Abstract
<jats:p>Background. The comorbidity of mental and cardiovascular diseases (CVD) represents a significant clinical problem associated with worse prognosis. However, until now, there has been a lack of systematic evidence-based guidelines for its management in cardiological practice. Objective: To inform the medical community about the key provisions and practical algorithms of the first 2025 ESC Clinical Consensus Statement on mental health and CVD. Material and methods. The Consensus is based on a critical analysis of over 680 scientific publications, including meta-analyses, large-scale population registry studies, prospective cohorts, and randomized clinical trials, summarizing the experience of managing millions of patients worldwide. Results. The Consensus establishes a bidirectional relationship between mental disorders and CVD. Depression, anxiety, and chronic stress are proven to be independent risk factors for the development of CVD (HR 1.14–1.55; RR 1.26–1.52), comparable in strength to traditional factors. The reverse vector («Heart → Psyche») is characterized by a high prevalence of affective disorders (20-30%) in cardiac patients, which worsen clinical outcomes. The document provides specific tools: a two-step screening algorithm using validated scales (PHQ-9, GAD-7), pharmacotherapy recommendations considering cardiovascular risks, and a multidisciplinary team approach. The practical ACTIVE (Acknowledge, Check, Tools, Implement, Venture, Evaluate) principle for integrated care is proposed. Conclusions. The 2025 ESC Clinical Consensus marks a paradigm shift, positioning the assessment of mental health as a mandatory component of cardiovascular examination. The implementation of standardized screening and multidisciplinary management is a new evidence-based standard of care aimed at improving clinical outcomes and patients' quality of life.</jats:p>