New clinical guidelines, evidence of silent atherosclerosis in young adults and a stronger push to address sex and gender disparities were among the defining messages of the 2026 European Society of Cardiology Congress. Maria Rubini, a cardiologist and senior researcher at the National Centre for Cardiovascular Research in Madrid, said updated recommendations were the meeting’s biggest scientific headline, while the REACT trial offered a potential trigger for earlier cardiovascular prevention.
The revised heart failure guidelines remove the category covering mildly reduced ejection fraction, leaving two principal categories and simplifying clinical decision-making. ESC guidelines also address cardiovascular disease alongside chronic kidney disease for the first time, while the Society issued its first recommendations on cardiac rehabilitation. Rubini, a member of the task force behind the Fifth Universal Definition of Myocardial Infarction, said the updated definition should also make practice more straightforward.
Rubini singled out the REACT trial, which found clinically silent atherosclerosis in almost 60% of apparently healthy participants, including people at an early age. The findings could shift primary prevention toward younger populations and broaden screening beyond blood tests and blood-pressure measurements. Ultrasound and other imaging technologies may play a greater role in detecting disease before symptoms develop, she said.
Women’s cardiovascular health was another major focus. Rubini noted that cardiovascular disease remains the leading killer of women and men, but women remain underrepresented in research, underdiagnosed and undertreated. Congress sessions included a young investigator award, clinical case discussions and a joint session with the World Health Organization. Rubini also welcomed more balanced trial participation and increased reporting of data broken down by sex.
Her focus now extends to the ESC’s new Committee on Gender, Diversity and Inclusivity, which she will lead. Its first tasks will include assessing the Society’s current position and expanding its gender policy into a broader diversity and inclusion policy. The committee will also continue projects developed by the Gender Task Force, including a Women’s Heart Health Programme, webinars and dedicated guidance on sex-specific risks.
Rubini called for equal representation of women and men in cardiovascular research and dedicated funding for issues including hormonal status, early menarche and risk factors affecting younger women. At CNIC, her work has shifted from acute cardiac care toward prevention, particularly identifying and treating atherosclerosis early.
She also identified implementation of the EU Safe Hearts Plan as a major ESC priority. Artificial intelligence was a leading congress theme, but Rubini said the record attendance of more than 33,000 cardiovascular professionals inspired her most, demonstrating the field’s shared commitment to reducing cardiovascular disease.
Original Source: https://www.emjreviews.com/cardiology/congress-review/esc-2026-interview-maria-rubini/
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Publish Date: 2026-09-30 15:37:00
