Valentín Fuster: Basic Director, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Doctor-in-Chief, Mount Sinai Medical Middle, New York, USA
Quotation: EMJ Cardiol. 2026; https://doi.org/10.33590/emjcardiol/HW1MHD76
As a long-standing contributor to the worldwide cardiology group, what makes the annual European Society of Cardiology (ESC) Congress such an essential platform for advancing cardiovascular science and affected person care?
Traditionally, this Congress has change into more and more higher over time, and attendance has continued to develop, which already tells you it’s profitable.
On the similar time, there’s one other essential facet: it’s the first main assembly of the educational 12 months in Europe. Individuals arrive very motivated and excited, bringing new scientific findings and views. It’s a very engaging assembly and has been very profitable over time, bettering constantly as time strikes ahead.
What points of the ESC Congress 2026 are you significantly trying ahead to, corresponding to scientific periods, rising applied sciences, or broader discussions about healthcare supply?
At this second, I’m concerned with understanding well being all through life. We’ve got been coping with illness for a very long time, and really efficiently, however now we have to perceive well being and learn how to forestall illness.
To me, this includes the identical science that now we have utilized to illness. It includes genetics, imaging, AI, and molecular biology. Allow us to perceive well being in order that we are able to forestall illness. That is my primary curiosity and, if you concentrate on it, it includes the entire cardiovascular subject, together with schooling.
Prevention must be preceded by an understanding of well being on the scientific degree. It isn’t simply prevention. We have to perceive what really results in well being. My view is that the scientific instruments now we have used to check illness ought to now be centered rather more on that.
Regardless of outstanding scientific progress, heart problems stays the main reason for dying worldwide. What do you see as the most important limitations stopping us from translating proof into population-level enhancements in well being?
Stopping heart problems could be very troublesome.
Once we ask why heart problems continues to be the main reason for dying regardless of all of the advances, I believe we’re coping with balancing two sides. On one aspect is the world of consumption, and on the opposite is the world of non-public decision-making.
The issue is that the world of consumption has been profitable.
In my opinion, understanding well being higher, recognising that high quality of life needs to be a serious precedence, and educating folks from childhood on these points would serve us a lot better in addressing heart problems because the main reason for dying.
We’ve got an issue with the world we reside in. The query is whether or not we are able to create totally different priorities inside ourselves. That’s the key, scientifically, educationally, and in any other case.
The idea of the cardiovascular polypill has been carefully related along with your work. Trying on the proof accessible as we speak, how do you see its function evolving in routine scientific follow worldwide?
Certainly one of as we speak’s main issues is adherence to treatment in a world that always pulls folks in several instructions. The polypill originated round 15 years in the past once I started engaged on making an attempt to simplify remedy, initially for sufferers who had skilled myocardial infarction and who required a number of drugs.
Combining these drugs right into a single capsule has been proven within the SECURE trial1 to work. Additionally it is inexpensive than taking the entire drugs individually.
The query now’s how we implement this worldwide. That course of has begun, nevertheless it takes time; adoption is growing in Europe and Latin America, whereas broader implementation in locations such because the USA and Australia remains to be wanted.
The long run is simplicity, which is of course engaging to us as human beings. The polypill began with myocardial infarction, however we are actually transferring into cerebrovascular illness and different areas as properly.
You might have labored extensively throughout Europe and the USA. Are there any classes that totally different healthcare programs might be taught from each other in bettering cardiovascular prevention and care?
Twenty years in the past, once we started the Nationwide Centre for Cardiovascular Analysis (CNIC), Madrid, Spain, the variations between the USA and Europe had been very important at many ranges. I might say that the USA was considerably forward in scientific improvement at the moment. Right now, nevertheless, the hole is turning into smaller and smaller. I journey incessantly between Madrid and the USA, and I can see that, scientifically talking, the variations are actually a lot much less pronounced.
Science, healthcare analysis, and schooling in Europe are advancing very quickly, and I don’t see main variations as we speak.
My prediction is that over the following 10–15 years, healthcare supply within the USA will transfer a lot nearer to the European mannequin. I really feel that each programs are already converging scientifically, and healthcare supply will doubtless observe.
Illness is turning into very costly to handle, and this actuality itself pushes programs in direction of higher healthcare supply.
As Basic Director of the CNIC, what would you say the establishment’s primary priorities are and what targets are you at the moment working in direction of when it comes to advancing cardiovascular science?
After I was given the chance to return to Spain, the place I used to be born, the unique goal was to attach fundamental science with scientific software, and, in the end, with society.
At the moment, there was a separation between fundamental scientists, clinicians, and scientific investigators. I consider now we have efficiently addressed a lot of that problem. Right now, the centre has practically 400 investigators, and fundamental scientists work along with scientific investigators.
As a driving power, I really feel very glad with what has been achieved.
Our final purpose is well being, as I proceed to say. The important thing query is: can we improve well being by means of science?
Over the previous 20 years, now we have moved from fundamental science to scientific software, and now in direction of well being itself. It’s a very thrilling evolution.
On the ESC Congress 2026, you may be taking part within the session ‘Fireplace with the Legends’. What does being thought of one of many subject’s ‘legends’ imply to you personally?
To me, ‘legend’ is a definition given by society. Frankly, I really feel that I’ve merely performed the most effective I might with the skills I used to be given and with the assistance of nice mentors.
You want motivation to do what you really get pleasure from. You additionally want vitality. Individuals are born with totally different ranges of vitality, however it’s essential. Most significantly, your motivation turns into a lot stronger when your purpose is to assist different folks.
That could be very totally different from ambition. Ambition typically includes serving to your self.
For household causes, and due to the mentorship and different influences I had, I at all times tried to do the most effective I might, with motivation, vitality, and a need to be useful. Being useful means mentoring younger folks, figuring out those that have the potential to contribute to society, and serving to them develop.
I can’t actually outline what a legend is. I can solely let you know what my driving forces have been. I really feel now we have a accountability to offer again to society, which has been beneficiant to us.
You’ve spoken concerning the significance of mentorship all through your profession. Having benefited from nice mentors your self and gone on to mentor generations of clinicians and researchers, what recommendation would you supply to early-career cardiologists looking for to construct significant and impactful careers?
After I meet younger individuals who need to change into cardiologists, investigators, and many others., there are 4 issues I emphasise.
First, you attain a stage in society the place you might be obliged to offer moderately than continuously obtain. At that time, your accountability is to be inventive and contribute, moderately than merely criticise.
Second, you might want to perceive your abilities. That is the place mentors are important. Younger folks typically suppose they are often their very own mentors, however that could be a mistake. Even at my age, I nonetheless have two mentors. A mentor helps you establish your true abilities. It’s best to put money into these abilities moderately than in ambitions that won’t align with them.
The third factor is teamwork. Society has modified. We’re all half of a bigger engine, and we should be taught to work with different folks.
Fourth, you want resilience. Life will not be straightforward for anybody. If you happen to anticipate the whole lot to go positively on a regular basis, you might be mistaken. You need to learn to overcome difficulties, each professionally and personally.
These are the 4 rules I focus on with younger folks. Above all, it’s essential to recognise your expertise and put money into it, the second level I discussed.
If you happen to might establish one space of cardiovascular analysis that deserves larger consideration from the worldwide medical group, what wouldn’t it be and why?
Twenty years in the past, once I was creating my basis, three phrases got here to thoughts: science, well being, and schooling.
Science is key as a result of we want the essential rules that drive discovery. Well being has change into more and more essential as a result of I’m satisfied that, after finding out illness, we also needs to examine well being itself.
Right now, nevertheless, I’m very centered on schooling.
A part of that’s mentorship, however a good bigger concern is educating kids. If we really need to scale back heart problems because the world’s main killer, we should begin throughout childhood.
In the intervening time, we’re working with roughly 50,000 kids around the globe on programmes centered on well being schooling. We’re additionally working carefully with the American Faculty of Cardiology (ACC) on this effort.
As I’ve progressed by means of my profession, I’ve realised increasingly more that now we have not paid sufficient consideration to educating kids. We frequently focus on prevention with adults, however by maturity persons are already far alongside their path and fewer more likely to change. Kids hear.
So, whereas science and well being stay important, schooling is turning into more and more crucial for my part.
How can we higher educate kids to assist heart problems prevention?
This concept is scientifically pushed.
Kids have fewer receptor pathways developed than adults, and what you educate them is saved and carried ahead into maturity. Once we look again on our personal lives, we are able to see how essential the primary 10 years had been. Mother and father, faculties, pals, and our broader atmosphere all helped form who we grew to become.
As adults, we’re closely influenced by our childhood experiences. So why not use childhood to show about well being and make it a precedence?
The purpose is to assist kids attain maturity already valuing well being as a part of their lives.
We at the moment have many tasks centered on this space and are frequently publishing our findings. I’m very hopeful that this strategy will make a contribution.
One concern is that there is no such thing as a topic referred to as ‘well being’ in main faculty programs around the globe. It’s largely absent.
We’ve got not too long ago accomplished a guide designed for college programs that focuses particularly on well being and encourages kids to make it a precedence. That displays the place our pondering is as we speak. We have to pay rather more consideration to kids and schooling as a result of we consider it could have a big influence on heart problems prevention.
Lastly, while you look again in your profession, what legacy would you most hope to have left on cardiovascular medication and the sufferers it serves?
Frankly, I’m not searching for a legacy.
What I hope is that I’ve contributed, even when solely a really tiny small quantity, to bettering the world we reside in.
The muse we created displays that development: beginning with science, making use of science clinically, extending it to society by means of well being, and now specializing in schooling.
I might not describe it as a legacy. I would like to consider it as contributing to a step-by-step course of that helps create a more healthy society.
If, on the finish of my life, I might say that I contributed even half a millimetre to a greater world, that might be sufficient for me. That’s all I might ask for.
