Key result
Primordial prevention targeting early risk factors remains an underutilized strategy to reduce global CVD burden.
Why the study?
Primordial prevention has been implemented far less than needed to reduce the global cardiovascular disease burden, prompting this review to increase understanding of the strategy.
Design
Review
Supports targeting early-life determinants; leaves open prospective evaluation of scalable interventions.
Primordial prevention is the strategy of preventing occurrence of cardiovascular risk factors from early life and promoting favourable life course trajectories of cardiovascular health. While the term ‘primordial prevention’ was introduced by Strasser in 1978, representing a society-wide strategy to prevent epidemics of cardiovascular risk factors, the concept has been implemented far less to date than is needed to reduce the global cardiovascular burden. The primary purpose of this review is to increase understanding of the concept and strategy of primordial prevention for reducing the burden of cardiovascular disease and its relation to cardiovascular health. We discuss the influence of upstream adverse social and structural determinants on the development of traditional cardiovascular risk throughout the life course. We summarise recent trial evidence of intervention effectiveness and highlight policy and practice opportunities that can achieve the potential of primordial prevention as a sustainable and equitable strategy for promoting cardiovascular health across the life course.
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Lim et al. (2026) studied this question. Primordial prevention, by targeting early life risk factor development and social determinants, is a promising but underutilized strategy to reduce global cardiovascular disease burden.
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