Cardiovascular Science, Medicine, and Society: The Brave New World: The ACC Braunwald Lecture 2025

Recent scientific and technological advances have dramatically expanded the possibilities in cardiovascular medicine. Landmark clinical trials have introduced transformative therapies for lipid disorders, heart failure, and obesity, offering clinicians powerful new tools to manage increasingly complex patient populations. Discoveries in molecular medicine, including gene therapies and RNA therapeutics, have ushered in new biopharmaceutical platforms and promise the potential for curative or infrequent dosing regimens. Minimally invasive, percutaneous, and robotic surgical techniques, along with next-generation devices and interventional procedures, are enhancing patient outcomes and broadening access to advanced care. The rapid rise of artificial intelligence and digital health technologies is reshaping how we gather, interpret, and act on data across the care continuum. Together, these developments mark the arrival of a brave new world in cardiovascular medicine. Yet the promise of this new era is tempered by unequal access, ethical dilemmas, and potential unintended consequences at both the patient and societal levels. This review is written in honor of Dr Eugene Braunwald, who has been a pioneer in cardiovascular science and technological innovation. The paper summarizes recent milestones in cardiovascular medicine and offers a forward-looking perspective on how to realize the full potential of innovation by translating scientific progress into equitable, responsible care and improved health outcomes.