARCHE
• Agenzia Sanitaria Regionale
• Vaaliala Federation of Municipalieties

The guide is now referenced in the Commission’s proposal, bringing the work of JACARDI’s Screening Work Package directly into EU health policy.

The guide’s main message is simple: the success of screening should not be measured only by the number of people who receive a health check. What matters is whether the right people are reached, reliable information is collected, and every result leads to a clear pathway for prevention, diagnosis, treatment, or ongoing support.

Further reading:
Discover the full JACARDI Screening Guide.
Read the European Commission’s Proposal for a council recommendation on cardiovascular health checks: an EU approach to early detection and screening (pdf)

Illustrations were created using generative AI under human direction and editorial review.

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The aim is to ensure that services and products are suitable for diverse needs and population groups. JACARDI’s Maturity Matrix is a tool for assessing understanding of equity and diversity at different stages of project implementation, using three categories: approaching, meeting and exceeding. Pilots are advised to use the tool during the planning of implementation to ensure a more comprehensive consideration of equity, diversity, and inclusivity aspects. Pilots complete the matrix during four phases of implementation during JACARDI, and two rounds have now been completed.

At the end of May, JACARDI’s equity and diversity experts Laura Musta, Natalia Skogberg, Maria Nousiainen organised a workshop for consortium members, where they shared feedback and results on how local projects are addressing equity and diversity, based on responses collected through the Maturity matrix tool.

Promising early results: local projects are developing more equitable workflows, and a clear commitment is evident

The results of the Equity and Diversity Maturity Matrix show that most JACARDI local projects are progressing steadily in integrating equity and diversity principles. Most teams are positioned at the “approaching” or “meeting” levels, with only a few consistently reaching the most advanced “exceeding” level. This outcome was expected and reflects a realistic development path rather than a shortcoming.

Local projects demonstrate commitment to and awareness of equity and diversity principles. However, there is variation in how these principles are implemented in practice.

The progress of the pilots provides clear evidence: in the first round of the Maturity Matrix, the tool was completed during the early stages of the work. According to these early-stage responses, projects had built strong foundations in team setup, capacity, and goal setting, often using internal critical reflection and some stakeholder consultation.

However, stakeholder engagement was usually limited to consultation, with less emphasis on co-design or continuous collaboration, reducing stakeholders’ influence on outcomes. Measuring impact, especially equity outcomes, remained challenging, and equity and diversity were not always central when selecting and implementing best practices.

After the second round of completing the matrix tool, the results show clear improvement, with many projects adapting their work based on feedback and using iterative approaches. Team capacity has strengthened, and good practices, such as co-design, multidisciplinary collaboration, continuous feedback, and inclusive communication, have emerged.

“These results underline that JACARDI pilots are on a positive trajectory, with strong commitment and clear progress over time. Of course there is still work to do. The next step is to move from awareness to consistent, actionable practice ensuring that equity and diversity are fully embedded in how pilots are designed, implemented, and evaluated,” senior planning officer Laura Musta summarises.

User feedback matters

During the second round of completing the maturity matrix, users also responded to a questionnaire assessing how relevant they find the tool.

According to the feedback, local projects consider the tool helpful in strengthening their understanding of equity and diversity, as well as in identifying key areas for action. The tool also functions as a continuous reporting mechanism that aligns closely with final implementation requirements.

At the same time, more work is needed to adapt the tool for use beyond JACARDI. This highlights the need for further simplification and adaptation.

“Overall, the results show that the matrix not only measures progress but also actively supports learning and reflection across the pilots”, chief researcher Natalia Skogberg concludes.

Infobox: Maturity Matrix Tool

• The 4Cs framework, critical reflection, context and data, co-design, and inclusive and accessible communication, guides projects towards more equitable workflows.
• The Equity and Diversity Maturity Matrix is a tool for pilot projects to strengthen inclusiveness and equity. It operationalises the 4Cs principles by providing concrete examples of how an equity and diversity lens can be applied at different levels within JACARDI’s methodology.
• The matrix consists of 41 statements that cover project phases from start to finish.
• The matrix is being completed four times during the project; two rounds have now been completed (in 11/2024-1/2025 and 11/2025-2/2026).

Further reading:

Skogberg et al. (2025) Embedding equity and diversity principles in a complex multi-national setting: methods, tools, capacity development and experiences from the first year of the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI). BMJ Global Health.

About the JACARDI Equity Lens Series:

Throughout this series, we share why equity and diversity are not optional add-ons but core components of truly equitable healthcare as well as a shared responsibility for everyone working in the field. To share the knowledge generated within JACARDI, the Equity Lens article series draws on the JACARDI Equity Masterclass series that provides an in-depth look into matters related to equity and diversity for JACARDI pilot teams conducting 143 healthcare interventions across Europe. The article series offers insights shared by a diverse pool of public health professionals within the consortium. By looking through an equity lens, we can build a more inclusive system for everyone. Join us in learning how an equity lens can shape daily practice and drive meaningful change.

Read the frevious articles in the series:

→ JACARDI’s 4Cs framework for advancing equity and diversity
→ Antiracism is integral to reducing health inequalities
→ Reframing NCD surveillance for equity-driven health systems

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Could you briefly introduce your role in JACARDI and the purpose of the visit?

Within JACARDI, where I am part of the Coordination Team and support the team responsible for the multidimensional assessment of pilot projects. I recently had the opportunity to visit a pilot site in Romania. Specifically, the pilot focuses on health literacy and awareness for patients living with cardiovascular diseases (CVD) and diabetes, particularly among people living in vulnerable conditions, including those in rural areas, with limited access to basic services.

The visit, conducted together with the multidimensional assessment team, aimed to strengthen collaboration developed over months of virtual exchanges, discuss the implementation of the pilot, and deepen our understanding of the data and methodological inputs needed for assessment.

What were your main takeaways from the site visit?

The experience closely connects with my work as a PhD student in health economics and my research activities at the Italian National Institute of Health (ISS). More importantly, the experience proved particularly meaningful in understanding what it means to implement public health interventions in complex and often underserved contexts.

At the beginning of the site visit, we met the Romanian National Institute of Public Health (INSP) team, responsible for designing and implementing the intervention. Our destination was Chirnogi, a rural village in the county of Călărași in south-eastern Romania, one of the areas of Romania with the highest prevalence of CVD, where a significant share of the population experiences  socio-economic disadvantage.

One of the most meaningful aspects of the visit was meeting the pilot team and the community nurses involved in the pilot project. Spending time with them helped me better appreciate the complexity of implementing public health interventions in real-world settings, as well as the essential role of community nurses in building trust and sustaining engagement with participants, a dimension that cannot be captured in plans or slides.

What did the visit reveal about the human side of public health implementation?

While travelling to the village with a community nurse and members of the pilot team, what struck me first was the pilot team’s strong commitment to engage directly with the community. At the same time, it also became clear how complex this can be, as external initiatives may initially be met with hesitation or uncertainty by some residents. This highlights the importance of building trust through time, continuity, and a deep understanding of the local context, as well as the need to co-design interventions with communities to ensure they are appropriate, meaningful, and accepted.

Why is on-site experience important for researchers?

Arriving in Chirnogi village was the most impactful part of the visit for me. I had the chance to see first-hand the reality the project is addressing, which cannot be fully captured through data and reports alone. Some aspects of daily life are only visible in person, and this experience reinforced my understanding of why such initiatives matter, giving me a renewed sense of purpose.

Here, I also had the opportunity to meet the mayor, who appreciated the work of the pilot team and its contribution to the community, highlighting the importance of local institutional support for the sustainability of public health initiatives. Walking through the village, the presence of Romanian and European Union (EU) flags side by side offered a simple but powerful reminder of shared values and the broader European context in which such initiatives are embedded.

How did the visit influence your perspective as a young researcher?

I started this visit expecting to observe the implementation details of a pilot intervention, thinking I would mainly engage in meetings and discussions on methodology and analysis. I left with something broader: a deeper awareness of the complexity and humanity behind public health actions in vulnerable contexts. 

Beyond methodologies and outcomes, this experience highlighted how essential it is to consider trust, communication, and contextual understanding when implementing interventions, and reinforced that pilots are not only about testing tools or protocols, but about engaging with people’s realities in all their complexity. Going there in person made this especially clear. 

Numbers and reports alone do not tell the full story, and the people involved in implementing these interventions deserve to be seen, acknowledged, and supported. What is being done in Chirnogi is not just a pilot but a model of how to reach communities with care, rigour, and respect, and one that can inspire similar efforts across different contexts in Europe. Overall, this visit was both grounding and enriching, strengthening my admiration for how small-scale, locally implemented interventions contribute to the broader vision of EU Joint Actions: improving health and wellbeing across very different settings in European countries.

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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.

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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

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Organised in the final phase of the project, the event brought together patient representatives, clinicians, researchers, policymakers, public health actors and European initiatives to discuss how early paediatric and family-based screening for Familial Hypercholesterolaemia (FH) can support cardiovascular prevention across Europe, particularly in the context of the EU Safe Hearts Plan.

From project outcomes to implementation

The event reflected PERFECTO’s core objective: moving early paediatric FH screening from evidence and awareness towards practical implementation in European health systems. Discussions also moved beyond FH alone, exploring how inherited lipid disorders and atherosclerotic cardiovascular disease  (ASCVD) risk factors can be better recognised within prevention strategies, how families can benefit from early diagnosis and cascade screening, and how health systems can integrate screening pathways in a sustainable and equitable way.

PERFECTO presented key results developed during the project, including the Personalised Communication Model (PCM), the Societal Return on Investment (sROI) model for paediatric FH screening, and work on health equity and health mediation.

The PCM, informed by evidence from Romania and Cyprus, supports more targeted communication with families, citizens and stakeholders by considering differences in awareness, trust, health literacy, perceived risk and readiness to act. The sROI model explored how early detection can create value beyond direct clinical outcomes, including benefits for families, health systems and long-term cardiovascular prevention.

Health equity was another central theme. PERFECTO’s health mediation work examined how social determinants of health, access barriers and health literacy gaps can influence participation in screening, diagnosis and follow-up, highlighting the need to embed equity from the earliest stages of screening design.

The event’s programme placed strong emphasis on implementation, reflecting European policy developments and national-level opportunities for action. Its high-level policy context was reflected through contributions from the Cypriot Minister of Health and Health Attaché, as well as engagement with Members of the European Parliament and European policy stakeholders. The event was endorsed by key cardiovascular and patient organisations, including the European Alliance for Cardiovascular Health (EACH), the European Atherosclerosis Society (EAS), the International Atherosclerosis Society (IAS) and the Global Heart Hub (GHH).

Patient Ambassadors also played an active role during the event, bringing lived experience into the discussions and showing how the knowledge and communication skills developed through PERFECTO can support continued advocacy beyond the project’s lifecycle.

Strengthening synergies with JACARDI and the Safe Hearts Plan

The closing event highlighted PERFECTO’s relevance within the wider European cardiovascular disease prevention landscape. The participation of Dr Benedetta Armocida, European Coordinator of JACARDI, in the session “From Framework to Implementation: JACARDI and the Operationalisation of the Safe Hearts Plan” strengthened the connection between PERFECTO’s work and JACARDI’s role in supporting implementation, sustainability and knowledge exchange across Member States.

This synergy is particularly important in the context of the Safe Hearts Plan. The project’s evidence and lessons informed European policy discussions on cardiovascular health checks and related protocols, helping bring attention to inherited lipid disorders, paediatric screening, family-based prevention, health equity and implementation pathways.

By bringing together the experience of an EU4Health Action Grant with the perspective of a Joint Action, the event showed how targeted projects such as PERFECTO can contribute evidence, tools and patient-led approaches, while JACARDI can support broader visibility, coordination and policy integration on the EU-level.

Although PERFECTO has now concluded, the closing event demonstrated that its work remains relevant for Europe’s next steps on cardiovascular prevention. Its legacy includes practical tools, trained Patient Ambassadors, stakeholder relationships and policy momentum supporting future discussions on early detection, equitable access and sustainable screening for inherited lipid disorders.

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Published in the European Journal of Public Health, the editorial Protecting Europe’s prevention infrastructure in the next EU budget argues that effective prevention requires strong public health institutions, professional networks, monitoring systems and governance structures that support collaboration and evidence-based policymaking across Europe.

“Europe already has ambitious health strategies. The question is whether it will retain the governance and implementation structures needed to turn those ambitions into coordinated and measurable action across Member States,” write Benedetta Armocida, Knut-Inge Klepp and Hanna Tolonen, public health experts involved in JACARDI and JA PreventNCD.

The editorial also highlights the role of Joint Actions such as JACARDI and JA PreventNCD in translating European health priorities into practical action across Member States. According to the authors, preserving cross-country cooperation, implementation capacity and accountability mechanisms will be essential for achieving Europe’s long-term health goals.

Read the full editorial

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Specifically, the study focused on women in midlife, a group with increased cardiovascular risk. Among the different dimensions of nutrition literacy, skills related to reading food labels and interpreting numerical information were the most clearly associated with healthier dietary patterns, such as Mediterranean diet, and higher consumption of fruit, vegetables and olive oil.

“Overall, these results suggest that practical everyday skills may play an important role in supporting healthier food choices”, says Chiara Lorini, Associate Professor of Public Health at the University of Florence and lead author of the study.

The findings are based on questionnaire data from 143 women recruited in primary health care settings. Most participants were classified as having limited nutrition literacy, while adherence to the Mediterranean diet was most often moderate.

Findings can help shape tailored community action

These findings have implications for public health practice. From a public health perspective, the study supports the development of tailored, community-based nutrition education interventions, especially in socially disadvantaged settings. 

“Skills such as reading food labels, estimating portions and interpreting numerical information may be promising targets for future community-based nutrition interventions,” Lorini says.

This makes accessible and relevant prevention approaches particularly important. At the same time, the authors stress that the findings are preliminary. Because the study was cross-sectional, it cannot show cause and effect, and larger longitudinal and interventional studies are needed to confirm the results.

These findings resonate with JACARDI’s broader mission to strengthen cardiovascular disease prevention across Europe through evidence-based, community-level action. By identifying specific, teachable skills – like reading food labels and interpreting nutritional information – as levers for healthier eating, the study offers a concrete starting point for the kind of tailored, accessible interventions JACARDI aims to promote in underserved communities. 

Publication: Nutrition Literacy and Adherence to the Mediterranean Diet in Women Aged 45–70 Years: A Cross-Sectional Analysis from the Ophelia Study in Florence
Authors: Chiara Lorini, Diletta Buresta, Chiara Marini, Claudia Cosma, Claudia Biagi, Chiara Milani, Giulia Naldini, Gabriele Cerini, Alice Graziani, Marco Del Riccio, Patrizio Zanobini, Veronica Gallinoro, Lorenzo Baggiani, Marco Nerattini and Guglielmo Bonaccorsi
Journal: Nutrients
Publication date: 15 April 2026
DOI: 10.3390/nu18081238

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By integrating data from primary care, specialised services and national insurance records, the project created a linked dataset covering nearly 77,000 individuals living with diabetes. The study was conducted in Belgium, where the Diabetes Data Cell Project brings together data from multiple parts of the healthcare system. This enables a longitudinal, across-system perspective on care, including information on treatments, complications, healthcare utilisation and costs, offering insights that are not possible with fragmented data sources alone.

“This project shows that it is possible to integrate health data across different parts of the healthcare system and make it usable for policy. This is a crucial step towards more informed and effective decision-making,” says lead author Astrid Lavens.

Implications for policymakers

The findings demonstrate that large-scale data linkage is feasible within existing legal and technical frameworks, and can support more systematic monitoring of care quality, identification of high-risk groups and evaluation of health policy measures.

Although developed in the Belgian health system, the approach is transferable and provides a model that can be applied in other European countries. Diabetes remains a major and growing public health challenge, while health data in many countries is still fragmented across multiple care systems. By addressing this gap, the project lays the foundation for a continuously updated national diabetes registry and contributes to broader European efforts, such as JACARDI and the European Health Data Space, to strengthen the use of real-world data in policy making.

Publication: Development of a comprehensive real-world evidence dataset to inform diabetes policy: the Diabetes Data Cell Project

Authors: Astrid Lavens, David Jaminé, Montse Urbina, Bert Vaes, Chantal Mathieu, Frank Nobels et al.

Journal: BMC Public Health

Publication date: 2 June 2026

DOI: https://doi.org/10.1186/s12889-026-27916-x

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