Overview

• Five medical societies (ABESO, SBC, SBEM, SBD, ABS) unveiled the 2025 evidence-based guideline at the Brazilian Cardiology Congress in São Paulo.
• Adults aged 30–79 with overweight or obesity must have 10-year risk estimated with the PREVENT calculator and be classified as low, moderate, or high risk, with a separate high-risk category for heart failure.
• Biomarker cutoffs are tailored for obesity, with NT-proBNP attention at 50 pg/mL for BMI above 35 versus above 125 pg/mL for those without obesity.
• Care targets include at least 5% weight loss for general benefit and 10% or more for moderate or high risk, with prioritized use of GLP-1 agents such as liraglutide, semaglutide, and tirzepatide in selected patients, citing data of a 20% reduction in major events with semaglutide 2.4 mg in non-diabetic individuals.
• Implementation faces cost and access constraints in the public system (SUS), prompting calls to prioritize higher-risk patients and expand risk assessment in primary care.