On 28 September 2026, the European Commission published its Proposal for a Council Recommendation on cardiovascular health checks: an EU approach to early detection and screening. For FH Europe Foundation and our community, this is an important milestone and there is much to welcome.
The proposal takes forward one of the flagship initiatives of the EU Safe Hearts Plan and sets out a European approach to cardiovascular health checks and earlier detection. For people and families affected by inherited lipid disorders, several elements are particularly significant.
The proposal explicitly recognises familial hypercholesterolaemia (FH), elevated lipoprotein(a) [Lp(a)] and inherited or genetically influenced cardiovascular risk. For adults aged 35–64, the proposed health checks include a full lipid profile, comprising total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, together with Lp(a) measurement once in adulthood. Family history is recognised as an important part of cardiovascular risk assessment. The proposal also places strong emphasis on equitable access, reaching underserved populations, patient involvement, referral and follow-up, and personalised prevention.
For our FH, Lp(a), FCS and wider inherited lipid community, this represents significant progress. Issues we have collectively advocated for over many years are increasingly becoming part of mainstream European cardiovascular prevention policy.
At the same time, there is an important opportunity to go further. The proposal embraces a life-course approach to cardiovascular health. We strongly welcome this principle. But for inherited lipid disorders, a genuine life-course approach must begin early in life. FH does not begin at 35. A child with FH is born with the condition and experiences elevated LDL cholesterol from birth. Identifying that risk early creates the opportunity to intervene before decades of exposure have accumulated.
The proposed Annex includes a cardiovascular health check for people under 35 and recognises the importance of family history, but the explicit full lipid profile appears in the systematic health checks proposed for adults aged 35–64.
This is why FHEF will continue to advocate for stronger recognition of early detection during childhood, combining universal paediatric screening with cascade and reverse cascade screening. These approaches reinforce one another. Finding a child with FH can lead to the identification of an affected parent and other relatives. Finding an affected adult can lead us to children, siblings and other family members. One diagnosis can become an opportunity to protect an entire family.
The publication on 28 September is a major milestone, but it is not the end of the process. The European Commission has published a Proposal for a Council Recommendation. The proposal now moves into discussion between Member States in the Council before a final Recommendation can be adopted. Council Recommendations are not legally binding in the same way as EU Regulations or Directives. Instead, they provide a common European policy framework and recommended actions that Member States can translate into their national health systems. This means the next phase of advocacy increasingly moves from Brussels to national capitals.
Our approach is simple - protect what has been achieved, strengthen what is still missing, prepare for implementation. We want to protect the recognition of FH, Lp(a), triglycerides, family history and inherited risk. We want to strengthen the life-course approach so that early identification of inherited lipid disorders, including during childhood, is properly reflected. And ultimately, we want to help turn European recommendations into effective national screening, diagnosis, referral and care.
FHEF will be sending an official communication to the European Commission, welcoming the proposal and recognising the considerable progress it represents, while highlighting opportunities to strengthen early detection across the life course. At the same time, we are mobilising our Network. On 6 and 8 October, FHEF is hosting dedicated briefings with our Community Network Leaders, ambassadors and wider community to examine the proposal, discuss its implications and coordinate the next phase of national engagement. Our members will be encouraged to engage constructively with their Ministries of Health and national policymakers, using scientific evidence, national experience and the lived experience of families to support the next steps.
“The publication of this proposal is an important achievement. FH and Lp(a) are recognised, triglycerides are included, and inherited cardiovascular risk and family history are now clearly visible. There is much to celebrate. Now we have an opportunity to build on that progress and suggest some targeted tweaks that could make the recommendations even stronger.
For families affected by inherited lipid disorders, particularly FH and its rare and severe form such as HoFH, early detection must mean early in life, starting in childhood. A stronger life-course approach would also benefit children living with conditions such as type 1 diabetes. Our communities now have an opportunity to help turn this European ambition into meaningful prevention for children, adults and entire families.”
Magdalena Daccord, CEO, FH Europe Foundation