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EU Coalition on Structural Heart Diseases

EU SHD Coalition

The Structural Heart Disease Coalition (SHD Coalition) is a European network that brings together experts including key opinion leaders, politicians, patients and industry that collaborate to ensure that SHD is prioritised in policy with the aim of decreasing the burden of the disease and improving patients’ quality of life.

Lobbying Activity

Meeting with Romana Jerković (Member of the European Parliament, Rapporteur) and The European Association of Hospital Pharmacists

3 Dec 2025 · Cardiovascular Health

Response to Strategy on Intergenerational Fairness

11 Nov 2025

The EU Structural Heart Disease (SHD) Coalition, a European multi-stakeholder platform dedicated to improving the diagnosis, treatment, and care of individuals affected by SHD, welcomes the European Commissions initiative to develop a Strategy on Intergenerational Fairness. This represents an important opportunity to promote solidarity and equality between generations and ensure that all Europeansyoung and old alikecan live in good health, contribute to society, and benefit from equitable access to care and innovation. In the context of demographic ageing and increasing health inequalities, the Strategy can play a pivotal role in guaranteeing that no generation is left behind and that Europes social model remains sustainable for the decades to come. Today, SHD, encompassing degenerative conditions such as aortic stenosis that primarily affect older adults, as well as congenital heart defects affecting younger people, impacts over 14 million Europeans, a figure expected to exceed 20 million by 2040. Unlike most cardiovascular diseases, SHD cannot be prevented through lifestyle changes but can be detected early and effectively treated. Yet up to half of severe cases remain undiagnosed until advanced stages, leading to avoidable hospitalisations, loss of independence, and premature mortality. Missed follow-up in younger congenital patients also results in preventable complications. Failing to address SHD undermines wellbeing across generations and increases the burden on families, caregivers, and healthcare systems. Ensuring early detection and access to care is therefore a matter of intergenerational fairness and solidarity. The forthcoming EU Cardiovascular Health (CVH) Plan offers a key opportunity to address these challenges and should be closely linked with the Strategy on Intergenerational Fairness. Cardiovascular diseases, including SHD, are Europes leading cause of death and disability, responsible for 3.9 million deaths annually and costing over 282 billion each year. Integrating cardiovascular health into the Strategy will promote active ageing by keeping older citizens healthy, independent, and socially engaged, while ensuring continuity of care for younger SHD patients as they reach adulthood. Early detection and timely care can prevent avoidable suffering, reduce healthcare costs, and preserve the social and economic contributions of all generations. To achieve this, the Strategy should recognise equitable access to healthcare across member states as a core pillar of intergenerational fairness. Early detection programmes such as heart checks, combining stethoscope exams and echocardiography for adults over 65, should be integrated into routine care, supported by sustainable EU and national funding. Innovation must also be at the heart of fairness. Digital diagnostics, AI-supported auscultation tools, and minimally invasive treatments can dramatically improve early detection and outcomes for SHD patients, but access remains uneven across Member States. Such measures can prevent severe complications, improve survival, and reduce the long-term burden on healthcare systems. Gender-sensitive approaches are equally essential. Women with SHD are more likely to be misdiagnosed or treated later than men, resulting in poorer outcomes. The Strategy should therefore promote gender-balanced research, awareness, and care models that address these inequities. In conclusion, the EU SHD Coalition calls on the European Commission to ensure that cardiovascular health is explicitly recognised as a priority within the Strategy on Intergenerational Fairness. This should include embedding early detection and access to care for SHD and other CVDs in national ageing and health equity policies; ensuring sustainable EU funding to support screening and innovation; and promoting intergenerational solidarity in healthcare, so that all citizens, regardless of age, benefit from timely diagnosis, treatment, and rehabilitation.
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Response to EU’s next long-term budget (MFF) – EU funding for competitiveness

7 Nov 2025

The EU Structural Heart Disease Coalition is a European network of leading clinicians, patient advocates, researchers, and policymakers working to advance the diagnosis, treatment, and care of individuals affected by Structural Heart Disease (SHD). Cardiovascular diseases (CVDs) represent the leading cause of death in the EU, affecting more than 60 million Europeans, and accounting for over 1.7 million deaths annually on the continent, and costing its economy an estimated 282 billion each year. Within this spectrum, SHD, a key subgroup of CVDs, is a growing but often overlooked public health challenge, affecting approximately 14 million Europeans. It cannot be prevented, but once detected, it can be easily treated. The SHD Coalition commends the European Commission's consultation on the upcoming Multiannual Financial Framework (MFF) and future financial programmes and welcomes the European Commissions strong commitment to tackling the cardiovascular disease burden through the development of an EU Cardiovascular Health (CVH) Plan, which explicitly recognises SHD as a key health priority. This response focuses on funding mechanisms to secure sufficient and dedicated resources that improve patient outcomes, strengthen healthcare resilience, and enhance Europes competitiveness. Given that the Commission has already alerted that the current budgetary cycle will not provide sufficient resources to ensure the full implementation of an ambitious and well-funded EU CVH Plan, the post-2027 MFF must include dedicated financial instruments to ensure its success. Adequate funding for the CVH Planincluding SHD initiativesis essential to reduce fragmented screening, delayed diagnosis, and unequal access to care. The EU Beating Cancer Plan demonstrates how matching policy ambition with funding can achieve measurable impact. Comparable investment in cardiovascular health will yield significant societal and economic returns by preserving workforce productivity, promoting healthy ageing, and stimulating innovation in medical technologies. Dedicated EU-level fundingcomplemented by national healthcare budgets and public-private partnershipsis crucial to ensure sustainable investment in prevention, diagnosis, treatment, research, and workforce capacity. Health-focused instruments within the proposed EU Competitiveness Fund should support early detection programmes, patient pathways, cardiovascular centres of excellence, registries, and health innovation. The integration of SHD and cardiovascular data into the European Health Data Space (EHDS) will support trans-national research, registries and evidence-based policy-making. Failing to envision sufficient funding for the CVH Plan will worsen the current situation, especially for SHD patients, where fragmented screening programmes, delayed diagnoses, and uneven treatment availability exacerbate health inequalities as well as patient mortality. This requires EU-level funding mechanisms, national healthcare budgets, and public-private partnerships to ensure stable financial support for treatment, research, and healthcare infrastructure. EU and national funding mechanisms should support innovative digital and AI-driven screening technologies like digital stethoscopes and shared data platforms, to improve detection and optimise treatment outcomes. Particular attention must be paid to gender bias and health inequalities, as women remain disproportionately underdiagnosed and undertreated in cardiovascular care. Patients and civil society should be actively involved in the design and monitoring of EU-funded CVH and SHD programmes to ensure responsiveness to real-world needs. The SHD Coalition urges the European Commission to allocate dedicated funding for SHD in the post-2027 MFF. Integrating SHD into the EUs broader strategic priorities, including the European Health Union, and the Digital Europe Programme, will deliver sustainable health, social, and economic benefits for all Europeans.
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Meeting with Viktória Ferenc (Member of the European Parliament)

24 Sept 2025 · World Heart Day video

Response to EU cardiovascular health plan

12 Sept 2025

The EU Structural Heart Disease (SHD) Coalition welcomes the European Commissions initiative to develop a comprehensive EU Cardiovascular Health (CVH) Plan, inspired by EU Beating Cancer Plan. To be impactful, the plan must address SHD, a subgroup of deadly CVDs that cannot be prevented through a healthy lifestyle but can be detected early and treated effectively. SHD, which includes conditions such as aortic stenosis and other valvular heart disease, is a degenerative disease linked to functional decline that affects over 14 million people in Europe today, a figure projected to rise to 20 million by 2040 due to ageing demographics. Without treatment, up to 75% of people with severe SHD die within three years. SHD is widely underdiagnosed or misdiagnosed, particularly in women and older adults, and 7 in 8 Europeans remain unaware of the condition. Yet, once diagnosed, effective treatment options are available that significantly improve survival, independence, and quality of life. Early detection is essential to save lives and reduce costs, but it is rarely routine in medical practice. SHD prevalence increases steeply with age, affecting 30% of those aged 85 and above. Early detection through auscultation and echocardiography significantly improves outcomes, but time, training and awareness barriers mean these checks are often missed. The lack of SHD-specific detection guidelines further contributes to delayed or missed diagnoses. To address this, we propose EU-wide early detection guidelines, including routine heart checks such as stethoscope exams and echocardiograms for people aged 65 and over. Digital tools, such as AI-powered auscultation and symptom checkers, should be used to support triage and referral. Screening programmes could be funded via EU4Health, ERDF or Digital Europe and the future EU MFF, and should foster support to Member States to embed SHD detection in national cardiovascular protocols, leveraging primary care, pharmacists, and mobile clinics. Gender-sensitive measures must also be integrated into the CVH Plan. Women with SHD are often diagnosed later, treated less frequently than men, and present atypical symptoms that lead to misdiagnosis. Women also remain underrepresented in clinical trials, resulting in significant evidence gaps. The CVH Plan must dedicate funding for research and care programs concentrating on womens cardiovascular health, particularly via SHD early detection and timely treatment for those 55 years old and above, as well as during key life stages such as postpartum and post-menopause. CVDs cost the EU EUR 282 billion annually, added with the exponential rise of SHD, sustainable funding is critical to make their detection, and treatment a reality. In the Netherlands alone, underutilisation of SHD treatment results in an annual productivity loss of between EUR 3 and 6 billion. Funding from EU4Health, the IHI, and Cohesion Funds should therefore be allocated to support screening and referral pathways infrastructure, to support Member States and allow development of tailored national SHD detection protocols and programmes, and the creation of data hubs, including EU wide registries. This could be managed by a EU Knowledge Centre on Cardiovascular Health. Public-private partnerships should be encouraged to accelerate the adoption of AI diagnostics and digital tools. Implementing existing best practices in SHD care will be essential to build effective SHD detection models. Evidence from France, Germany, Italy, Spain and the UK, highlights the value of age-based invitations for heart checks by GPs or cardiologists, the use of validated symptom questionnaires such as the Global Heart Hub tracker, the engagement of pharmacists and community health actors to raise awareness, and the integration of SHD checks into existing atrial fibrillation or heart failure screening programmes for efficiency. By integrating SHD into the plans priorities, the EC can save lives and reduce inequalities.
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Response to Gender Equality Strategy 2026-2030

8 Aug 2025

The EU Structural Heart Disease Coalition (SHD Coalition) is a European network of more than 60 leading clinicians, patient advocates, researchers, and policymakers working to advance the diagnosis, treatment, and care of individuals affected by Structural Heart Disease (SHD). SHD is a key form of cardiovascular disease (CVD) affecting the hearts valves, walls, and chambers. SHD is a growing public health concern in Europe; it is estimated that SHD currently affects 14 million people in Europe. It cannot be prevented but once detected it is easily treated. Addressing them can prevent many avoidable deaths and improve the quality of life of patients. It disproportionately impacts older people, and particularly women, who face persistent disparities in diagnosis, treatment access, and outcomes. With Europes ageing population, this means that in 2040 more than 20 million people will suffer from SHD. CVDs remain the leading cause of death among women in Europe, with a mortality rate of 37% compared to 31% in men, far exceeding deaths from all cancers combined. Despite this, gender equality efforts in health have largely focused on reproductive and sexual health, leaving a major gap in addressing NCDs like SHD. Women with SHD are often diagnosed later, present with more advanced disease, and are less likely to receive timely life-saving treatment. This is due to several factors, including a lack of routine cardiovascular screening for women, atypical or misattributed symptom presentation (e.g., fatigue or breathlessness mistaken for anxiety or aging), and the frequent prescription of antidepressants, which can result in prolonged treatment for misdiagnosed cardiovascular symptoms and contribute to late referrals and poorer outcomes. Women are also frequently excluded from clinical trials and overlooked in clinical practice due to sex- and gender-related biases. For instance, women are underrepresented in cardiovascular clinical trials, representing only about 2030% of study populations. Women with SHD also experience higher rates of postoperative complications, in-hospital mortality, and poorer access to rehabilitation. This stems from delayed diagnosis and advanced disease at the time of treatment. For example, women with severe aortic stenosis are typically older at diagnosis (79 vs. 74 years), present with higher surgical risk scores, and more frequently enter care in critical preoperative states The upcoming 20262030 Gender Equality Strategy presents a critical opportunity to integrate equal access to care into the EUs broader gender agenda. The SHD Coalition calls on the European Commission to recognise the burden of SHD and other CVDs in women as a core example of gender inequality, with targeted policy and funding responses to address it. The strategy must explicitly address the systemic gaps that disadvantage women with cardiovascular problems, such as SHD. This includes increased investment in sex-sensitive cardiovascular research, clinical trials and in equitable access to treatment. While research is essential to closing the knowledge gap, funding for treatment itself is urgently needed. Equally important is improving early detection. The strategy should support routine cardiovascular screenings for women aged 55 and over, and during key life stages such as postpartum and post-menopause. These programs must account for sex-specific symptoms and risk profiles and be supported by training for general practitioners, nurses, and specialists. The use of AI tools should be promoted to help reduce gender bias in diagnosis and referral, and it shall be ensured that healthcare professionals receive comprehensive training in sex-sensitive care. Medical curricula must integrate knowledge of how CVDs manifest differently in women and be supported by guidelines that reflect these differences. Equal access to treatment alternatives across Member States must also be guaranteed to ensure that women receive appropriate care.
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Meeting with Olivér Várhelyi (Commissioner) and

16 Jul 2025 · Preparation for the upcoming EU Cardiovascular Action Plan

Meeting with Viktória Ferenc (Member of the European Parliament)

26 Mar 2025 · Introduction, exchange of views

Meeting with Vytenis Povilas Andriukaitis (Member of the European Parliament)

14 Mar 2025 · Introductory meeting

Meeting with Oliver Schenk (Member of the European Parliament)

5 Mar 2025 · Strukturelle Herzerkrankungen

Meeting with Ralf Kuhne (Cabinet of Commissioner Stella Kyriakides)

12 Jun 2024 · Cardiovascular health

Response to Interim evaluation of the EU4Health Programme 2021-2027

8 Jan 2024

The EU Structural Heart Disease (SHD) Coalition recognises that the EU4Health program, with its substantial 5.3 billion budget for the 2021-2027 period, stands out as unparalleled financial support from the EU in the health sector. This program sends a clear signal that public health is a top priority for the EU and serves as a key instrument in advancing the vision of a European Health Union. Moreover, the Coalition appreciates the ongoing efforts of the EU4Health Programme in funding projects for the prevention of non-communicable diseases (NCDs), particularly cardiovascular diseases (CVDs) which are mainly addressed through the just launched EU Joint Action on Cardiovascular Diseases and Diabetes (JACARDI) with a budget of 53 Million EUR. Combined with the 10 million EUR stakeholder projects, this financial support is a step in the right direction, supplementing concrete recommendations on CVD and diabetes within the Healthier Together initiative on NCDs. However, this funding does not match the scale of the challenge represented by CVD, which are still the leading cause of death in Europe, accounting for 36% of all deaths and impacting the lives of some 60 million people who live with CVD. Beyond the human costs, CVD also takes a considerable toll on healthcare systems, productivity and informal care by caregivers, with an estimated cost of EUR 210 billion per year in the EU. In particular, the European Commission must intensify its efforts to address the specific needs of patients suffering from Structural Heart Disease (SHD), with a particular emphasis on ensuring equal access to early detection of this disease mostly linked to ageing. Its estimated that 14 million people in Europe were living with SHD in 2020, and that by 2040, this will increase to 20 million, mostly due to the ageing European population. Recent estimates indicate that every year, more 50 000 Europeans die from Heart Valve Disease only. In addition, a recent report (see attachment) from the International Longevity Center finds that age, socio-economic status, gender, ethnicity, and geographical location significantly reduce the likelihood of being diagnosed and receiving treatment. It is evident that women are less likely to regularly receive a heart check with a stethoscope by their General Practitioner than men. Taking the above into consideration, the EU Structural Heart Disease Coalition urges the Commission to allocate future EU4Health funding to: 1. Develop an EU Cardiovascular Health Plan (CVD), including an EU-wide target for early detection of CVD including SHD. 2. Enable systematic targeted heart checks in community and primary care, to address inequalities in detection and access to treatment of SHD. 3. Supporting the development of heart disease plans in Member States, including SHD, that reduce the preventable burden of this disease through awareness campaigns, data collection, prevention, detection and treatment. In conclusion, while acknowledging the positive steps taken by the EU4Health Programme, we emphasise the urgency of further action to combat CVDs, especially SHD. By enhancing support for targeted projects to tackle the inequalities in the detection and treatment of CVDs and SHD, we can collectively strive to mitigate the devastating impact of cardiovascular diseases on European citizens.
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