1. Home
2. News
3. ESC Congress 2025 – Advancing Integrated Cardiovascular Health (Guidelines Updates)

ESC Congress 2025 – Advancing Integrated Cardiovascular Health (Guidelines Updates)

10 September 2025 (Last updated: 10 Sep 2025 16:24)

Madrid, Spain – August 2025 – The European Society of Cardiology (ESC) Congress 2025 in Madrid has once again served as the world’s largest gathering of cardiovascular professionals, driving ground-breaking science and fostering global dialogue on critical health challenges. His Majesty King Felipe VI emphasised that cardiovascular health is a global challenge and that knowledge should "encounter no borders" when it contributes to progress. This year's congress saw the publication of several significant guidelines and consensus statements, all aiming to reduce the burden of cardiovascular disease and improve patient outcomes.

[NEW PODCAST COMING SOON: We’ll be discussing the highlights from ESC in our upcoming podcast on Spotify.]

1. A Cultural Shift for Mental Health and Cardiovascular Disease

A new ESC Clinical Consensus Statement, the first of its kind developed under the auspices of the ESC Clinical Practice Guidelines Committee, calls for a cultural shift in how the adverse combination of mental health conditions and cardiovascular disease (CVD) is addressed. The statement highlights the multidirectional relationship where one condition increases the risk of the other, leading to much poorer long-term health outcomes for patients experiencing both.

Key recommendations include:

• Systematic screening and support for mental health conditions should be normalised within cardiovascular care.
• Patients undergoing treatment for mental health conditions should be regularly assessed for cardiovascular disease risk.
• The establishment of Psycho-Cardio Teams, comprising mental health professionals (psychologists, psychiatrists) alongside cardiovascular specialists, is advised to provide integrated, person-centred care tailored to local needs.
• The guidelines also identify substantial gaps in knowledge regarding optimal strategies for improving population mental health to reduce CVD risk, and effective screening and treatment of mental health conditions in CVD patients. This includes a particular need for evidence-based protocols for individuals with severe mental illness, who face an increased risk of arrhythmias and sudden cardiac death due to various factors including distress, unhealthy lifestyles, and certain medications.

[COMING SOON: PCCS President, Prof Raj Thakkar will be delivering a presentation on this within our Academy – make sure you’re a member so you don’t miss it!]

2. Updated Guidelines for Valvular Heart Disease

The updated ESC/EACTS Guidelines for Valvular Heart Disease aim to prevent the under-treatment of patients and support more equitable, higher-quality care. Recognising an exponential increase in medical knowledge, these guidelines integrate new data from randomised controlled trials, particularly concerning newer, less invasive therapy options.

Significant points include:

• Updated recommendations for the use of less invasive techniques such as transcatheter aortic valve implantation (TAVI) or minimal invasive mitral valve surgery. TAVI, for instance, is described as a minimally invasive procedure to replace a malfunctioning valve, improving blood flow.
• Emphasis on shared and patient-centred decision-making by multidisciplinary expert Heart Teams.
• Recommendation that patients with complex conditions or requiring complex procedures should be referred to high-volume specialist centres.
• Expansion of guidance on sex-specific considerations, assessment of disease causes, and management of multiple/combined valvular heart diseases.
• Acknowledgement of the increasingly important role of advanced imaging techniques (e.g., 3D echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging) in screening and evaluation.

3. New Guidelines for Myocarditis and Pericarditis

For the first time, the ESC has published combined guidelines for myocarditis and pericarditis, aiming to improve diagnosis and treatment and facilitate a quicker return to exercise and work for patients. These conditions are thought to be widely underdiagnosed.

Key innovations:

• Introduction of a new umbrella term: inflammatory myopericardial syndrome (IMPS). This term will increase awareness of the spectrum of the disease, allowing for more timely diagnosis and better management.
• Provision of algorithms and easy-to-use flow charts to help medical professionals better recognise, diagnose, and treat these conditions.
• A paradigm change in diagnosis, increasing awareness of multimodality imaging, with a special role for cardiac magnetic resonance imaging (CMR).
• Specific guidance to help patients return to work and exercise more promptly, often after additional testing like CMR to ensure safety, thereby aiding recovery and supporting mental health.
• Highlighting significant evidence gaps and the need for large-scale prospective multicentre trials, especially for chronic conditions and specific patient groups (children, women of childbearing age, pregnant/breastfeeding women, the elderly).
• Recommendations for managing complicated IMPS cases with a multidisciplinary team including cardiologists, imaging experts, infectious disease experts, surgeons, intensive care specialists, and geneticists. Genetic testing is also recommended for patients with recurrent IMPS.

4. Focused Update on Lipid Levels and Cardiovascular Risk

A new ESC/EAS Focused Update to Guidelines on managing lipid levels introduces a new approach to assessing cardiovascular risk and reaching treatment goals.

Key recommendations:

• Use of new prediction algorithms, SCORE2 and SCORE2-OP, which predict both the risk of cardiovascular disease events and death. SCORE2-OP is specifically tailored for individuals between 70 and 89 years old. These algorithms enable a more precise approach to reducing cardiovascular risk in patients with high LDL cholesterol levels and encourage combination lipid-lowering therapy.
• Statin use is now recommended for more people living with HIV (aged 40 and older, irrespective of CVD risk), following the REPRIEVE trial which showed a significant reduction in CVD. People with HIV have a two-fold increased risk of atherosclerotic cardiovascular disease (ASCVD).
• Consideration of statin therapy for cancer patients at high risk of chemotherapy-related cardiovascular toxicity, particularly those receiving anthracycline-based chemotherapy, which can lead to heart failure.
• After reviewing available evidence, this focused update does not support the use of dietary supplements or vitamins without documented safety and significant LDL-C-lowering efficacy for lowering the risk of ASCVD. A specific warning was issued regarding red rice yeast, which has been banned by the European Union at effective dosages due to links with deaths.
• Endorsement of healthy dietary habits, such as low saturated fat, whole grains, vegetables, fruit, and fish, to lower LDL cholesterol.
• Guidance updated on LDL cholesterol-lowering drugs like bempedoic acid for statin-intolerant patients, and on lipid-lowering therapies for acute coronary syndromes.

5. Updated Guidelines on Cardiovascular Disease and Pregnancy

The updated ESC Guidelines for the management of cardiovascular disease and pregnancy place a strong focus on women’s autonomy to make their own reproductive choices, especially in high-risk pregnancies.

Key changes and recommendations:

• Moving away from advising women with rare, high-risk conditions (e.g., vascular Ehlers-Danlos syndrome, pulmonary arterial hypertension) against pregnancy, to a model of transparent dialogue and shared decision-making. Counselling should consider genetic background, family history, and previous vascular events.
• Emphasis on ensuring that important medication is not withheld unnecessarily during pregnancy, as pregnant women are at risk of sub-optimal treatment due to limited data. New guidance includes encouraging statin use throughout pregnancy for some women and updates on hypertension medications and cardiogenetic disorders.
• Recommendation for the establishment of Institutional Pregnancy Heart Teams in specialist hospitals, tailored to local geographical, birth rate, and sociocultural factors. These multidisciplinary teams are associated with lower maternal death rates, reduced hospital readmissions, and improved patient safety.
• A call for personalised, pregnancy-related risk assessments for all women with CVD, considering medical needs, medication, maternal age, smoking history, comorbidities, BMI, obstetric history, and socio-economic status, alongside maternal preferences.
• Clearer information on when caesarean sections are appropriate, noting that they are often performed in women with CVD risk without evidence of reduced risk, and potentially increasing foetal risk.
• Recommendations to postpone pregnancy for at least one year after heart transplantation, factoring in individual risks.

These comprehensive updates from ESC Congress 2025 reflect the European Society of Cardiology's mission to reduce the burden of cardiovascular disease by advancing medicine and helping people live longer, healthier lives.

References:

New ESC/EACTS Guidelines Guidelines for Valvular Heart Disease will help prevent under treatment of patients and support more equitable, higher quality care

New guidance recommends a new approach to assess cardiovascular risk and reach treatment goals for lipid levels

New Guidelines for myocarditis and pericarditis aim to improve diagnosis and treatment – and help patients return to exercise and work more quickly

ESC calls for a cultural shift to deal with the adverse combination of mental health conditions and cardiovascular disease

Updated ESC Guidelines put focus on women’s autonomy to make their own reproductive choices about high-risk pregnancies

View other News