The Cardioalianza association has announced the manifesto "Let no heart be left behind," in which it demands fairer, more comprehensive, and person-centered cardiovascular care, as well as concrete actions to reduce inequalities in access to and management of cardiovascular diseases.
Coinciding with the celebration of World Heart Day, on September 29, Cardioalianza has disseminated this document that outlines ten commitments aimed at ensuring that the entire population has the same opportunities to prevent, detect, and treat cardiovascular pathologies. The text also emphasizes ensuring homogeneous access to cardiac rehabilitation and adequate follow-up, regardless of place of residence, age, gender, or economic situation.
In this context, the entity recalls that cardiovascular diseases continue to be one of the greatest public health challenges both in Spain and internationally. In our country, circulatory system pathologies were the second leading cause of death in 2025, only behind tumors, and accounted for 25.7 percent of all deaths.
In practice, this means that one in four deceased individuals in Spain died from a circulatory system disease. Within this group, ischemic heart diseases represented the leading cause of mortality, with 26,711 recorded deaths.
Cardioalianza emphasizes that, on a global scale, the magnitude of the problem is even greater. According to the World Health Organization (WHO), cardiovascular diseases are the leading cause of death worldwide and are responsible for approximately 32 percent of all deaths, that is, around one in three deaths.
Furthermore, around 80 percent of cardiovascular deaths are concentrated in low- and middle-income countries, where barriers to access prevention, diagnosis, and treatments have a particularly pronounced effect.
Let place of residence not make a difference
In light of this situation, Cardioalianza denounces that not all individuals have the same options to care for their cardiovascular health or to receive appropriate care when a heart or circulatory system disease arises.
"A heart does not understand postal codes, age, gender, or income level. Neither should cardiovascular care," said Tomás Fajardo, president of Cardioalianza.
Spain has had since 2022 the Cardiovascular Health Strategy of the National Health System (ESCAV), which establishes a common framework to address cardiovascular health comprehensively, covering prevention, diagnosis, treatment, rehabilitation, and continuity of care.
In the European context, the EU Safe Hearts Plan, presented by the European Commission in December 2025, has reinforced this line of action by placing prevention, early detection, comprehensive and personalized care, and the reduction of health inequalities among its priority axes.
However, Cardioalianza warns that, from the perspective of people with cardiovascular disease, notable differences persist in access to prevention, diagnostic tests, therapies, rehabilitation programs, and clinical follow-up.
According to the association, the territory in which one lives, socioeconomic conditions, gender, or the availability of certain health resources can decisively influence the care received. "Spain has strategies and tools to improve cardiovascular health. The challenge now is for those commitments to translate into noticeable changes for people, so that receiving a timely diagnosis, accessing cardiac rehabilitation, or having adequate follow-up does not depend on postal code or personal circumstances," adds Fajardo.
Recognizing warnings, caring for the heart, and demanding measures
The proposal from Cardioalianza is also integrated into the international campaign "Don't Miss a Beat/ #NoPierdasElLatido" from the World Heart Federation (WHF), which this year urges identifying warning signs, protecting heart health, and demanding responses to the leading cause of death worldwide.
The WHF reminds that certain symptoms may go unnoticed or be misinterpreted and points out that a very high proportion of cardiovascular deaths is related to risk factors that can be prevented or controlled.
For Cardioalianza, the prevention and early recognition of warning signs are essential, but they are not enough on their own: "People also need health systems capable of facilitating an early diagnosis, coordinated care, and equitable access to cardiovascular resources".