National Heart Center/Saudi Heart Association 2025 Guidelines for Cardiovascular Diseases Prevention and Risk Assessment

OBJECTIVES: To develop an evidence-based clinical guideline for the prevention and management of cardiovascular diseases (CVDs) in Saudi Arabia, tailored to local epidemiology and healthcare needs. METHODS: A multidisciplinary task force comprising cardiologists, public health specialists, and epidemiologists from different healthcare sectors in Saudi Arabia developed the guideline. Evidence synthesis was based on a comprehensive literature review and adaptation of international guidelines, particularly the 2021 European Society of Cardiology recommendations, contextualized to the Saudi setting. RESULTS: The guideline provides recommendations for both primary and secondary CVD prevention. Primary prevention emphasizes risk assessment incorporating genetic, lifestyle, and clinical factors, as well as lipid and glucose profiling. Lifestyle modifications, including dietary changes, smoking cessation, physical activity, weight management, and psychosocial support, are prioritized. Pharmacologic therapy targets lipid levels, blood pressure, and glycemic control, tailored to individual risk categories. For secondary prevention, strategies include post-event risk stratification, comorbidity management (diabetes, hypertension, chronic kidney disease), and optimization of pharmacologic therapy for coronary artery disease, heart failure, cerebrovascular disease, and peripheral artery disease. Lifestyle interventions, supervised cardiac rehabilitation, and routine follow-up for complication monitoring and treatment adjustment are integral components. CONCLUSION: This guideline presents an updated, evidence-based framework specifically designed for the Saudi population, underscoring prevention, lifestyle modification, and optimized pharmacologic management to address the rising burden of CVDs.