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............................................................................................................................................................................. Smoking and tobacco use • Adolescence is the most vulnerable period for the uptake of smoking, with lifelong consequences. • Previous prevention campaigns reduced tobacco use in girls much less than in boys. • Teenagers should be informed that smoking is not helpful in weight control. • High taxes on all tobacco products is the most effective policy measure to reduce smoking uptake by the young. • There should be restrictions on smokeless tobacco due to strong evidence of harm. • Also, restrictions on e-cigarettes due to evidence of harm. • Plain packaging is effective in reducing the attractiveness of tobacco products. • There should be restrictions on advertising, promotion, and sponsorship by the tobacco industry. • A goal would be to make a common European decision to achieve a smoking-free Europe by 2030. Alcohol • Alcohol intake is associated with increased CV mortality, and alcohol use is the leading risk factor for premature death and disability among people aged 1549 years. • The interventions for addressing the harmful use of alcohol are cost-effective, with a good return (i.e. increasing alcoholic beverage minimum unit pricing and excise taxes, restricting access to alcoholic beverages, and implementing comprehensive restrictions and bans on advertising and the promotion of alcoholic beverages). • Healthcare providers may inquire about alcohol intake in every medical evaluation and should inform patients that alcohol is energy-dense: it provides 7 kcal/g and no nutrients. Environment, air pollution, and climate change • Air pollution contributes to mortality and morbidity, and specifically increases the risk of respiratory and CV diseases. • Environmental exposure has taken on new urgency, as air pollution, in addition to its health effects, has also been ascribed as a major contributor to climate changes, notably through the burning of fossil fuels leading to increasing emissions of carbon dioxide. Risk management of disease-specific cardiovascular disease Coronary artery disease • Multidimensional prevention is crucial for short- and long-term outcomes in CAD. Heart failure • Patients with HF benefit from multidisciplinary care management programmes. • Several neurohormonal antagonists, as well as novel molecules, improve clinical outcomes in symptomatic patients with HFrEF. Cerebrovascular diseases • Ischaemic events are mainly caused by atherothrombosis, cardioembolism, or small vessel disease, whereas intracerebral haemorrhage is mostly caused by hypertensive angiopathy or cerebral amyloid angiopathy. • Platelet inhibitors are recommended for non-cardioembolic events and anticoagulants for cardioembolic events. • In patients with a previous stroke or TIA and high BP, BP lowering reduces the recurrence risk. • In patients with stroke or TIA, statins prevent CVD and cerebrovascular events. • Lower extremity artery disease • LEAD is associated with an increased CVD risk. • Antiplatelet therapy (alone or in combination with low-dose oral anticoagulation) reduces the risk of adverse limb events and overall CVD risk in patients with LEAD. • Smoking cessation and control of other CVD risk factors improve prognosis. Chronic kidney disease • Hypertension, dyslipidaemia, and DM are prevalent among individuals with CKD and require a high-risk treatment strategy approach. • Risk management includes lifestyle, smoking cessation, nutrition, sufficient RAAS blockade, target BP control, lipid management, and—in established CVD—aspirin. • A high value is placed on self-management education programmes and team-based integrated care in patients with DM, CKD, and CVD. Atrial fibrillation • Holistic management of patients with AF improves prognosis and reduces health-related costs. • Comprehensive risk-factor modification and targeting underlying conditions reduce AF burden and recurrence. Multimorbidity • The number of patients with multiple CV and non-CV comorbidities is rapidly increasing. • Therapeutic competition should be considered in multimorbid patients, as the treatment of one condition might worsen a coexisting condition. • A paradigm shift from disease-focused to patient-centred care for multimorbid CVD patients is recommended. 8 Gaps in evidence CVD risk classification • Country-specific risk algorithms for patients with established CVD and people with DM. • Formal comparison of effectiveness and cost-effectiveness of CVD risk-guided treatment vs. treatment guided by risk factor level. • Comparison of the precision of competing risk-adjusted CVD risk models vs. standard CVD risk models. • Incorporating potential risk markers into conventional risk models, such as socioeconomic status and ethnicity. • Comparison of treatment benefit-guided strategy vs. risk-guided strategy in reducing risk factor levels and CVD risk. 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