With annual ASCVD deaths projected to rise from 20.5 million (2025) to 35.6 million (2050), the authors make the Lancet case for earlier and longer primary prevention — aimed at slowing atheroma formation rather than intervening only once disease becomes symptomatic. The piece frames prevention as a life-course intervention and provides relevant context for conversations about early statin initiation, Lp(a) screening, and lifestyle measures.
As the global population ages, older adults with atherosclerotic cardiovascular disease (ASCVD) are projected to drive a growing proportion of morbidity, mortality, and health-care spending in the coming years.1,2 Annual deaths from ASCVD are projected to rise substantially, from 20·5 million deaths in 2025 to 35·6 million in 2050.3,4 As an emerging generation of clinicians caring for an increasingly complex aging population, we see an opportunity to re-examine primary prevention with a focus on lifelong healthy cardiovascular aging.
