[The 2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease : A successful plea for...

The negative impact of psychological factors on the development and course of cardiovascular disease is impressively documented in the European Society of Cardiology (ESC) 2025 Clinical Consensus Statement on mental health and cardiovascular disease (ESC-CCS-2025), which cites a total of 687 references. In particular, chronic stress, depression, anxiety disorders, and post-traumatic stress disorder can increase the cardiovascular risk by up to twofold, and these factors are often associated with an unhealthy lifestyle (smoking, unhealthy diet, physical inactivity, obesity). Conversely, due to their often existentially threatening nature, cardiovascular diseases can secondarily lead to significant psychological distress. Based on this broad body of evidence, readers are encouraged to apply this knowledge in clinical practice as directly and extensively as possible. As there are several barriers to implementing these recommendations, the ACTIVE principles propose guidance on how structures can be improved or newly created in order to enhance the diagnosis and treatment of psychological distress and mental disorders in patients with cardiovascular disease. To this end, establishment of a "Psycho-Cardio team" and expansion of a stepped-care model are recommended. The statement also emphasizes that caregiving relatives of patients may themselves experience severe emotional distress and often require support. Furthermore, the situation of patients with a primary, severe mental disorder is highlighted, as their cardiovascular care is frequently characterized by stigma and undertreatment. In our view, the ESC-CCS-2025 represents a milestone in psychocardiology, calling on all of us to translate this knowledge into practice and to create or expand effective structures of care.