What changed recently

2025 focused update of the 2019 ESC/EAS guideline, incorporating newer lipid-lowering trial evidence while retaining risk-based LDL-C goals.

First full US revision since 2017: adopts the PREVENT equations for risk estimation (replacing the Pooled Cohort Equations) and reaffirms a <130/80 mm Hg treatment goal.

Reorganizes AF management around the patient-centred AF-CARE pathway, foregrounding comorbidity and risk-factor management.

Introduces a new 'Elevated BP' category (120–139/70–89 mm Hg) and a 120–129/70–79 mm Hg on-treatment target for most adults, with a Class I emphasis on out-of-office measurement.

Replaces the 2014 guideline and 2019 focused update: introduces a four-stage AF classification, emphasizes early rhythm control, and positions catheter ablation as first-line in selected patients.