Highlights of Cardiovascular Disease Prevention Studies Presented at the 2025 European Society of Cardiology Conference.

PURPOSE OF REVIEW: This review summarizes key findings from cardiovascular disease prevention studies presented at the 2025 European Society of Cardiology (ESC) Conference. It highlights trials on novel therapies, vaccination, blood pressure management, and the use of technology and risk scores to guide treatment. RECENT FINDINGS: The CONFIDENCE trial showed that a combination of finerenone and empagliflozin significantly reduced the urine albumin-creatinine ratio in patients with type 2 diabetes mellitus and chronic kidney disease. The DANFLU-2 trial found that the high-dose influenza vaccine was associated with fewer cardio-respiratory hospitalizations in older adults compared to the standard dose. The RETREAT FRAIL trial demonstrated that tapering antihypertensive medications in frail, elderly patients safely reduced pill burden without increasing all-cause mortality and adverse cardiovascular (CV) and non-CV outcomes. In diagnostics, the AI-Gatekeeper trial showed an AI tool reduced unnecessary advanced imaging for coronary artery disease (CAD) by 76%, lowering costs without compromising safety. The CAC CV-PREVITAL trial found that adding a coronary artery calcium score to standard risk assessment improved blood pressure control. The REBOOT-CNIC trial challenged a paradigm, showing that beta-blockers provided no significant benefit in post-myocardial infarction patients without reduced ejection fraction. A Post hoc analysis of SURMOUNT-5 found that tirzepatide offers a more pronounced long-term reduction in cardiovascular disease risk compared with semaglutide for adults with obesity and without diabetes. The NATURE-Legacy trial provided compelling evidence for the "legacy benefit" of early, modest reductions in LDL-C and blood pressure. The AIMHY-INFORM Dual Therapy Arm highlighted ethnic differences in blood pressure responses to dual therapy, while the OUTREACH trial demonstrated that providing feedback to patients on antihypertensive adherence using urine testing improved medication adherence. The 2025 ESC Conference featured several impactful studies on cardiovascular disease prevention, highlighting the importance of a multifaceted approach that incorporates the strategic integration of AI and a deeper understanding of patient-specific factors. As cardiovascular disease remains the leading global cause of death, these findings underscore the necessity of moving toward more personalized, evidence-based, and technologically-driven preventive care to improve patient outcomes and reduce the overall disease burden.