Congenital heart disease (CHD) is the most common congenital anomaly and remains an under-recognised contributor to the global burden of cardiovascular disease. Once regarded as a paediatric condition, its burden now extends across the life course, as growing numbers of patients survive into adulthood and require lifelong, specialised care. Here we examine the global burden of CHD and propose actionable strategies. Data from the Global Burden of Disease (GBD) study, supplemented by peer-reviewed literature, global reports, and expert input, were used. We examined trends in CHD incidence, prevalence, mortality, and disability-adjusted life years (DALYs), from 1990 to 2023. In 2023, an estimated 2.3 million children were born with CHD, and 16 million people were living with the condition worldwide, up from 11.8 million in 1990, with the largest increase in lower-middle-income regions. CHD has remained the leading cause of neonatal and infant mortality among non-communicable diseases across all regions since 1990. Age-standardised mortality reached 4.7 deaths per 100,000 people globally in 2023, remaining four times higher in low-income (5.7) than in high-income (1.4) regions. Profound inequities persist across the accessibility, capacity, quality, and affordability of care, as high-income countries have 140-180 times as many cardiac surgeons as low-income countries. Coordinated initiatives such as Kerala's Hridyam programme have shown that meaningful gains are achievable even in resource-limited settings. Persistent care disparities are driven less by an absence of clinical knowledge than by unequal access to timely diagnosis, treatment, and lifelong follow-up. Addressing the global CHD crisis will require coordinated efforts from policymakers, healthcare systems, and global health organisations, supported by the proposed 2027 World Health Assembly resolution on childhood-onset heart disease.

Cities are dense population hubs where lifestyle, environmental and socioeconomic factors influence health outcomes, including morbidity and mortality secondary to cardiovascular disease. The City Heartbeat Index offers a city-level benchmarking framework that enables policy leaders to assess and implement the prevention and management of cardiovascular disease in urban environments.

Cardiovascular diseases (CVDs) are the leading global cause of mortality, with treatment adherence posing a major barrier to effective prevention and control. Single pill combinations (SPCs), also known as fixed-dose combinations, simplify treatment by combining multiple agents into one pill, improving adherence and reducing cardiovascular risk. This World Heart Federation Roadmap synthesizes the latest clinical evidence and identifies key barriers to SPC implementation, including limited manufacturing, affordability, regulatory complexity, and inconsistent guideline inclusion. Drawing on global expert input and health systems analysis, the Roadmap outlines practical, context-specific solutions to improve access, scale-up, and integration of SPCs into national strategies, especially in low- and middle-income countries. It serves as a tool for policymakers, clinicians, and advocates to drive progress in aligning cardiovascular prevention efforts with evidence-based, people-centred care.

Obesity is a growing global epidemic with significant implications for cardiovascular diseases (CVD). It couples as an independent risk factor and driver for multiple pathways leading to CVDs. Here we examine obesity's impact on CVD and propose actionable strategies. Data from the NCD Risk Factor Collaboration (NCD-RisC), Global Burden of Disease (GBD) survey, and regional health surveys databases were used. We examined trends in obesity prevalence and CVD mortality attributable to high body mass index (BMI), disaggregated by sex, geography, socioeconomic status, and urban-rural residence. Evidence from national policy initiatives and clinical management guidelines was also reviewed. As of 2022, over 1 billion people globally were living with obesity. Since 1990 the age-standardised obesity prevalence has doubled among women (from 8.8% to 18.5%) and tripled among men (from 4.8% to 14%). Globally, the number of annual CVD deaths attributable to high BMI (25 kg/m2 or over) more than doubled between 1990 and 2021, reaching 1.9 million in 2021. Reducing global obesity to 2019 levels could save an estimated US$2.2 trillion annually by 2060. Positive steps have been made in recent years, with the implementation of several global, national and local initiatives that show promise in tackling obesity and CVDs, in addition to the emergence of potentially game-changing medical interventions, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs). Yet, to tackle obesity and associated CVD, there is a need for a holistic approach across clinical and public health interventions that accounts for the multiple determinants of obesity. We recommend the implementation of evidence-based, cost-effective public health measures, and the incorporation of obesity-specific recommendations into cardiovascular guidelines. Addressing the global cardiovascular crisis linked to obesity will require coordinated efforts from policymakers, healthcare systems, and global health organisations.

CVD, mostly manifest in the form of CAD and stroke, is the leading contributor to adult mortality and is the foremost cause of premature deaths in the most populous parts of the world, represented by LMIC. As the world rededicates its commitment to overcome the health and developmental threats posed by NCD, effective interventions directed at CVD must receive the highest priority in multi-sectoral policies and health system practices. Support must be tailored to country priorities and capacities to encourage and support the development of national systems, as recently underscored in the Lusaka agenda4with its roadmap for strengthening global health initiatives (GHI) and domestic financing for health in support of universal health coverage (UHC).

Background:The SECURE trial demonstrated that the cardiovascular (CV)-polypill (acetylsalicylic acid [ASA] + atorvastatin + ramipril) reduces CV mortality by 33% in patients with acute myocardial infarction compared to standard care. The 2023 ACS ESC Guidelines recommend the polypill to improve outcomes and adherence. Objective:This study aims to establish a global consensus on the optimal use of the CV-polypill in secondary prevention. Methods:A two-round, modified Delphi method was used, featuring a 30-statement evidence-based questionnaire validated by eight renowned cardiologists. Fifty clinicians from 19 countries in Europe, Latin America, and Asia were invited to join the Delphi panel. Panelists ranked responses using a three-point Likert scale for agreement and importance. Consensus was defined as ≥80% agreement or rating statements 'very important' or 'important'. Statements without consensus after the first round were refined with evidence and feedback in the second round. Remaining disagreements were resolved in a face-to-face meeting. Descriptive statistics were applied. Results:Response rate was 76% (round 1) and 74% (round 2); 82% were cardiologists, with 74% frequently recommending the CV-polypill. Consensus was achieved on 93.3% of statements. Research showing a 24% relative risk reduction in major adverse CV events over a median of 3 years with the CV-polypill post-acute myocardial infarction, compared to usual care, reached 97.4% agreement for clinical implementation, and a 100% consensus supported polypill use at hospital discharge or first follow-up visits; 81.1% agreed on a prompt initiation after patient stabilization. There was agreement on algorithms for initiating (97.3%), considering patient preferences (97.4%) to the polypill and its cost savings over usual care (89.5%). Conclusion:The Delphi consensus on real-world use of a CV polypill (ASA, atorvastatin, and ramipril) for secondary prevention post-acute coronary syndrome supports early initiation (within 8 days or at discharge). The findings provide a foundation to inform practice and policy, identifying priorities for further research.