Cardiovascular health as an unmet priority in addiction medicine: Implications of recent cardiovascular strategies

Abstract Aims To examine how recent cardiovascular strategies that emphasise mental health, psychosocial vulnerability, equity and integrated care expose a major and under‐addressed gap in addiction medicine: the limited integration of cardiovascular prevention into routine care for people with substance use disorders (SUD). Methods We conducted a narrative, policy‐informed analysis based on a selective synthesis of key international cardiovascular frameworks and health system strategies that explicitly incorporate mental health and psychosocial determinants into cardiovascular prevention. These priorities were examined in relation to existing evidence on cardiovascular risk, care pathways and service organisation in people with SUD. Results Contemporary cardiovascular strategies increasingly recognise mental health conditions, social disadvantage and chronic vulnerability as central determinants of cardiovascular risk and outcomes; however, these principles have not been systematically integrated into addiction medicine. People with SUD commonly present with clustering of traditional cardiovascular risk factors, high exposure to psychotropic medications, delayed recognition of cardiovascular conditions and reduced access to preventive interventions. Structural barriers, diagnostic overshadowing and fragmentation between addiction, mental health, primary care and cardiovascular services contribute to persistent cardiovascular inequities and preventable morbidity and mortality in this population. Conclusions Cardiovascular health remains marginal within addiction medicine despite its major contribution to preventable morbidity and premature mortality in people with substance use disorders. Integrating basic cardiovascular risk assessment, preventive interventions and coordinated care pathways into addiction services is a pragmatic and achievable approach to reducing avoidable cardiovascular harm and health inequality.