EPHA submitted a response to the European Commission’s consultation on cardiovascular health checks, as a contribution to a call for evidence on strengthening evidence-based, life-course and equity-focused approaches to cardiovascular disease (CVD) prevention and early detection.
EPHA welcomes the initiative as an opportunity to strengthen prevention across the cardiovascular spectrum, including evidence on cardio and vascular, renal, metabolic, diabetes, respiratory and obesity-related conditions. It highlights the need for more systematic identification of underdiagnosed conditions within screening pathways. While current approaches focus on major cardiovascular risk factors, additional attention is needed for inherited lipid disorders such as Familial Hypercholesterolaemia (FH), elevated Lipoprotein(a) (Lp(a)), Homozygous Familial Hypercholesterolaemia (HoFH), and Familial Chylomicronaemia Syndrome (FCS), which remain underdiagnosed and insufficiently integrated into early detection.
The submission highlights the value of more integrated screening across related disease areas, including alignment with diabetes prevention pathways (e.g. type 1 diabetes) and greater integration of vascular and respiratory health within cardiovascular prevention. Approaches such as ankle-brachial index (ABI) for peripheral arterial disease (PAD), abdominal aortic aneurysm (AAA) screening, and targeted respiratory function assessment for higher-risk groups are identified as relevant elements of multimorbidity-sensitive prevention frameworks.
On equity, drawing on findings from the PERFECTO project, EPHA highlights persistent disparities in access to lipid screening, genetic testing, diagnosis and care, driven by social determinants including income, education, geography, health literacy and trust in healthcare systems. These inequities disproportionately affect women, underserved communities and lower-income groups, particularly in relation to FH. EPHA therefore supports strengthened community-based approaches to improve equitable access to screening and follow-up care.
The response also underlines the societal and economic value of earlier detection and treatment of inherited lipid disorders. Evidence shows that earlier identification can reduce cardiovascular events, avoid costly complications, improve productivity, and support health system sustainability. Many FH screening strategies are cost-effective compared with no screening and may be cost-saving in certain contexts.
Key points raised by EPHA focus on:
- Integrated lipid screening: stronger integration of lipid screening into cardiovascular health checks, alongside structured pathways for early detection of inherited lipid disorders, including paediatric and cascade screening
- Vascular screening: inclusion of vascular screening as a relevant component of prevention pathways
- Respiratory assessment: targeted respiratory function assessment for higher-risk populations
- Equity and outreach: community-based outreach strategies to improve access for underserved populations
- Data and monitoring: improved disaggregation of data to identify and address inequities in screening uptake and outcomes
- Multimorbidity and system integration: stronger integration between cardiovascular screening and broader non-communicable disease (NCD) prevention pathways, including diabetes and respiratory health