Overview

• Adults aged 30–79 with overweight or obesity and no prior cardiovascular disease must have 10-year risk of myocardial infarction, stroke and heart failure calculated with the PREVENT score.
• Clinicians must classify patients into low, moderate or high cardiovascular risk using defined bands of less than 5%, 5% to under 20%, or 20% or higher.
• The guideline sets weight-loss targets of at least 5% for less severe cases and 10% or more for those at moderate or high cardiovascular risk.
• Cardiac biomarker thresholds are adjusted for obesity, with NT-proBNP of 50 pg/mL prompting concern versus 125 pg/mL in people without obesity.
• Modern GLP-1 drugs including semaglutide, tirzepatide and liraglutida are endorsed for selected higher-risk patients, with authors citing high costs and limited public-system availability that require prioritization.