New European Society of Cardiology guidelines, the first dedicated guidance on cardiovascular disease and chronic kidney disease, cardiac rehabilitation recommendations and emerging evidence on silent atherosclerosis were among the key developments highlighted at ESC Congress 2026, according to cardiologist and researcher Maria Rubini.
New ESC Guidelines Among the Major Highlights
Looking back at the European Society of Cardiology (ESC) Congress 2026, Maria Rubini, Cardiologist and Senior Researcher at the National Centre for Cardiovascular Research (CNIC) in Madrid, Spain, identified the new clinical guidelines as one of the meeting’s most important scientific highlights.
Among the changes she highlighted were revisions to heart failure classification. According to Rubini, the new heart failure guidelines remove the separate category of heart failure with mildly reduced ejection fraction, leaving two categories. She said the change could help simplify clinical practice.
New Guidance on Cardiovascular Disease and Kidney Disease
Another major development was the introduction of the first ESC guidelines addressing cardiovascular disease and chronic kidney disease. The two conditions frequently intersect in clinical care, making coordinated cardiovascular and kidney health management an important area for clinicians.
ESC Congress 2026 also saw the introduction of the first ESC guidelines on cardiac rehabilitation, adding another major guideline area to the meeting’s scientific programme.
Fifth Universal Definition of Myocardial Infarction
Rubini also highlighted the Fifth Universal Definition of Myocardial Infarction, for which she served as a task force member. She described the document as offering a new approach to defining myocardial infarction and said it could help simplify clinical practice.
Together, the guideline updates represented what Rubini considered one of the central scientific themes of the 2026 ESC Congress.
REACT Trial and the Future of Cardiovascular Prevention
Among the late-breaking trials presented at the congress, Rubini singled out the REACT trial as having the potential to influence cardiovascular prevention.
According to Rubini, the study found evidence of silent atherosclerosis in almost 60% of apparently healthy participants, including people at a relatively young age. The finding could prompt further discussion about when and how cardiovascular disease prevention should begin.
Could Imaging Play a Bigger Role in Detecting Atherosclerosis?
The findings also raise questions about the way apparently healthy people are assessed for cardiovascular risk. Traditional risk assessment commonly includes factors such as blood pressure and blood tests, while imaging can provide information about structural changes in blood vessels.
Rubini suggested that imaging techniques such as ultrasound could have a greater role in identifying atherosclerosis in the future. If research supports broader clinical use, such approaches could potentially complement conventional cardiovascular risk assessment.
However, findings from a research study should not automatically be interpreted as a recommendation for population-wide screening. Further evidence and clinical guidance are needed to establish which individuals should undergo imaging and how such findings should influence treatment.
Women’s Cardiovascular Health Remains a Major Concern
Rubini also discussed her work as Chair of the ESC Gender Task Force from 2024 to 2026. She highlighted the continuing importance of sex and gender differences in cardiovascular disease.
Cardiovascular disease remains a leading cause of death among both women and men. Rubini pointed to concerns that women have historically been underrepresented in research, as well as underdiagnosed and undertreated in some areas of cardiovascular care.
She said these disparities were among the factors that motivated her interest in women’s cardiovascular health.
Moving From Discussion to Action on Sex and Gender
During her tenure, Rubini highlighted several developments intended to increase attention to sex and gender in cardiovascular medicine.
She pointed to two EU policy initiatives mentioned in the interview—the Safe Hearts Plan and the Gender Equality Strategy 2026–2030—as examples of broader policy efforts that place emphasis on sex and gender in cardiovascular health.
According to Rubini, the ESC worked with policymakers during the development of these initiatives, which she described as an important step towards translating discussion around sex and gender into practical action.
Dedicated ESC Topic Area for Sex and Gender
Within the ESC Gender Task Force, one notable change was the creation of a dedicated topic category for sex and gender in cardiovascular health. Previously, women’s health had been included under the broader category of “special populations.”
The task force has also curated a collection of articles focused on sex and gender in cardiovascular health and is planning additional educational initiatives, including webinars and a major women’s heart health programme.
Women’s Heart Health Featured at ESC Congress 2026
Women’s cardiovascular health was also represented through several activities at the 2026 congress. These included a dedicated Young Investigator Award focused on women’s health and clinical case sessions addressing cardiovascular disease in women.
A joint session with the World Health Organization (WHO) also focused on women’s cardiovascular health, highlighting the growing emphasis on sex-specific and gender-sensitive approaches in cardiovascular medicine.
Clinical Trials Increasingly Reporting Sex-Disaggregated Data
One of the developments Rubini found particularly encouraging was the increasing inclusion of women and men in clinical trials and the growing availability of sex-disaggregated research data.
Reporting results separately by sex can help researchers identify potential differences in disease presentation, treatment response and outcomes. More balanced participation can also improve the relevance of clinical evidence to the populations receiving care.
What ESC Congress 2026 Means for Cardiovascular Care
The developments highlighted by Maria Rubini point to several interconnected priorities in modern cardiology: clearer clinical definitions, updated guidelines, earlier identification of cardiovascular disease, closer attention to the interaction between cardiovascular and kidney health, and more inclusive research.
The focus on women’s cardiovascular health also reflects a broader effort to ensure that differences related to sex and gender are incorporated into cardiovascular research, education and clinical practice.
While individual studies such as REACT may influence future approaches to prevention, changes in routine clinical care ultimately depend on the totality of evidence, guideline recommendations and further validation.
Key Takeaways From the ESC Congress 2026 Interview
- New ESC guidelines were identified as a major scientific highlight of the 2026 congress.
- Heart failure classification has been revised, according to Maria Rubini, with heart failure with mildly reduced ejection fraction no longer retained as a separate category.
- The ESC introduced its first guidelines on cardiovascular disease and chronic kidney disease.
- The first ESC guidelines on cardiac rehabilitation were also highlighted.
- The Fifth Universal Definition of Myocardial Infarction offers a revised approach to defining myocardial infarction.
- The REACT trial found silent atherosclerosis in almost 60% of apparently healthy participants, according to Rubini.
- Women’s cardiovascular health received dedicated attention through research, educational sessions and collaboration with the WHO.
- Clinical trials are increasingly including women and men more evenly and reporting sex-disaggregated data.
Conclusion
ESC Congress 2026 highlighted a broad evolution in cardiovascular medicine, from updated definitions and clinical guidelines to earlier approaches to cardiovascular prevention and greater attention to sex and gender differences.
For clinicians, the developments discussed by Maria Rubini underline the importance of keeping pace with changing guidelines while interpreting emerging research within the wider body of clinical evidence. For cardiovascular research, the increasing focus on inclusive trials and sex-disaggregated data could provide more detailed evidence for understanding and treating heart disease across different patient populations.
Source: Interview with Maria Rubini, Cardiologist and Senior Researcher, National Centre for Cardiovascular Research (CNIC), Madrid, Spain, published by EMJ Cardiology on September 30, 2026.
Primary keyword: ESC Congress 2026
Secondary keywords: ESC 2026 guidelines, heart failure guidelines 2026, cardiovascular disease and chronic kidney disease, cardiac rehabilitation guidelines, REACT trial, silent atherosclerosis, women’s cardiovascular health, sex and gender in cardiology, myocardial infarction definition
Meta title: ESC Congress 2026: Key Cardiology Guidelines & Research
Meta description: ESC Congress 2026 highlighted new heart failure guidance, cardiovascular-kidney disease recommendations, the REACT trial and advances in women’s cardiovascular health.
Disclaimer: This article is intended for healthcare professionals and is based on the cited interview and information provided. It is not a substitute for official clinical guidelines or professional medical judgement.
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