European «Safe Hearts» Plan: a new roadmap for cardiovascular health

Faced with the growing burden of cardiovascular diseases in Europe, the European Commission presented the plan "« Safe Hearts »This is a strategy aimed at strengthening prevention, early detection, and lifelong care. This plan is part of an integrated approach to non-communicable diseases and intends to significantly reduce premature mortality linked to cardiovascular diseases. Among the identified determinants, tobacco plays a central role, both in terms of its contribution to the health burden and the regulatory challenges it raises at the European level.[1].

A structuring plan to address the leading cause of death in Europe

Cardiovascular diseases are the leading cause of death in the European Union, with approximately 1.7 million deaths each year. They affect nearly 62 million people and represent a significant health burden, characterized by chronic disabilities and a substantial reduction in quality of life. Economically, their overall cost is estimated at over €280 billion annually, including healthcare expenditure, lost productivity, and years of work lost due to morbidity and premature mortality. Across Europe, cardiovascular mortality disparities remain particularly pronounced, with rates up to six times higher in some Member States.

In response to this situation, the European Commission presented the "Safe Hearts" plan as a strategic initiative to structure European action across the entire cardiovascular health continuum. This plan takes a long-term perspective, given that projections indicate an increase of nearly 90 per 100,000 lives in the prevalence of cardiovascular diseases between 2025 and 2050, and a rise of more than 70 per 100,000 lives in the number of deaths over the same period without strengthened measures. Based on three pillars—prevention, early detection, and improved care—the plan aims to reduce premature cardiovascular mortality by 25 per 100,000 lives by 2035, while simultaneously strengthening the equity and efficiency of European healthcare systems.

Prevention as a priority lever of public policies

The plan places prevention at the heart of the European strategy to combat cardiovascular disease, noting that nearly 80% of these conditions could be avoided through effective action on modifiable risk factors. Yet, prevention remains marginal in health policies, representing only about 3% to 5% of healthcare spending in most Member States, even though it is one of the most cost-effective investments for sustainably reducing cardiovascular mortality and morbidity. In a context of an aging population and increasing pressure on healthcare systems, the plan emphasizes the need for a structural rebalancing in favor of prevention.

To this end, the European Commission recommends the development or strengthening of integrated national cardiovascular health plans, based on a life course approach and combining population-based interventions with targeted actions for the most at-risk groups. These strategies must be based on cross-sectoral action, integrating, in particular, food policies, physical activity, the reduction of harmful environmental exposures, and the fight against risky behaviors. The plan also emphasizes the importance of reducing social and territorial health inequalities, as socioeconomically disadvantaged populations remain both more exposed to risk factors and less likely to benefit from prevention and screening measures.

Strengthening screening and early detection is another key focus of the recommendations. The plan emphasizes that major risk factors such as high blood pressure, high cholesterol, and diabetes remain under-detected in a significant portion of the European population, contributing to the occurrence of preventable cardiovascular events. In this context, the Commission announces the preparation of a Council recommendation to support the implementation of harmonized cardiovascular health checkups, adapted to national contexts, and accompanied by awareness campaigns designed to increase public participation.

Finally, the plan highlights the role of digital tools and health data in improving personalized prevention and the effectiveness of public policies. The development of interoperable data systems and the use of validated digital solutions should enable better risk identification, more effective population monitoring, and enhanced evaluation of prevention strategies. By simultaneously addressing the individual, social, and structural determinants of cardiovascular health, the plan aims to create a coherent and sustainable framework for significantly reducing the cardiovascular burden in Europe, while strengthening the equity and resilience of healthcare systems.

Tobacco, a major determinant explicitly identified

Tobacco is identified as one of the most significant preventable determinants of cardiovascular health in Europe. The document notes that active smoking and exposure to secondhand smoke are responsible for approximately 20% of coronary heart disease and contribute significantly to strokes and premature mortality. Even low levels of tobacco use induce significant and potentially immediate cardiovascular risks, a fact that remains largely unknown. Despite a gradual decline in smoking prevalence over the past decade, more than one in five Europeans remains a smoker, with significantly higher rates among socially disadvantaged populations.

Recent data also highlight worrying signs among young people. In 2022, more than one in six 15-year-olds reported having smoked cigarettes in the month preceding the survey. At the same time, e-cigarette use has increased significantly, with an estimated rise of over 40% in recent years, raising concerns about the early development of nicotine addiction. The plan highlights that nearly one in five young users of nicotine products started with e-cigarettes, confirming the risk of multiple and sustained patterns of use.

In this context, the plan underlines the proven effectiveness of tobacco control policies. Approximately 40% of the decline in smoking observed in the European Union over the last decade is attributed to taxation policies. The European Commission thus reiterates the central role of taxation and regulation in reducing the cardiovascular risks associated with tobacco, while emphasizing the need to adapt the legislative framework to the rapid developments in the tobacco and nicotine product market. By fully integrating tobacco and new nicotine products into its cardiovascular strategy, the plan confirms that the fight against smoking remains a key lever for sustainably reducing cardiovascular mortality and health inequalities in Europe, and for relieving strained healthcare systems.

©Generation Without Tobacco

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[1] Press release, A Milestone for Cardiovascular Health in Europe: The EU Safe Hearts Plan, World Heart Federation, published December 19, 2025, accessed December 29, 2025