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.

Work ability literacy in action: how Finnish leaders are strengthening workplace resilience

In Finland, the concept of work ability literacy, the knowledge and skills needed to understand, support, and strengthen employees’ capacity to work well, is moving from research into real-world practice. Through JACARDI pilot interventions led by the Finnish Institute of Occupational Health, healthcare and social services leaders are being equipped with tools and strategies that help them support work ability, promote recovery, and lead healthier, more resilient work communities.

The Finnish healthcare system has been undergoing changes for several years. In the reform implemented in 2023, healthcare and social services (HSS) were transferred from municipalities to the responsibility of regional authorities known as wellbeing services counties. This brought significant changes to organizational structures and their operations, as well as to the roles and positions of personnel. The healthcare and social services sector has certain profession-specific work strain factors, such as ethical strain, work pressure and shift work. With the reform, employees had some new stress factors to face: new working methods, in some cases new colleagues and a new organization. 

Based on research, work-related stress factors, such as work pressure, job stress, ethical strain, and uncertainty in work, have a significant impact on employees’ well-being. Work stress, shift work and sleep problems related to these increase the risk of cardiovascular diseases (CVD) and type 2 diabetes (T2D). Before the start of JACARDI, in autumn 2023, 38% of Finnish HSS personnel reported lowered work ability and only 35% reported good work recovery. The results are based on the “Mitä kuuluu?” (“How are you?”) study and surveys on well-being at work, conducted for Finnish wellbeing services counties.

Thus, the Finnish Institute of Occupational Health is conducting JACARDI pilots for the Finnish social and healthcare sector aiming to train HSS leaders to better support work ability in their work units. The aim is to increase the work ability literacy of the HSS leaders so that they can support employees who have or are at risk of CVD or T2D, and to support prevention of these diseases. Additionally, the pilots aimed to promote work recovery, health, and work ability through training for so-called work ability partners – employees of the participating work units. These work ability partners are expected to implement tasks that improve work ability in their units alongside their leaders.

What is work ability literacy?
Work ability literacy is defined as the understanding of the demands and the effects of work on one’s health and ability to work, and actions to promote one’s own work ability during work and leisure. 

The concept of work ability literacy was developed by the Finnish Institute of Occupational Health. It builds on health literacy principles and the Work Ability House model. It expands health literacy principles to include the context of work, profession, demands and effects of work on work ability, working conditions, and actions to promote and maintain work ability. By promoting work ability literacy, workplaces can better support employees in maintaining health and work capacity, ultimately contributing to improved labor participation for those living with cardiovascular disease and diabetes.

Put on your own oxygen mask first before assisting others

Starting the work at the end of 2023 and at the beginning of 2024, representatives of wellbeing services counties pointed out that the leaders are stressed and overworked, and the first priority should be to enhance their work ability and work recovery. Thus, the training program is initially aimed at helping leaders strengthen their work ability and recovery skills. 

The leaders began the training online with four group discussions designed to help them reflect on their situation, identify what is going well and where there is room for improvement, and try out methods to enhance one’s work recovery and work ability. The aim was also to provide opportunities for peer support. Subjects of the training included work recovery, work ability and work ability literacy, lifestyle factors, stress management techniques and psychological flexibility.

Results from the “Mitä kuuluu?” (“How are you?) study and well-being at work surveys conducted for Finnish wellbeing services counties: 
Research of the HSS personnel in Finland shows that around 50% of unit supervisors, managers and executive management experience high job demands. However, the management also has high decision latitude, which is why supervisors and managers tend to experience less work stress. 49% to 50% of social and health care unit supervisors, managers and executive management have felt insecurity due to workload exceeding their capacity during the years 2024 and 2025. In autumn 2025, the experiences of uncertainty due to the threat of job termination were most common among managers and executives (32%) as well as unit supervisors (31%).

After the training to improve leaders’ work recovery and work ability, the focus shifts to training aimed at motivating them and teaching them skills to lead work recovery and work ability in their work units, as well as facilitating and supporting the development efforts of their work communities. An important aim is to integrate actions improving work ability into the work processes and structures, such as regular meetings and other recurring events.

The aim is also to support discussions about work ability at the workplace, focusing on work rather than individual work ability. Leaders receive training on how to conduct one-on-one discussions and group discussions. They are also trained on psychological safety within the work community. One of the main tasks in the training is to build an annual cycle for improving work ability. 

Simultaneously, with leaders training, there is ongoing partner training for work ability. Work ability partners are employees of the work units, who received training to improve work ability and work recovery in the work units together with the leaders. These partners delivered tasks and challenges for individuals and the community to improve work recovery, health behaviors and mental wellbeing.

The work ability annual cycle as a solution for implementation

The work ability annual cycle compiles key actions that promote work ability and recovery within the workplace community. It helps leaders to systematically lead the development of work ability and recovery. The work ability annual cycle makes the promotion of work ability a shared responsibility, not just for supervisors or management. This applies to both the planning and implementation. The work ability annual cycle integrates the promotion of work ability and recovery into the daily life of the workplace, highlighting small daily actions. Annual planning facilitates operations amidst everyday busyness. It encourages supervisors to reflect on and discuss work ability, and to seek common solutions and development methods with their teams.

Permanent structures for work ability support

During the JACARDI project, the Finnish HSS sector has faced new challenges due to economic difficulties. HSS organizations have been undergoing downsizing. Challenges in HSS in Finland seem to continue, and the need for work ability support is extremely important now and in the future. Permanent structures for work ability support are needed.

Leaders in HSS play a significant role in promoting work ability and work recovery of the work unit. To lead work ability in their units in an ever-changing work environment, they must first take care of themselves. The work ability annual cycle, developed together with the workplace community, can be utilized by embedding the theme of work ability into workplace meetings and thus keeping the theme alive systematically throughout the year.

Learn more at the Finnish Institute of Occupational Health’s dedicated project page.

References 

Duchaine, C. S., Aubé, K., Gilbert-Ouimet, M., Vézina, M., Ndjaboué, R., Massamba, V., Talbot, D., Lavigne-Robichaud, M., Trudel, X., Pena-Gralle, A.-P. B., Lesage, A., Moore, L., Milot, A., Laurin, D., & Brisson, C. (2020). Psychosocial Stressors at Work and the Risk of Sickness Absence Due to a Diagnosed Mental Disorder. JAMA Psychiatry, 77(8), Article 8. https://doi.org/10.1001/jamapsychiatry.2020.0322 

Gan Y, Yang C, Tong X, Sun H, Cong Y, Yin X, Li L, Cao S, Dong X, Gong Y, Shi O, Deng J, Bi H, Lu Z. Shift work and diabetes mellitus: a meta-analysis of observational studies. Occup Environ Med. 2015 Jan;72(1):72-8. doi: 10.1136/oemed-2014-102150. Epub 2014 Jul 16. PMID: 25030030.  

 Gao, Y., Gan, T., Jiang, L., Yu, L., Tang, D., Wang, Y., … Ding, G. (2019). Association between shift work and risk of type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies. Chronobiology International, 37(1), 29–46. https://doi.org/10.1080/07420528.2019.1683570  

Hackett RA, Steptoe A. (2017) Type 2 diabetes mellitus and psychological stress – A modifiable risk factor. Nature Reviews Endocrinology, 13(9), Article 9. https://doi.org/10.1038/nrendo.2017.64 

Kivimäki M, Kawachi I. (2015) Work Stress as a Risk Factor for Cardiovascular Disease. Current Cardiology Reports, 17(9), 74. https://doi.org/10.1007/s11886-015-0630-8  

Laitinen J, Selander K, Ervasti J, ja Kivimäki M. 2024. ”Mitä kuuluu hyvinvointialueiden työhyvinvoinnille 2023”. https://urn.fi/URN:ISBN:978-952-391-148-2. (in Finnish)

Laitinen J, Selander K, Nikunlaakso R, Ervasti J. 2025. ”Mitä kuuluu sosiaali- ja terveydenhuollon työhyvinvoinnille 2024”. https://urn.fi/URN:ISBN:978-952-391-199-4 (in Finnish)

Laitinen J, Nikunlaakso R, Ervasti J, ja Kivimäki M. 2026. ”Mitä kuuluu hyvinvointialueiden työhyvinvoinnille 2025”. https://urn.fi/URN:ISBN:978-952-391-231-1 (in Finnish

Lamiani, G., Borghi, L., & Argentero, P. (2017). When healthcare professionals cannot do the right thing: A systematic review of moral distress and its correlates. Journal of Health Psychology, 22(1), 51–67. https://doi.org/10.1177/1359105315595120 

Li W, Chen Z, Ruan W, Yi G, Wang D, Lu Z. (2019) A meta-analysis of cohort studies including dose-response relationship between shift work and the risk of diabetes mellitus. European Journal of Epidemiology, 34(11), 1013–1024. https://doi.org/10.1007/s10654-019-00561-y 

Nyberg ST, Fransson EI, Heikkilä K, Ahola K ym. (2014) Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women. Diabetes Care, 37(8), 2268–2275. https://doi.org/10.2337/dc13-2936 

Rosa D, Terzoni S, Dellafiore F, Destrebecq A. (2019) Systematic review of shift work and nurses’ health. Occupational Medicine, 69(4), 237–243. https://doi.org/10.1093/occmed/kqz063 

Rudkjoebing, L. A., Bungum, A. B., Flachs, E. M., Eller, N. H., Borritz, M., Aust, B., Rugulies, R., Rod, N. H., Biering, K., & Bonde, J. P. (2020). Work-related exposure to violence or threats and risk of mental disorders and symptoms: A systematic review and meta-analysis. Scandinavian Journal of Work, Environment & Health, 46(4), Article 4. https://doi.org/10.5271/sjweh.3877 

Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. de. (2017) Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLOS ONE, 12(10), e0185781. https://doi.org/10.1371/journal.pone.0185781 

Sun M, Feng W, Wang F, Li P, Li Z, Li M, Tse G, Vlaanderen J, Vermeulen R, Tse LA. (2018) Meta-analysis on shift work and risks of specific obesity types. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 19(1), 28–40. https://doi.org/10.1111/obr.12621 

Xi J, Ma W, Tao Y, Zhang X, Liu L, Wang H. (2025). Association between night shift work and cardiovascular disease: a systematic review and dose-response meta-analysis. Frontiers in Public Health, 2025:13, 1668848. doi: 10.3389/fpubh.2025.1668848 

 Xie F, Hu K, Fu R, Zhang Y, Xiao K, Tu J. Association between night shift work and the risk of type 2 diabetes mellitus: a cohort-based meta-analysis. BMC Endocr Disord. 2024 Dec 18;24(1):268. doi: 10.1186/s12902-024-01808-w. PMID: 39696306; PMCID: PMC11653577.  

Cantabrians take control of their health: new workshops for heart health and diabetes

The Valdecilla Health Research Institute (IDIVAL) is leading and supporting an initiative in Cantabria focused on heart health and diabetes workshops, contributing its expertise in nursing research and community-based interventions to JACARDI.

As an institutional partner of JACARDI, IDIVAL is implementing a pilot scheme within JACARDI’s Work Package 10 focused on patients’ self-management. The pilot aims to support people living with chronic conditions in developing the practical skills and confidence needed to manage their health effectively.

The Nursing Research Group at IDIVAL is supporting the development, communication and implementation of the workshop series called ‘Taking Control of Your Health’ (‘Tomando el control de su salud’).  These workshops are an adaptation of an evidence-based intervention created at Stanford University by Kate Lorig. The concept of these workshops is rooted in the Chronic Disease Self-Management Programmes (CDSMP), based on Albert Bandura’s theory of self-efficacy and the Chronic Care Model. The Spanish adaptation ensures that the approach is accessible and relevant to the local context. 

Initially implemented in the Cantabria region by the Escuela Cántabra de Salud, it is now responsible for the delivery, development, management of the workshops, and other related initiatives. The local health education center provides logistical support, conducts a multidimensional evaluation of the program, and explores opportunities for further improvement.

Participants learn from each other and strengthen their self-efficacy, as well as their confidence in their ability to act. Seeing peers address similar challenges and achieving small, realistic goals, fosters a strong sense of shared progress. “It helped me to be responsible and not fall into bad health habits, like leading a too sedentary lifestyle”, noted one participant. 

Conscious self-care supported

A central element of the sessions is the use of ‘action plans’, which helps participants turn intentions into concrete, achievable commitments.

“In Cantabria, we are observing that when people feel supported and truly heard, change becomes possible”, concludes Gina Lladó, Coordinator of the pilot in Cantabria. “We want these workshops to be more than a standalone initiative. Our aim is for them to become a sustainable tool that can be firmly integrated into the community and reach more and more people over time. What we are seeing during the ongoing implementation encourages us to continue refining and strengthening this initiative”

By equipping people with the skills to manage cardiovascular disease and diabetes, the pilot supports JACARDI’s objectives of promoting health equity, prevention, and sustainable, person-centered care. Ongoing evaluation and collaboration with community partners will inform the program’s future expansion and integration into routine practice.

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

From pilots to policy: highlights from the Irish JACARDI Heart Health Symposium

The Irish JACARDI Heart Health Symposium took place on 13 February at University College Dublin, bringing together clinicians, researchers, policymakers and programme leads from across Europe. The day showcased the strength of collaboration under JACARDI and the practical progress being made in cardiovascular and diabetes prevention.

The symposium opened with a welcome from Ireland’s Minister for Health, Jennifer Carroll MacNeill, setting the tone of innovation and equity in cardiovascular and diabetes prevention. Dr Benedetta Armocida, Coordinator of JACARDI, provided an overview of JACARDI’s objectives, highlighting the Joint Action’s commitment to shared learning and scalable implementation across Member States.

The spotlight then turned to the pilots – the core of JACARDI. Six pilots from Ireland, Finland, Belgium, Hungary and Ukraine presented their work, with a particular focus on cardiovascular screening and patient self-management.

Pilot presentations: progress across Europe

• Ireland:
  • STOP‑CVD (HSE): Katie Ellwood and Pooja Salgar outlined progress using natriuretic peptide screening to support risk stratification in primary care.
  • Healthy Heart Clubs (Croí Heart & Stroke Charity): Lisa Hynes highlighted the importance of structured rehabilitation and long‑term self‑management after cardiac events.
• Finland: Mia Färm (Finnish Diabetes Association) presented the Finnish Risk Calculator, supporting early identification and timely lifestyle intervention.
• Belgium: William Leysen (Diabetes Liga) shared preliminary results from the Halt2Diabetes studies, demonstrating the value of coordinated community‑level screening.
• Hungary: Gréta Máto (OKFŐ) discussed the role of advanced nurse practitioners in strengthening cardiovascular and diabetes screening in primary care.
• Ukraine: Nataliia Hryb (Public Health Centre Ukraine) discussed how they are delivering type 2 diabetes screening in challenging circumstances, underscoring resilience and commitment to patient care.

Across all pilots, a clear message emerged: prevention must be systematic, data-informed and patient-centred.

Women and cardiovascular health: advancing equity

The mid-morning session turned the focus on women with cardiovascular disease (CVD), a key pillar of JACARDI’s commitment to equity and diversity in cardiovascular and diabetes care. The session featured a keynote from JACARDI’s own Dr Héctor Bueno, Co-Leader on the Work Package on Data, who delivered a powerful message: “women are not small men”. His presentation emphasised the need to recognise sex-specific differences in disease presentation, diagnosis, and management.

This was further explored by Dr Mary Ryder, Associate Professor of General Nursing, and Prof. Amy O’Higgins, Consultant Obstetrician at The Coombe Hospital, offering complementary perspectives. Dr Ryder discussed the importance of addressing social determinants of health in cardiovascular prevention, while Prof O’Higgins focused on optimising cardiovascular health during pregnancy, a critical window for long‑term outcomes.

The session was rounded out by a patient story, providing a personal perspective on living with CVD. Her experiences reinforced the human impact behind the statistics and research, leaving a lasting impression on all attendees.

Diabetes and cardiovascular health

The afternoon session turned to diabetes, reflecting its deep interconnection with cardiovascular disease. Dr James (Jim) Januzzi from Harvard Medical School delivered a keynote on heart failure risk across the spectrum of dysglycaemia, stressing the need for integrated approaches. Dr Lisa Devine outlined the successes of Ireland’s Chronic Disease Management Programme, demonstrating how structured, national-level programmes can support early detection, patient engagement, and improved outcomes.

Finally, Prof. Sean Dinneen discussed progress toward a National Diabetes Registry in Ireland, reinforcing the importance of robust data to ensure interventions reach those who need them most, and highlighted the synergies brought about by projects such as JACARDI.

People at the heart of prevention

One of the strongest impressions from the day was how much can be achieved when expertise, curiosity, and compassion are translated into structured action. The symposium wasn’t just about data, tools, or programmes. It was about people: the teams working on the ground across Europe translating strategy into practice, the patients whose stories remind us why these efforts matter, and the exchange of knowledge among colleagues united in a common purpose.

The symposium left attendees not only informed but inspired. It reaffirmed the importance of integrated, patient-centred approaches for a healthier and stronger Europe.

Cardiovascular health in focus: new OECD report and JACARDI experts highlight the path from data to implementation

Cardiovascular disease (CVD) still causes around 1.7 million deaths every year in the European Union. It remains a leading cause of mortality, although most of this burden is preventable. That was the key message of the OECD webinar on 10 February presenting the new EU-funded report ‘State of Cardiovascular Health in the European Union’, which also introduced new monitoring tools and highlighted how the EU Safe Hearts Plan can be translated into practical action, with JACARDI playing an active implementation role. 

The webinar, moderated by Francesca Colombo, Head of the Health Division at the OECD Directorate for Employment, Labour and Social Affairs, brought together more than 300 participants from EU institutions, national authorities, research, clinical practice and patient organisations.

Opening the event, Antonio Parenti from the European Commission’s Directorate-General for Health and Food Safety warned that progress in reducing cardiovascular deaths has slowed across Europe. Without stronger prevention and earlier intervention, the overall burden could grow substantially. The recently launched EU Safe Hearts Plan is designed to support Member States in strengthening national plans across prevention, screening, treatment and rehabilitation, with particular attention to vulnerable groups and inequalities in access to care.

New OECD data presented during the webinar show that over three-quarters of cardiovascular deaths in the EU are linked to modifiable risk factors, and trends are worsening in several areas. Around 22% of EU residents live with hypertension, 15% with obesity and 8% with diabetes, while psychosocial risks such as stress, depression and sleep problems affect roughly one third of the population. 

Important screening gaps persist: in the 45–54 age group, nearly three in ten adults have not had their blood pressure checked in the past year, and many have gone five years without testing blood sugar or cholesterol. Speakers stressed that screening only improves outcomes when it is followed by timely diagnosis, treatment and long-term patient support.

From the patient perspective, the panel highlighted that delays and fragmentation in diagnosis and care pathways remain a major barrier to better cardiovascular outcomes. Konstantina Boumaki, Board Member of the European Patients’ Forum, warned that late diagnosis and long waiting times not only worsen prognosis but also erode patient trust in the system. She stressed that reducing inequalities is not about delivering identical care to everyone, but about ensuring that all patients can truly access timely diagnosis, treatment and support; a principle that should guide how national cardiovascular plans are designed and implemented.

Alongside the report, the OECD and the European Commission launched a new Cardiovascular Health Dashboard, an online platform that allows policymakers, researchers and the public to track risk factors, care quality and patient pathways across EU countries.

From measurement to implementation

The discussion focused on a recurring weak point in public health policy: implementation. While the evidence on cardiovascular prevention and care is strong, most strategies fail in execution, noted Dr Héctor Bueno, co-leader of JACARDI’s Work Package on data and scientific coordinator of the Cardiovascular Health Strategy of Spain’s National Health System. The key is a clear vision, participation of patients and citizens, as well as political ownership.

Plans only deliver results when they are operational, measurable and realistic, stressed Dr Bueno. Measurement “is essential for visibility and accountability: without indicators, progress cannot be tracked”. 

He described how the Spanish strategy is built on a broad indicator framework covering prevention, primary care, acute and chronic care, gender aspects and education, supported by a core set of priority measures. Digital integration, interoperable registries and automated data systems are critical to make monitoring sustainable. Dr Bueno also underlined that aligning scientific evidence, political commitment and citizen engagement is as important as funding when moving from strategy to practice.

JACARDI’s cross-sector contribution to the Safe Hearts Plan

Dr Benedetta Armocida, coordinator of JACARDI, highlighted how the joint action supports the Safe Hearts Plan through cross-sector and patient-journey approaches that connect health literacy, risk awareness, screening and prevention with long-term care pathways. “Cardiovascular prevention is not only a health system responsibility but a societal one, requiring coordinated action across sectors,” Dr Armocida noted, reflecting a Health in All Policies approach. 

JACARDI pilots already include early-life interventions to improve children’s understanding of cardiovascular risk and workplace-focused prevention models, alongside broader work on food literacy, healthy environments and equitable access. Digital health and AI tools can accelerate impact, she added, “but only if they are properly integrated into routine care, trusted by users and supported through professional training”. 

The overall conclusion was clear: Europe now has stronger data, shared metrics and a dedicated policy framework through the Safe Hearts Plan. With its indicator frameworks, cross-sector pilots and implementation focus, JACARDI is helping to transform evidence and ambition into tangible improvements in cardiovascular health. 

References:

OECD (2025), The State of Cardiovascular Health in the European Union, OECD Publishing, Paris 

EU Safe Hearts Plan (pdf)

The State of Cardiovascular Health in Europe Dashboard, OECD

The Cardiovascular Health Strategy (CVHS) of Spain’s National Health System, Ministry of Health, Spain (pdf)

Call for papers: join the scientific debate on cardiovascular disease and diabetes

The current policy landscape offers unique momentum for strengthening collective action on noncommunicable diseases. To stimulate discussion on the challenges and opportunities related to cardiovascular disease and diabetes, the International Journal of Public Health and Public Health Reviews have opened a joint call for papers.

Authors are invited to submit Original Articles, Theory and Concept papers, Reviews, and Policy Briefs for the special issue “Strengthening the public health response to cardiovascular diseases and diabetes”. The call for papers is open until 15 January 2027. Submissions will be reviewed by an editorial board that includes two experts from JACARDI, Yhasmine Hamu and Edwin Wouters.

Developed in line with the JACARDI mission, the special issue seeks to foster actionable knowledge that advances effective, equitable, and sustainable responses. Its aim is to support healthier lives, more resilient health systems, and stronger commitment to tackling noncommunicable diseases.

Topics of interest, identified in collaboration with JACARDI, include:

• Primary prevention, including health literacy, awareness, and health promotion
• Screening of high-risk populations
• Integrated health pathways, including health care organization, patient self-management, and reintegration into the workforce
• Data infrastructure and digital technologies as drivers of evidence-informed decision-making and innovation
• Health system strengthening, with a focus on governance, financing, and service delivery
• Strategies to reduce health inequities and ensure that populations living in vulnerable situations are not left behind

Accepted papers will be published on a rolling basis in the online special issue.

Be part of the call and support the creation and dissemination of knowledge that strengthens our public health response to cardiovascular disease and diabetes!

For more information on the call visit the website of the International Journal of Public Health.

How JACARDI can support the implementation of the EU Safe Hearts Plan

Benedetta Armocida, coordinator of JACARDI, presented the Joint Action’s role in shaping screening and early detection approaches under the Safe Hearts Plan, during a dedicated webinar organized by the European Commission.

On 15 January 2026, the European Commission hosted the first stakeholder webinar dedicated to the Safe Hearts Plan, the EU’s first-ever cardiovascular health plan, adopted on 16 December 2025. The online event brought together nearly 500 stakeholders from across Europe and provided a key platform to exchange views on how to support the implementation of the Plan and its flagship initiatives [1].

The webinar [2] marked an important milestone in the roll-out of the Safe Hearts Plan, which aims to tackle cardiovascular diseases (CVDs), the leading cause of mortality in the European Union, through coordinated action on prevention, early detection and screening, and treatment, care and rehabilitation, while addressing cross-cutting challenges such as data and digitalisation, research and innovation, and health inequalities.

Opening the meeting, Commissioner for Health and Animal Welfare, Olivér Várhelyi, underlined the urgency of action and the importance of collaboration with stakeholders to turn the Plan into concrete results.

“Cardiovascular diseases remain Europe’s number one killer, placing a growing burden on our health systems, societies and economies. With the Safe Hearts Plan, we now have a strong policy tool at EU level, but its success will depend on close cooperation with Member States and stakeholders to make it a reality,” said Commissioner Várhelyi.

Supporting early detection and screening

During the webinar, the coordinators of key Joint Actions, JACARDI and JA PreventNCD, presented how their work contributes to the implementation of the Safe Hearts Plan. Dr Benedetta Armocida, coordinator of JACARDI, highlighted the Joint Action’s strong alignment with Pillar 2 of the Plan: early detection and screening, including the flagship initiative on an EU Protocol on Health Checks for CVDs.

JACARDI brings together 21 countries and 81 partners, working to translate EU priorities into concrete, country-level implementation. In particular, Work Package 8 on screening high-risk populations, led by Hanna Tolonen and Luigi Palmieri, is developing common protocols and tools to support Member States in the design, organisation and sustainability of effective screening programmes.

“We are testing and implementing practical solutions that can support the Safe Hearts Plan on the ground. Our pilot projects on early detection and screening aim to generate evidence and tools that help Member States reach high-risk populations, while embedding equity and sustainability across all activities. The aim is to provide further evidence and the result of our pilots to support the implementation of the European plan,” said Dr Armocida.

In practice, JACARDI is implementing 19 pilot projects focused on screening for CVDs and diabetes across different European countries, assessing the feasibility of diverse screening approaches. The Joint Action has also developed an online risk assessment tool selection guide, supporting professionals in selecting appropriate risk prediction methods.

Addressing inequalities is a core priority for JACARDI, fully aligned with the Safe Hearts Plan. Across its 143 pilot projects, the Joint Action promotes equity and diversity, targeting both the general population and high-risk groups, with a focus on integrated care pathways, self-management and social participation.

The webinar also showcased the strong alignment between the Safe Hearts Plan and other EU initiatives. Knut Jønsrud, project manager of JA PreventNCD, emphasised the importance of addressing key risk factors and reducing social inequalities through a life-course approach.

“Several flagship initiatives of the Safe Hearts Plan, such as modernising tobacco control legislation and strengthening health literacy, are closely aligned with our work. A people-centred, equity-focused approach and cross-sectoral collaboration are essential to achieving lasting impact,” said Jønsrud.

A coordinated EU response

Antonio Parenti, director for Public Health, Cancer and Human Security in the Directorate General for Human and Food Security of the European Commission (DG SANTE), stressed the scale of the challenge posed by CVDs and the need for decisive, coordinated action at EU level.

“CVDs cost the EU more than €280 billion every year. Without strong and coordinated action, this burden will continue to grow, affecting future generations, health systems and economic resilience. The Safe Hearts Plan is our collective response to this challenge,” Parenti stated.

He highlighted the Plan’s three pillars and its ten flagship initiatives, designed to improve population health, foster innovation and support sustainable healthcare systems. Prevention remains a cornerstone of the Plan, as nearly 80% of CVDs can be prevented through lifestyle changes, alongside strengthened, patient-centred and multidisciplinary care [3].

Next steps

The European Commission will now collect and analyse the feedback and ideas shared by stakeholders during the webinar. A second stakeholder webinar is planned for the second half of 2026, ensuring continued dialogue as the Safe Hearts Plan moves into its implementation phase.

For JACARDI, the webinar confirmed the relevance of Joint Actions as key instruments to support EU health policies and demonstrated how collaborative, evidence-based approaches can help reduce the burden of CVDs across Europe.

[1] About the Safe Hearts Plan flagship initiatives

Adopted in December 2025, the EU Safe Hearts Plan is underpinned by ten flagship initiatives designed to deliver clear EU added value across prevention, care and innovation, while supporting Member States in addressing cardiovascular diseases in a coordinated and sustainable way:d

• A lifelong, personalised and digitally enabled prevention programme – ‘EU cares for your heart’
• Empowering consumers through information on food processing in the EU
• Modernising tobacco control legislation
• The Commission will examine which appropriate tools, including possible financial actions, could be deployed to support/fund public health actions in the field of primary prevention and stimulate food reformulation and healthier consumer choices
• Proposal for a Council recommendation on vaccination against respiratory infections as a preventive measure for cardiovascular diseases
• EU protocol on health checks for cardiovascular diseases
• Proposal for a Council recommendation on personalised treatment and monitoring of cardiovascular diseases
• Incubator for innovation and integration of AI and digital technologies in cardiovascular healthcare
• EU cardiovascular health inequalities dashboard
• Cardiovascular Disease Research and Innovation Roadmap

[2] Stakeholder Webinar the Safe Hearts Plan – Meeting documents
[3] Questions and answers on the EU Safe Hearts Plan

A defining CVH moment in Europe: The Commission announced the Safe Hearts Plan

“When Europe acts together, we do not simply improve systems, we improve lives,” points out Benedetta Armocida, Coordinator of JACARDI, as the European Union’s Cardiovascular Health Plan is launched. At a time when cardiovascular disease remains Europe’s leading cause of death, this moment marks a collective step toward strengthening heart health across the continent.

Cardiovascular diseases (CVDs) remain the leading cause of death and disability in Europe, as confirmed by the newly released OECD report “The State of Cardiovascular Health in the European Union“. CVD claims 1.7 million lives each year, more than cancer and diabetes combined, and affects an estimated 62 million people. CVDs also contribute significantly to disability, early retirement, and absenteeism, lower the quality of life and reduce life expectancy, according to data from the European Commission [1], [2], [3].

The total economic burden of CVD in the EU is estimated at EUR 282 billion annually, around 2% of GDP, and significantly higher than that of cancer. The OECD report highlights stark geographic, gender and socio-economic disparities in cardiovascular outcomes and access to care, reinforcing the need for coordinated EU-level action. It also acknowledges JACARDI’s input to the report, and references JACARDI’s 4C Framework and pilot actions in France and Spain.

Bearing that in mind, the European Commission’s launch of the Cardiovascular Health Plan, under the name Safe Hearts Plan, marks a decisive moment for public health in the region. JACARDI strongly welcomes this Plan, as coordinated European action is essential to reduce the number of people falling ill with cardiovascular diseases, and to prevent premature deaths for those with existing conditions or risk factors, such as obesity, diabetes and high blood pressure.

“The launch of the Cardiovascular Health Plan marks a pivotal moment for Europe’s public health. JACARDI welcomes this initiative, recognizing the crucial role of Joint Actions in fostering collaboration among countries, experts, and stakeholders. By working together, sharing knowledge, and aligning efforts, we can ensure that advances in prevention, care, and innovation in cardiovascular health truly reach all communities, leaving no one behind,” notes Prof Graziano Onder, Scientific Coordinator of JACARDI.

The Plan arrives at a critical time. For too long, CVD and diabetes have lacked the political visibility their burden demands. The CVH Plan opens the door to a new European approach that puts prevention first, strengthens early detection and screening, and promotes equity and integrated, patient-centred care across health systems. For JACARDI, this initiative is an essential step towards making the healthy choice the easy and default choice for citizens across Europe.

“The CVH Plan is a decisive step forward, and JACARDI is proud to contribute with its experience and technical expertise. Our work shows that no cardiovascular strategy can be effective without putting equity at the centre, addressing the gaps linked to income, geography, education and gender that still shape health outcomes across Europe. We look forward to supporting the implementation of a Plan that has the potential to change lives across the region”, explains Dr Benedetta Armocida, coordinator of JACARDI.

The CVH Plan is needed as fragmented efforts can no longer address challenges that are inherently interconnected. “Prevention, early detection, treatment, rehabilitation, digital innovation, community engagement, these elements only create real impact when they are aligned and mutually reinforcing”, adds Dr Armocida.

Equally important is the improvement of data collection and use, ensuring that high-quality, reliable information drives policy decisions, guides clinical practice and allows progress to be measured transparently across countries, as highlighted in a recent policy paper published in The Lancet Regional Health – Europe, developed jointly by the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), the Joint Action Prevent Non-Communicable Diseases (JA PreventNCD), and the WHO Regional Office for Europe (WHO/Europe), [4].

“Robust and accessible data are essential to understand where inequalities arise, to identify people at risk earlier and to ensure timely, high-quality care across Europe. Strengthening data systems, from availability and quality to interoperability and sharing, is key to improving early detection, screening programmes and continuity of care”, says Dr Héctor Bueno, co-leader of the working group on data availability, quality, accessibility and sharing from JACARDI.

Through its multidisciplinary network, technical expertise and strong partnerships, JACARDI stands ready to support the successful rollout of the Safe Hearts Plan. The Joint Action will continue to contribute practical knowledge on prevention, governance, data systems and quality of care, building on lessons learned from other European health initiatives and aligning closely with the shared vision set out by the European cardiovascular community.

Joint Actions are more than projects, they are engines of collaboration. JACARDI can serve as a bridge between countries, stakeholders, and other EU initiatives, helping to translate the CVH Plan into coordinated, coherent, and sustainable action across Europe.

JACARDI is generating concrete insights on equity, early detection, integrated care, digital tools, data systems, and workforce capacity. These lessons, grounded in practice and validated across diverse health systems, can inform the plan’s priorities, standards, and operational frameworks. JACARDI remains fully committed to supporting the European Commission in prioritizing the Cardiovascular Health Plan and promoting its effective implementation across Member States, ensuring that every step forward translates into meaningful impact for people’s health.

The Safe Hearts Plan at a glance:

• Prioritises prevention as one of its main pillars
• Sets clear targets, including reducing mortality related to cardiovascular disease by 25% by 2035
• Encourages Member States to develop or implement national cardiovascular health plans by 2027
• Emphasises reducing health inequalities and improving access to healthcare
• Supports an EU protocol on health checks to shift the focus from treatment to prevention
• Addresses lifestyle risks, including unhealthy diets, ultra-processed foods, and smoking

Read the full European Commission Safe Hearts Plan here.


References:
[1] OECD (2025), The State of Cardiovascular Health in the European Union, OECD Publishing, Paris,
[2] Cardiovascular health; European Commission
[3] Fighting cardiovascular disease – a blueprint for EU action, June 2020. European Heart Network and the European Society of Cardiology.
[4] Benedetta Armocida, Hanna Tolonen, Ivo Rakovac, Beatrice Formenti, Jill Farrington, Allison Ekberg, Hector Bueno, Giovanni Capelli, Silvia Francisci, Morten S. Frydensberg, Ane Fullaondo, Linda Granlund, Yhasmine Hamu Azcarate, Torben F. Hansen, Emil Høstrup, Tomi Mäki-Opas, Luigi Palmieri, Markku Peltonen, Valentina Possenti, Marco Silano, Gundo Weiler, Kremlin Wickramasinghe, Edwin Wouters, Knut-Inge Klepp, Graziano Onder, Gauden Galea, Strengthening non-communicable diseases monitoring systems in Europe through a multistakeholder collaborative approach: a key priority for advancing data-driven policymaking, The Lancet Regional Health – Europe, Volume 61, 2026, 101553, ISSN 2666-7762,

A historic step for global health: UN adopts declaration on NCDs and mental health

The Eightieth United Nations General Assembly (UNGA) has adopted a landmark global political declaration to tackle noncommunicable diseases (NCDs) and mental health in an integrated way, recognising that conditions like cardiovascular disease, diabetes, cancer, chronic respiratory illnesses and mental health disorders are now the leading causes of death, disability and lost opportunity worldwide.

This declaration marks a pivotal shift in global health policy, setting concrete, measurable targets for 2030 and calling on governments to act with urgency, equity and accountability.

The first-ever global outcome targets set out by the declaration to be achieved by 2030 include:

• 150 million fewer tobacco users;
• 150 million more people with hypertension under control;
• 150 million more people with access to mental health care.

The declaration goes beyond health systems, addressing the wider determinants of health – such as air pollution, unhealthy diets, harmful marketing practices, and digital harms – and emphasises that NCDs and mental health must be tackled together, through whole-of-government and whole-of-society collaboration.

This is a huge opportunity to reset global efforts and accelerate progress on the Sustainable Development Goals, especially on reducing premature deaths and promoting well-being for all.

Where JACARDI fits in

JACARDI’s mission aligns directly with this global vision. By advancing evidence-based, integrated prevention and care models for cardiovascular disease and diabetes – key components of the NCD burden – JACARDI helps translate these high-level political commitments into action on the ground.

Our work in harmonising data, strengthening health pathways, supporting policy implementation, and fostering cross-country learning directly contributes to the declaration’s ambitions of measurable impact and equity. With its emphasis on collaboration, scalability, prevention and inclusion, JACARDI is uniquely positioned to support Member States in meeting these targets, bridging research, policy and practice for lasting change.

Can artificial intelligence help shape smarter cardiovascular policies across Europe?

What if policymakers across Europe had faster, clearer and more reliable data to guide decisions in cardiovascular health? Addressing that challenge, one of JACARDI’s pilot teams from CNIC presented their work at the ESC Digital & AI Summit 2025, showcasing AI innovations designed to turn evidence into actionable policy.

At the European Society of Cardiology Digital & AI Summit 2025, researchers Fatima Sanchez-Cabo, Juan Ignacio Alvarez Arenas, Daniel Jiménez Carretero, from the Computational Systems Biomedicine group at CNIC (Spanish Cardiovascular Research Center), and active members of JACARDI’s Working Group on Data Availability, Quality, Accessibility and Sharing, presented their poster: CARMINA: Optimizing low-parameter language models for high-quality cardiovascular research assistance. The work was featured in the session From bench to bedside: the potential roles of large language models in cardiovascular medicine, moderated by Professor Lis Neubeck, from Edinburgh Napier University; and Associate Professor Johan Verjans MD PhD FESC FRACP, from the University of Adelaide.

Why does this matter?

Within JACARDI’s Pilot 57, CNIC is developing EUROCARDIAB, a pioneering federated data platform integrating cardiovascular health indicators from across Europe. One of its key features is a CVD impact simulator that models how changes in risk factors could reduce event prevalence, providing policy makers with reliable, data-driven scenarios for national planning.

A dedicated web front-end will share these insights and will also host CARMINA (Cardiovascular And Research-driven Molecular Insight with Novel Assistant), an AI-powered research assistant designed to support specialized cardiovascular research. CARMINA will orchestrate the Intelligent Policy Agent (IPA), enabling autonomous trend analysis, computational modeling of interventions, and the creation of clear, actionable policy briefings for decision-makers in cardiology and diabetology.

This year’s ESC Digital & AI Summit motto, “Prepare for the next frontier in cardiovascular care”, aligns strongly with JACARDI’s overarching mission: accelerating patient outcomes and transforming clinical workflows across Europe through better data, smarter tools and more equitable care pathways.

Today, accurate, comparable and timely data on cardiovascular disease and diabetes remain limited, yet this information is essential for developing targeted policies that reduce disease burden, improve healthcare for all citizens and help close persistent inequalities.

The ESC Digital & AI Summit remains a key meeting point for global leaders, innovators and technology experts shaping the digital transformation of cardiovascular care, and pilots like this one from CNIC demonstrate how JACARDI is already turning that vision into meaningful, data-driven progress across Europe.

Learn more about CARMINA here.