This review highlights the importance of implementing preventive cardiology guidelines-both for primary and secondary prevention-to improve patient outcomes and reduce the burden of cardiovascular disease. Despite the availability of comprehensive guidelines, adherence remains suboptimal, resulting in a persistent gap between evidence-based recommendations and real-world clinical practice. To address this, we conducted a narrative review of studies published between January 2010 and March 2024 using PubMed, Scopus, and Web of Science. Studies were included if they focused on the implementation of cardiology guidelines and identified either barriers or facilitators to adherence. The synthesis of findings was structured using the Consolidated Framework for Implementation Research (CFIR), which organizes implementation factors into five domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and implementation process. Key strategies identified include continuous education and training for healthcare providers, integration of guidelines into clinical workflows through Clinical Decision Support Systems (CDSS), and strengthening of organizational infrastructure. Simplifying guidelines to increase usability and fostering patient engagement via educational interventions and digital tools were also emphasized. By aligning identified barriers with evidence-based solutions through the CFIR framework, this review provides a structured and practical roadmap for enhancing guideline adherence. Ultimately, these strategies aim to bridge the evidence-practice gap in preventive cardiology, enhancing the effectiveness, equity, and consistency of both primary and secondary cardiovascular prevention efforts.
Keywords: Cardiology; Clinical Practice Guidelines; Evidence-Based Practice; Guideline Adherence; Health Education; Patient Compliance.
© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.