Francesco Cosentino: Policy change can only happen when it is driven both at EU and national level

As the European Commission prepares to launch the European Cardiovascular Health Plan, recognizing the strong link between cardiovascular disease and diabetes is more important than ever. However, for real impact, the plan must provide funding that reflects the scale of the CVD burden, says Francesco Cosentino, Vice-President of the European Society of Cardiology (ESC) from 2020 to 2022, and a member of JACARDI’s Stakeholder Advisory Board. JACARDI’s work in optimizing the availability of health data can play a vital role in shaping future policies and ensuring data availability will also be key to improving adherence to guidelines.

What significance does JACARDI hold for you and your organization in terms of its mission and values?

The mission of the European Society of Cardiology (ESC) is to reduce the burden of cardiovascular disease (CVD). Our society is very supportive of the great work being undertaken through JACARDI, which aims to support European countries in reducing the burden of CVD and diabetes and improve quality of care for the individuals affected.

How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular disease and diabetes in Europe?

I believe that JACARDI, through its numerous science-based pilot projects in 18 EU countries and with its network of 76 partners, has great potential to foster community spirit, knowledge sharing and to create value for tackling the increasing prevalence of CVD and diabetes across Europe. I think that JACARDI’s main strength is the integrated approach addressing both diseases simultaneously with a focus on the entire patient journey.

How do you think JACARDI will influence future collaboration on cardiovascular disease and diabetes prevention in Europe?

JACARDI specifically reflects the realities of patients who live with two comorbidities. We know CVD remains the predominant cause of death and disability in Europe. In the European Union, 62 million people live with CVD and close to 30 million new cases are diagnosed every year. In addition, 1 in 10 adults live with diabetes. What we also know is that people with diabetes have a two to three times higher cardiovascular risk than people without diabetes. They also see their life expectancy reduced by 10-14 years.

It is important to diagnose CVD and diabetes as early as possible to prevent complications and reduce healthcare costs. Recognizing these interlinkages between these two comorbidities is also crucial in the context of the incoming European Cardiovascular Health Plan from the European Commission. I believe that diabetes will be included within this plan.

So, joint health checks based on common risk factors for both diseases, such as high body mass index (BMI), high blood pressure, tobacco and alcohol consumption, high blood glucose and high LDL cholesterol are sensible and cost-effective options for the identification of high cardiovascular risk in individuals.

Based on your experience chairing the ESC Guidelines on Diabetes and Cardiovascular Disease, how can JACARDI’s research contribute to shaping future clinical guidelines in Europe?

Our ESC Guidelines on Diabetes and Cardiovascular Disease are an excellent tool to implement evidence-based, person-centered treatment strategies. This is what we call personalized medicine, which we know is effective in reducing cardiovascular risk in patients with diabetes. I believe that findings from JACARDI may potentially help the implementation of our guidelines in the daily clinical practice.

A critical step is ensuring that the clear target outlined in the ESC guidelines, to achieve better outcomes for people living with diabetes and CVD, is met for all patients. However, we are not there yet.

In this regard, data availability, data sharing and utilization are really crucial to improve patients’ and healthcare professionals’ adherence to the guidelines. One of the Work Packages of JACARDI aims to optimize the way individuals, communities, and organizations access, understand and use health information. These can be very helpful in shaping future guidelines.

With your background in cardiovascular pharmacology, what role do you think pharmacological innovations will play in complementing JACARDI’s efforts to reduce the burden of cardiovascular disease and diabetes?

I believe that a wide range of stakeholders have an important part to play in improving cardiovascular health in our population. This also includes the innovations coming from pharma and device companies. We hope that the innovation pipeline will continue to improve in the coming years as many clinical needs remain unmet.

Collaboration is definitely key and this is why the ESC is also a proud partner of the European Alliance for Cardiovascular Health (EACH), which comprises 21 leading organizations, including medical societies, industries and patients organizations.

Given your leadership experience in the European Society of Cardiology, how can JACARDI help drive policy changes at the European level to improve cardiovascular and diabetes care across diverse healthcare systems?

The ESC together with the European Alliance for Cardiovascular Health, has been advocating for a European Cardiovascular Health Plan for many years. Now finally, the policy context is extremely positive. The President of the EU Commission put CVD on the agenda and the Commissioner for Health has committed to developing a European Cardiovascular Health Plan, similar in ambition to Europe’s Beating Cancer Plan.

This was announced on the 3rd of December 2024, on the same day the Ministers of Health from the 27 Member States of the European Union approved the Council Conclusions on the Improvement of Cardiovascular Health in the EU.

It is clear that the plan is coming. What we need to ensure is that there is significant funding attached to the plan, proportionate to the burden of CVD. I believe the magnitude of work and effort from JACARDI also shows the interest at Member State level of this being a priority topic.

Policy change can only happen when it is driven at both the EU and national levels. And JACARDI showcases this important complementary nature with 80% of the close to €60 million in funding coming from the EU and the remaining 20% from the 21 participating European countries. I think collaboration is key and the driving force behind making real progress.

Prof. Francesco Cosentino is a Professor of Cardiology at the Karolinska Institute and University Hospital in Stockholm, Vice-President of the European Society of Cardiology (ESC) from 2020 to 2022 and co-Chair of the ESC Advocacy Committee from 2022 to 2024. He chaired the 2019 ESC Guidelines on Diabetes and Cardiovascular Disease and serves as Deputy Editor of the European Heart Journal and Consulting Editor of Cardiovascular Research Journal.

As a leading researcher, he has received grants and awards from national and international research councils and private foundations and has authored over 200 original articles in top-ranking, peer-reviewed journals. As a member of JACARDI’s Stakeholder Advisory Board, he contributes to work packages focused on data insights (WP7), screening (WP8), patient pathways (WP9), and patient self-management (WP10).

Learn more about Francesco Cosentino and his work here, and about ESC here.