Advancing cardiovascular prevention: regional results from the Italian Health Examination Survey – CUORE Project

Within JACARDI’s framework, the Italian Health Examination Survey (ITA-HES) – CUORE Project has delivered new regional results on major risk factors for non-communicable diseases. Implemented under Work Package 8, the pilot is being carried out in seven Italian regions and is coordinated by the Istituto Superiore di Sanità.

The initiative responds to the World Health Organization recommendation that Member States conduct health examination surveys every five years to monitor progress in prevention and control of non-communicable diseases, particularly cardiovascular diseases.

From data collection to regional action

Screening activities have been completed in four regions – Emilia-Romagna, Piedmont, Liguria and Lazio – and a dedicated report (for 2025) has been distributed to regional stakeholders in each territory.

The survey is based on direct health examinations of random samples of the adult population. It has a dual purpose:

• to strengthen surveillance of cardiovascular and metabolic risk factors through objective measurements;
• to provide population screening for early detection of risk conditions and promote health awareness at individual level.

Regional reports present key indicators recommended for monitoring non-communicable diseases, including:

• Blood pressure: levels, hypertension, awareness and treatment
• Lipid profile: total cholesterol, HDL, triglycerides, hypercholesterolemia, awareness and treatment
• Glycaemic status: blood glucose, diabetes prevalence, awareness and treatment
• Body mass index, obesity, overweight, normal weight, waist and hip circumference
• Nutrition habits based on 24-hour urine collection salt and potassium intake
• Physical activity: inactivity prevalence and daily steps
• Smoking habits: prevalence and cigarette consumption
• Overall absolute cardiovascular risk

Strengthening prevention and equity through evidence

Beyond estimating health indicators, the pilot assessed the impact of screening at individual level, including awareness of risk conditions and opportunities for health promotion. By combining surveillance and prevention, the ITA-HES – CUORE Project supports JACARDI’s objectives to reduce the burden of cardiovascular diseases and diabetes, promote early detection, and improve equity in access to preventive services.

The experience from these four regions demonstrates the feasibility and added value of systematic health examination surveys at regional level. The next steps include completion of activities in the remaining regions and continued collaboration with regional stakeholders to translate findings into targeted prevention policies and actions.

What the results reveal

The analysis of the data collected in the four regions highlights a substantial burden of modifiable cardiovascular risk factors in the adult population, together with important gaps in awareness and treatment. Across regions, elevated blood pressure, high total cholesterol and altered glycaemic status were frequently identified through direct measurements, and a proportion of individuals with these conditions were not aware of their risk status or were not receiving treatment.

In the Piedmont region, 40% of men and 24% of women with hypertension (systolic blood pressure >=140 mmHg and/or diastolic blood pressure >=90 mmHg and/or under specific treatment) were unaware of possible blood pressure problems, and 10% of men and 8% of women who were aware were not receiving treatment.

The results also show relevant levels of overweight and obesity based on body mass index and waist circumference, as well as non-optimal salt intake measured through 24-hour urine collection. In the Emilia-Romagna region, 79% of men and 69% of women were overweight or obese, and more than half of the population consumed more salt than recommended.

In addition, physical inactivity and current smoking remain present in a significant share of the population. Compared to data collected approximately 15 years ago, a common trend in all four regions examined shows a significant reduction in hypercholesterolemia. High cholesterol was defined as having total cholesterol levels of 240 mg/dl or higher, or taking medication to treat it. Overall, the results of main health indicators underline the need for strengthened primary prevention, early detection and targeted health promotion strategies at both national and regional level, in line with JACARDI’s objectives.

Access available results from all regions here.

Strengthening European Health: JACARDI at the JARED Consortium Day

The Joint Action on REspiratory Diseases (JARED) is a major European initiative dedicated to reducing the burden of chronic respiratory diseases through improved prevention, early detection, and integrated care models across the EU. Since chronic conditions like respiratory diseases, diabetes, and cardiovascular issues often share common risk factors, building strategic synergies between Joint Actions is essential to create a unified, high-impact approach to public health and societal prosperity.

In this context, JACARDI contributes to these goals by strengthening prevention and management strategies for cardiovascular diseases and diabetes across Europe within a single framework. By promoting health promotion, reinforcing screening, integrated care pathways and self-management, together with labour participation and improved data governance, JACARDI reinforces a cross-disease, system-based approach that complements JARED’s goals.

Addressing shared risk factors — such as tobacco use, unhealthy diets, physical inactivity, environmental exposures, and social determinants of health — allows both Joint Actions to amplify their impact beyond single disease areas and move toward a more cohesive NCD strategy at EU level.

Building synergies across European public health initiatives

The event program featured a high-level opening with remarks from the WHO and the European Respiratory Society (ERS), followed by a deep dive into JARED’s first-year achievements in indoor air quality, patient pathways, and reaching vulnerable populations. A dedicated session on Strategic Synergies brought together coordinators from various European projects to discuss how to align our efforts for maximum impact.

During this session, Benedetta Armocida, Coordinator of JACARDI presented on building synergies for impact between JACARDI, JARED, and JA PreventNCD, focusing on how coordinated intervention strategies can drive broader societal prosperity. Together, we are ensuring that European health interventions are not just individual projects, but a cohesive movement toward a healthier future.

Three JACARDI pilots showcased at the 45th French Hypertension Days

At the 45th French Hypertension Days in Marseille in December 2025, the French Public Health Agency (Santé publique France) hosted a special session to showcase three innovative JACARDI pilot projects addressing hypertension. 

This annual congress, organized by the French Society of Hypertension, brings together more than 500 healthcare professionals from French-speaking countries to share advances in hypertension management.

Session Highlights 

The session opened with Dr. Clémence Grave, who presented key French epidemiological insights:

• Hypertension affects over 17 million French adults
• It accounts for nearly 9% of all deaths, yet 1 in 2 adults with hypertension remain unaware of their condition.

To bridge the gap between these alarming statistics and clinical practice, Dr. Grégory Lailler introduced the three main interventions within JACARDI, implemented in the framework of hypertension prevention and health promotion:

• Tension’Elles: A targeted intervention in maternity clinics to raise awareness among women who experienced hypertensive disorders during pregnancy about their future cardiovascular risk, while supporting healthier lifestyle changes. This intervention pilot introduces an innovative care pathway that improves follow-up for women and enhances coordination between hospitals and community care. By identifying risks early, it ensures a seamless transition for women, connecting them with community-health professionals to manage their long-term cardiovascular health and boost the health literacy in these populations.
  
• TAC (Tension Artérielle – les Chiffres): A public communication campaign to increase awareness of blood pressure numbers and hypertension thresholds, piloted in four high-prevalence French areas.
  
• TA Tension: A pharmacy-based screening program to identify undiagnosed or uncontrolled hypertension, with loaned self-measurement devices to confirm diagnoses. Leveraging the strategic role of pharmacists as accessible, frontline healthcare providers, this program decentralizes screening. It transforms local pharmacies into key diagnostic hubs, providing patients with low-threshold access to professional medical devices and expert guidance right in their neighborhoods.

Dr. Olivier Obrecht concluded by outlining the National Health Insurance’s nationwide strategies to combat hypertension:

• free self-measurement devices for all newly practicing general practitioners, ensuring better access to diagnostic tools;
• a nationwide awareness campaign to improve hypertension screening rates;
• a newsletter reaching nearly 30 million insured individuals, promoting prevention and early detection;
• an action plan against therapeutic inertia, assessing the effectiveness of antihypertensive treatments after prescription to optimize patient care.

Impact and Outcomes 

The session generated strong interest from all healthcare professionals, especially regarding the implementation of new strategies at a national level to tackle the burden of hypertension. It fostered the following:

• Collaboration: a platform for professionals to exchange ideas and refine interventions with national and local stakeholders.
• Network expansion: opportunities to engage with new partners in the JACARDI project and align efforts across France.

The session offered a pivotal moment to unify stakeholders and strengthen collective action against hypertension.

Contributors:

In addition to the main author listed above, this article was prepared with contributions from Santé publique France:

Grégory Lailler, Clémence Grave, Diane Gozlan, Mounia El Yamani, Salima Afiri, Morgane Merat, Andrea Guajardo Villar

Croí’s Healthy Hearts Club: empowering patients in heart disease self-management

Croí, the heart and stroke charity based in the west of Ireland, is leading one of Ireland’s pilot projects as part of JACARDI. This pilot, called the Healthy Hearts Club, focuses on patient self-management for those recovering from heart events, such as heart attacks. It aims to help individuals manage long-term health risks like high blood pressure and low physical activity. This project builds on Croí’s experience in heart disease prevention and rehabilitation and provides a crucial support system to patients after their initial cardiac rehabilitation.

A Sustainable Model for Long-Term Health

Cardiovascular disease remains the leading cause of death worldwide, and many patients face challenges in maintaining the positive changes achieved during rehabilitation. The Healthy Hearts Club offers a community-based model to help patients continue managing their heart health after formal rehabilitation ends.

“Cardiac rehabilitation is life-saving, but sustaining those changes is key to long-term health,” says Dr. Susan Connolly, Consultant Cardiologist at University Hospital Galway, who is a co-investigator on the project. “The Healthy Hearts Club provides ongoing support and helps patients stay on track with their health goals.”

The programme involves up to 160 patients, all of whom have completed cardiac rehabilitation through the through the Irish health service in Galway. Participants engage in six months of support, including regular nurse check-ins and group workshops on exercise, nutrition, emotional wellbeing, and heart disease risk factors. This ongoing support aims to help participants integrate these healthy habits into their daily lives.

Supporting Long-Term Change through Personalised Care

The Healthy Hearts Club emphasizes peer support, personalized care, and group activities tailored to the participants’ needs. By joining the programme soon after rehabilitation, patients are given the tools to continue the progress they’ve made, ensuring sustainable change over the long term.

“We believe that empowering people with the knowledge and tools to manage their health is essential for sustainable, person-centered care,” says Dr. Lisa Hynes, Head of Health Programmes at Croí. “This initiative aligns perfectly with our commitment to delivering innovative prevention and self-management programmes.”

In addition to in-person support, Croí will explore the use of digital health tools to further enhance the programme. Building on the success of Croí’s previous online self-management programme, the Healthy Hearts Club will assess how digital solutions can support long-term heart health.

A European Approach to Heart Disease Prevention

One of JACARDI’s goals is to integrate best practices across the entire patient journey—from screening and self-management to integrated care and workforce reintegration. The Healthy Hearts Club is a key component of this effort, with the programme’s evaluation aiming to develop scalable models for improving heart disease management across Europe.

“We’re excited to see how this project evolves and contributes to the broader European conversation on heart health,” says Dr. Connolly. “The insights we gain will help improve the long-term care and outcomes for patients.”

A Collaborative Effort for a Healthier Future

Croí’s leadership in the Healthy Hearts Club is part of the wider JACARDI programme, which connects Irish experts with a pan-European network of professionals working to reduce the burden of cardiovascular disease and diabetes. Dr. Hynes adds, “This collaboration with the HSE and European partners is a unique opportunity to learn from each other and translate research into real-world improvements in care.”