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Volume 15
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10.3390/jpm15080355
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Review

Behavioural Cardiology: A Review on an Expanding Field of Cardiology—Holistic Approach

by
Christos Fragoulis
1,*,†,
Maria-Kalliopi Spanorriga
1,†,
Irini Bega
1,
Andreas Prentakis
2,
Evangelia Kontogianni
2,
Panagiotis-Anastasios Tsioufis
1,
Myrto Palkopoulou
1,
John Ntalakouras
1,
Panagiotis Iliakis
1,
Ioannis Leontsinis
1,
Kyriakos Dimitriadis
1,
Dimitris Polyzos
1,
Christina Chrysochoou
1,
Antonios Politis
2 and
Konstantinos Tsioufis
1
1
First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
2
First Department of Psychiatry, Eginition Hospital, Vas. Sofias 72–74, 11528 Athens, Greece
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Pers. Med. 2025, 15(8), 355; https://doi.org/10.3390/jpm15080355
Submission received: 26 June 2025 / Revised: 23 July 2025 / Accepted: 1 August 2025 / Published: 4 August 2025
(This article belongs to the Special Issue Personalized Diagnostics and Therapy for Cardiovascular Diseases)
Versions Notes

Abstract

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health.
Keywords: behavioural cardiology; cardiovascular disease; psychosocial risk factors; metabolic factors; HEARTBEAT model; personalised medicine; digital health behavioural cardiology; cardiovascular disease; psychosocial risk factors; metabolic factors; HEARTBEAT model; personalised medicine; digital health

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MDPI and ACS Style

Fragoulis, C.; Spanorriga, M.-K.; Bega, I.; Prentakis, A.; Kontogianni, E.; Tsioufis, P.-A.; Palkopoulou, M.; Ntalakouras, J.; Iliakis, P.; Leontsinis, I.; et al. Behavioural Cardiology: A Review on an Expanding Field of Cardiology—Holistic Approach. J. Pers. Med. 2025, 15, 355. https://doi.org/10.3390/jpm15080355

AMA Style

Fragoulis C, Spanorriga M-K, Bega I, Prentakis A, Kontogianni E, Tsioufis P-A, Palkopoulou M, Ntalakouras J, Iliakis P, Leontsinis I, et al. Behavioural Cardiology: A Review on an Expanding Field of Cardiology—Holistic Approach. Journal of Personalized Medicine. 2025; 15(8):355. https://doi.org/10.3390/jpm15080355

Chicago/Turabian Style

Fragoulis, Christos, Maria-Kalliopi Spanorriga, Irini Bega, Andreas Prentakis, Evangelia Kontogianni, Panagiotis-Anastasios Tsioufis, Myrto Palkopoulou, John Ntalakouras, Panagiotis Iliakis, Ioannis Leontsinis, and et al. 2025. "Behavioural Cardiology: A Review on an Expanding Field of Cardiology—Holistic Approach" Journal of Personalized Medicine 15, no. 8: 355. https://doi.org/10.3390/jpm15080355

APA Style

Fragoulis, C., Spanorriga, M.-K., Bega, I., Prentakis, A., Kontogianni, E., Tsioufis, P.-A., Palkopoulou, M., Ntalakouras, J., Iliakis, P., Leontsinis, I., Dimitriadis, K., Polyzos, D., Chrysochoou, C., Politis, A., & Tsioufis, K. (2025). Behavioural Cardiology: A Review on an Expanding Field of Cardiology—Holistic Approach. Journal of Personalized Medicine, 15(8), 355. https://doi.org/10.3390/jpm15080355

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