Cardiovascular disease remains the leading cause of morbidity and mortality worldwide and is strongly influenced by lifestyle. Vascular Age (VA) reflects the age of an individual’s blood vessels compared with those of a healthy person and translates cardiovascular risk into an intuitive metric that facilitates risk communication in clinical practice. The Lifestyle Medicine Assessment (LMA) questionnaire, developed by the American Academy of Family Physicians, evaluates five key lifestyle domains using a concise 21-item tool. In Spain, a nationwide health campaign with the participation of primary care, “The Time Machine: Get Ahead of the Future and Gain Years of Life”, integrated LMA and VA to promote cardiovascular prevention across 39 cities, involving 17,283 participants between 2022 and 2025.To describe lifestyle habits, clinical parameters and Vascular Age, and to explore their relevance for cardiovascular preventionA cross-sectional descriptive study was conducted using anonymized data from 17,283 adults aged ≤85 years. Lifestyle habits were assessed using the LMA total score (0–50) and five lifestyle domains (0–10). Clinical parameters included body mass index (BMI), blood pressure, total cholesterol, smoking status and diabetes. Vascular Age was calculated using standard cardiovascular risk algorithms.The mean LMA score was 34.2 (SD 6.1), with 41% of participants scoring below 35 points. The most compromised lifestyle domains were physical activity (42% scoring <7 points) and nutrition (38% scoring <7 points). Mean BMI was 27.6 kg/m², and obesity affected 21% of participants. Mean systolic blood pressure was 132 mmHg and mean total cholesterol was 198 mg/dL. Smoking prevalence was 18% and diabetes 9%. Vascular Age exceeded chronological age by a mean of +4.8 years (median +5; interquartile range +2 to +8).These findings show room for improvement in lifestyle behaviours and cardiovascular risk profiles among adults reached through a real-world intervention linked to primary care. The excess in Vascular Age highlights the cumulative impact of modifiable lifestyle factors globally.The LMA questionnaire combined with Vascular Age identifies priority targets for lifestyle intervention, particularly physical activity and nutrition, offering a scalable and clinically meaningful strategy for strengthening cardiovascular prevention in primary care and community settings.

Cardioneurovascular diseases remain the leading cause of mortality in high-income countries and are projected to become the primary global cause of death by 2030. Accurate cardiovascular risk (CVR) assessment is essential for effective primary prevention. While current guidelines emphasize using risk scores to guide treatment, few studies have compared the different validated scores within a real-world primary care population.The objective was to describe CVR levels in primary prévention using four validated scores  and to analyze patients’ characteristics according to risk level.We conducted an observational, cross-sectional multicenter study from January to February 2022 in two French primary care centers of XXX region. Adults aged 40–69 years without a history of cardiovascular disease were included. CVR was assessed using ESC-SCORE2, Framingham Risk Scale [FRS], CUORE, and Globorisk based on patient’s medical records. Médical, biological and treatments date were collected. Patients were categorized as low, moderate, high CVR. Associations between CVR level, patients’ characteristics were analyzed using chi-squared tests for categorical variables and t-tests for continuous variables.A total of 478 patients were included, including 86 (18%) patients without a calculable CV score due to missing data.  Patients were classified as high CVR for : 8.2% with ESC-SCORE2, 21.5% with FRS, 2.9% with CUORE, and 2.3% with Globorisk. Overall, 24.2% of evaluable patients were classified at a high risk by at least one score. Among them, 47.4% were receiving statin therapy.This study highlights major discrepancies in CVR stratification depending on the tool used. The large sample, and the simultaneous use of several scores strengthen the validity of this original study. FRS appears to overestimate risk in the French population compared to ESC-SCORE2. Furthermore, the inability to calculate scores for a portion of patients underscores the practical challenges of implementing these tools systematically in routine primary care.There is substantial heterogeneity in CVR stratification depending on the score applied. These findings highlight the need for risk prediction tools specifically developed for primary care to optimize cardiovascular primary prevention strategies.

Socioeconomic inequalities are a structural determinant of cardiovascular disease. Although robust evidence demonstrates a persistent social gradient in cardiovascular morbidity and mortality, it is unclear whether this gradient is still detectable once risk is operationalised through standardized biomedical algorithms in real-world primary care. Assessing whether socioeconomic status (SES) influences SCORE2/SCORE2-OP classification is essential for advancing equity-oriented prevention—an objective inherent to primary care’s commitment to equitable and solidaristic health systems.To determine whether SES indicators are associated with global cardiovascular risk categories, estimated using SCORE2/SCORE2-OP, in a primary care population undergoing ambulatory blood pressure monitoring (ABPM).We conducted a cross-sectional study (2011–2022) in rural Burgundy, France. Consecutive adults referred for 24-hour ABPM were included irrespective of indication. Cardiovascular risk was stratified according to ESC guidelines. SES was operationalised using professional qualification and use of means-tested complementary health coverage. Multivariable logistic regression models evaluated associations between SES and risk strata, following WONCA methodological requirements for quantitative original studiesAmong 1,408 participants (mean age 62.6 ± 13.9 years; 53.3% women), 30.9% were classified as low-to-moderate risk, 50.5% as high risk, and 18.5% as very high risk. Office blood pressure was above guideline thresholds in 76.7%. After adjustment for demographic and clinical covariates, low-to-moderate professional qualification was associated with reduced odds of very high risk (OR 0.60; 95% CI 0.37–0.99). No other SES indicator exhibited a stable or clinically meaningful association with SCORE2/SCORE2-OP categories.In contrast with the well-established population-level social gradient, SCORE2/SCORE2-OP displayed low sensitivity to SES variation within this primary care cohort. Several mechanisms may explain this attenuation: constrained granularity of routinely available SES indicators; selection effects introduced by referral for ABPM; and partial homogenisation of cardiovascular profiles among individuals already engaged in risk evaluation. These findings resonate with conceptual framework showing that biomedical quantification may under-represent socially patterned vulnerability in primary care populations, which challenges the discipline’s capacity to act upon inequities.Global cardiovascular risk estimated through SCORE2/SCORE2-OP showed limited socioeconomic stratification in this primary care context. Refining risk assessment tools to better capture social vulnerability appears necessary to support primary care’s role in promoting equity in prevention.

Cardiovascular diseases are the leading cause of death worldwide and prevention is difficult to implement. Self-assessment of goal attainment using Goal Attainment Scaling (GAS) offers a structured method for assessing individual goal attainment and satisfaction.Analysis examined the frequency, achievement and satisfaction with self-set health goals of patients with at least one lifestyle-related cardiovascular risk factor within the context of GP practice.DECADE is a cluster-randomised controlled study with four study arms. Intervention groups received patient materials (IG1 and IG3) and/or additional structured patient-centered consultations with their general practitioner (IG2 and IG3). The patients (n=712) completed questionnaires at the start of the study (t0), after 6 months (t1) and after 12 months (t2). At t1 and t2, health goals, goal attainment (6-point Likert scale) and satisfaction (5-point Likert scale) were assessed. Analyses were performed using medians and group differences using Kruskal-Wallis tests.At t1 and t2, participants reported a median of six health goals. The most frequently reported goals were healthy eating, regular physical activity and weight loss. Although the patients had largely achieved their goals (Mt1=2.74 [0.33-5.00]; Mt2=2.71 [0.00-5.00]), they were only partially satisfied with achieving the goals (Mt1=2.80 [1.00-5.00]; Mt2=2.75 [1.00-5.00]). Patients who received additional consultations (IG2 and IG3) showed significantly higher GAS scores at t2 than those in groups without consultations (Controll Group and IG1) (M=2.80; M=2.86 vs. M=2.50; M=2.58, p=0.004).The most frequently mentioned goals were lifestyle-oriented. The DECADE intervention supports patients in achieving their health goals. Regular consultations with GPs showed to be helpful.Structured, patient-centered consultations are beneficial for achieving health goals for patients with cardiovascular risk.

Cardiovascular disease (CVD) is the leading cause of death in women globally, yet persistent inequities remain across diagnosis, treatment and outcomes. Women continue to experience delayed recognition of symptoms, lower treatment intensity and poorer prognosis. WONCA Europe emphasises equity, person-centredness and community orientation, while the World Health Organization (WHO) highlights gender disparities as a major obstacle to cardiovascular prevention. Rural primary care settings face additional barriers linked to access, workforce pressures and sociocultural factors. Understanding how primary-care clinicians perceive female ASCVD risk is essential for addressing inequalities in frontline care.To examine primary-care healthcare professionals’ (HCPs) perceptions of female ASCVD risk, identify barriers to equitable care, and explore opportunities to strengthen gender-sensitive cardiovascular management in rural settings.A cross-sectional mixed-methods survey was conducted across two rural English counties (September–October 2025). A total of 107 HCPs completed an anonymous questionnaire. Quantitative items were analysed using frequency distributions and weighted averages. Qualitative free-text responses were examined using Braun and Clarke’s thematic analysis. Findings were mapped to WONCA and WHO frameworks to assess alignment with international priorities.Most respondents (60.2%) agreed that gender influences CVD presentation, yet only 40.9% believed it influenced management, highlighting a discrepancy between diagnostic awareness and therapeutic action. Confidence in identifying female-specific risk factors was moderate (56.7%). A majority (76.6%) felt existing guidelines inadequately address women’s CVD risk. Barriers included limited consultation time, under-recognition of atypical symptoms, sociocultural influences on women’s help-seeking, insufficient training, and restricted access to diagnostics—issues particularly prominent in rural practice. Participants recommended integrating CVD risk assessment into women’s health reviews, enhancing multidisciplinary collaboration, embedding gender-equity audit cycles, and improving public education. Qualitative themes reinforced the need for culturally sensitive communication and stronger organisational support.Findings reveal that although clinicians recognise gendered patterns in CVD, systemic and educational constraints undermine equitable management. These challenges mirror WHO concerns and reflect departures from WONCA’s equity-driven principles.Strengthening gender-sensitive cardiovascular care in rural primary care requires improved training, adapted guidelines, enhanced diagnostic access and equity-focused audit structures. Community-based health literacy initiatives and integrated multidisciplinary approaches are essential to improving early recognition and long-term outcomes for women.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in Europe, with persistent disparities across sociodemographic groups. Socioeconomic inequalities, migration, and urbanization have intensified concerns about how intersecting social determinants—such as sex, income, country of birth, and area of residence—shape CVD risk. Traditional analyses often overlook the compounded effects of these factors, necessitating intersectional approaches to inform equitable public health strategies.This study aimed to analyze intersectional patterns in major CVD prevalence (myocardial infarction, coronary heart disease, and stroke) using data from the European Health Interview Survey (EHIS) 3. Objectives included quantifying CVD prevalence across key sociodemographic factors, estimating independent and joint effects using logistic regression and interaction models, and identifying high-risk subgroups through odds ratios and average marginal effects.A cross-sectional analysis was conducted using EHIS 3 data from 248,908 adults across 30 European countries. CVD prevalence was based on self-reported diagnoses. Multivariable logistic regression models estimated odds ratios (ORs), adjusting for age and covariates. Interaction terms assessed intersectional effects, and average marginal effects (AMEs) quantified predicted probabilities. Sensitivity analyses tested robustness.Women had lower odds of CVD than men (OR: 0.744; AME: –2.1%). Low-income individuals had higher odds than those with medium-high income (OR: 1.761; AME: +4.1%). Compared to native-born individuals, those born in EU and non-EU countries had lower odds (ORs: 0.784 and 0.600). Rural residence had minimal effect (OR: 1.020).  Intersectional disparities emerged: men with low income, born in the EU, and living in urban areas had the highest odds (OR: 2.08), followed by native-born men (OR: 1.82). Women with low income and native-born status also had elevated odds (ORs: 1.41 and 1.35), while women with medium-high income born outside the EU had lower odds (OR: 0.35).Findings reveal compounded disadvantage among low-income and migrant populations, especially women. The results emphasize the need for intersectional frameworks to identify and address structural inequities in cardiovascular health.The results underscore the limitations of one-dimensional analyses and the necessity of intersectional frameworks to identify high-risk groups.

Women who experience hypertensive disorder of pregnancy (HDP) and/or gestational diabetes (GD) face an increased risk of cardiovascular disease (CVD). To reduce this risk, cardiovascular risk management (CVRM) in primary care is essential, yet guidelines and implementations vary.This review offers an overview on CVRM for women after HDP and/or GD. First, we compare recommendations for CVRM in (inter)national guidelines. Second, we evaluate the effect of lifestyle interventions in these women. Third, we identify barriers and facilitators for implementation of CVRM on the level of women, social context and healthcare professionalsA narrative review was done. PubMed was systematically searched from start to September 2025 for published clinical guidelines on CVRM after HDP/GD beyond the immediate postpartum period, studies on lifestyle interventions after HDP/GD and barriers and facilitators for implementing CVRM for this population. Studies limited to postpartum care (≤ 6 weeks postpartum) were excluded. Two researchers independently performed abstract screening, full text screening, and data extraction.Guidelines on CVRM after HDP generally recommend informing women of their increased CVD risk and blood pressure measurement, with most guidelines additionally recommending comprehensive cardiovascular risk assessment (i.e. weight, glucose, lipids, proteinuria). Guidelines for follow-up after GD typically recommend a glucose test every 1-3 years. Screening for cardiovascular risk after GD is recommended in few guidelines. Although multiple studies indicate that lifestyle counselling is effective for long-term cardiovascular risk reduction, the evidence for this intervention remains inconclusive. Finally, barriers to CVRM implementation include lack of knowledge, self-scheduling, and limited time for women, while facilitators include receiving reminders, involvement of family for women and structured guidelines for healthcare professionals.The clinical guidelines differ in their recommendations. Also, studies on lifestyle interventions differ in their clinical effectiveness, mainly due to a lack of comparable lifestyle interventions with uniform outcomes. Future research should focus on long-term, cardiovascular outcomes, as well as on the experiences and preferences of CVRM in different social contexts to facilitate implementation.Substantial variation exists in guidelines’ recommendations on CVRM after HDP/GD. Standardized, integrated guidelines combined with feasible implementation strategies are essential to improve cardiovascular prevention in this high-risk population.