EU “Safe Hearts Plan” cardiometabolic screening targets: pre-implementation baseline in Germany

Background

Aims of the new EU Safe Hearts Plan include 1) a 25% reduction in premature cardiovascular mortality and 2) annual health checks – covering blood pressure (BP), blood lipids/cholesterol, and glucose – for adults aged 25+, with participation targets by 2035. We present German pre-implementation data for this cardiometabolic screening.

Methods

We use cross-sectional population-weighted data from 29,994 adult participants from the panel Health in Germany, 2025 annual survey, with questions on measurement of BP, cholesterol and glucose in the last year.

Results

For Germany 2025, the proportions of adults with measurements within the last year compared to Safe Hearts goals are: women aged 25-64: BP 70.4% (95% CI 68.7-72.0) vs. goal 75%; cholesterol 47.5% (45.9-49.0) vs. 65%, glucose 44.2% (42.8-45.7) vs. 65%; women aged ≥65: BP 85.1% (83.5-86.5) vs. 90%; cholesterol 74.7% (72.9-76.5) vs. 80%, glucose 71.5% (69.6-73.4) vs. 80%; men aged 25-64: BP 63.7% (62.1-65.4) vs. 75%; cholesterol 48.4% (46.8-49.9) vs. 65%, glucose 46.2% (44.7-47.8) vs. 65%; men aged ≥65: BP 87.1% (85.7-88.3) vs. 90%; cholesterol 80.0% (78.3-81.6) vs. 80%, glucose 78.0% (76.4-79.6) vs. 80%. Differences by education were small.

Conclusions

Compared to Safe Hearts cardiometabolic screening targets, Germany has gaps particularly in 25-64-year olds and gender inequalities with less BP measurements in younger men and less glucose and cholesterol measurements in older women. Increased screening costs are expected since current cardiometabolic screening is more restrictive. Safe Hearts has inspired a clinically focused cardiovascular health (CVH) plan by the German Cardiac Society. However, Germany still lacks a government-adopted, comprehensive prevention strategy that includes population measures on physical activity, nutrition, alcohol, and tobacco use. It is unlikely that cardiometabolic screening will be sufficient to substantially reduce the premature CVD mortality in Germany.

Key messages

• Pre-implementation data for the EU Safe Hearts cardiometabolic screening goals show gaps in Germany in particular in working age adults and age-group specific gender inequalities.

• Safe Hearts has inspired a clinically focused cardiovascular health (CVH) plan by the National Cardiac Society in Germany but no comprehensive prevention-oriented governmental CVH plan yet.