The ABCs of cardiovascular disease prevention: communicating what we know in 2026

Despite numerous breakthroughs in Preventive Cardiology, control of key cardiovascular disease (CVD) risk factors including blood pressure and diabetes has stagnated in the past decade, driven in part by the obesity epidemic and population aging. Improving dissemination and implementation of the latest guidelines and evidence-based recommendations is a key national priority for CVD prevention. The ABCs of CVD Prevention is a structured framework identifying actionable domains for CVD prevention, first published in 2001 and last updated in 2021, designed to maximize clarity and uptake of key preventive recommendations. In this State-of-the-Art review, we provide a comprehensively updated version of the ABCs reflecting what we know in 2026, with two practice pearls per domain and accompanying figures and materials to support dissemination. The ABCs of CVD Prevention are: Assess CVD Risk, Antiplatelets, Blood Pressure, Body Fat, Cholesterol, Cigarettes & Alcohol, Diet, Diabetes & Cardiovascular-Kidney-Metabolic Syndrome, Exercise, Extend Healthspan, Heart Failure, and Atrial Fibrillation. The ABCs have the potential for population-level impact with clinical uptake and educational efforts across specialties and settings, supported by the evidence and materials herein.