The Heart of the Nation 3.0

We are getting much closer to a fundamentally new model for combatting circulatory system diseases that is based on the ultra-early detection of cardiovascular risk – long before the onset of clinical symptoms or the occurrence of an initial cardiovascular event. Modern diagnostic capabilities allow us to assess an individual’s long-term probability of suffering a heart attack, stroke, or other cardiovascular complications decades in advance. Russia’s inclusion of lipoprotein (a) testing – a persistent, genetic risk factor – in its compulsory medical insurance system has marked a significant milestone in this regard. This alters the very logic of preventive care by making it possible to identify high-risk individuals early, create personalized monitoring programmes for them, and promptly address modifiable risk factors. The next step is to integrate this capability into daily primary care, ensure continuity between outpatient and inpatient services, and make this model accessible in all regions. How should ultra-early cardiovascular risk assessments be organized at the regional level? How can we ensure adherence to preventive measures and continuous monitoring over the long term? Which models of clinical monitoring and secondary preventive care will enable us to prevent both initial and recurrent cardiovascular events?