REVIEW
Int. J. Public Health
Bridging the implementation gap in cardiovascular prevention: a narrative review and call to action
- GK
Grzegorz Kubielas 1,2
- JG
Jacek Gonos 3
- CS
Christopher S. Lee 4,1
- AD
Angela Durante 5,6
- MB
Michela Barisone 7
- NS
Nicola Straiton 8,9
- AJ
Adrian Jurczyk 1
- KK
Katarzyna Kułaga 2
- MJ
Maria Jędrzejczyk 1
- IU
Izabella Uchmanowicz 1,10
1. Wroclaw Medical University, Wrocław, Poland
2. Narodowy Fundusz Zdrowia, Warsaw, Poland
3. Foundation of Wroclaw Medical University, Wroclaw, Poland
4. Boston College Connell School of Nursing, Chestnut Hill, United States
5. Scuola Superiore Sant'Anna, Pisa, Italy
6. Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanita Pubblica, Pisa, Italy
7. IRCCS Humanitas Research Hospital, Rozzano, Italy
8. Australian Catholic University, Fitzroy, Australia
9. St Vincent's Hospital (Melbourne) Limited, Fitzroy, Australia
10. Edinburgh Napier University, Edinburgh, United Kingdom
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Abstract
Objectives: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, yet substantial gaps persist between evidence-based prevention strategies and their real-world implementation. This narrative review aimed to identify and synthesize contemporary models, programmes, and implementation strategies in preventive cardiovascular care, highlighting factors that facilitate or hinder adoption at scale. Methods: Narrative synthesis drawing on searches in MEDLINE (PubMed), Embase, and the Cochrane Library (to July 2025), prioritising systematic reviews, major guideline statements, and large multicentre studies. Results: Community programmes yield modest but meaningful reductions in blood pressure, lipids, and glucose. Clinical programmes achieve greater individual-level effects but are constrained by limited reach. Key barriers include misaligned incentives, workforce limitations, and persistent inequities. The Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) frameworks remain underutilised. Emerging digital tools and updated cardiovascular risk models offer new opportunities but require pragmatic integration. Conclusion: Strengthening preventive cardiovascular care requires aligning health-system incentives, integrating implementation science, and leveraging technology to support scalable and equitable prevention models.
Summary
Keywords
Cardiovascular disease prevention, Community health programmes, health systems, Implementation Science, primary prevention
Received
16 December 2025
Accepted
22 April 2026
Copyright
© 2026 Kubielas, Gonos, Lee, Durante, Barisone, Straiton, Jurczyk, Kułaga, Jędrzejczyk and Uchmanowicz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Grzegorz Kubielas, grzegorz.kubielas@umw.edu.pl
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.