The role of ‘Power’ in transformative CVD prevention

Power has long been recognized in health promotion as a fundamental force that shapes people’s access to resources, participation in decision-making, and influence over the conditions that determine their health. To advance prevention more broadly, cardiovascular disease (CVD) prevention in particular, we need to explicitly consider how power dynamics operate at structural, institutional, and interpersonal levels. Doing so allows us to identify whose interests shape prevention agendas, whose knowledge is valued, and whose needs are prioritized within health systems. Traditional models of CVD prevention often reproduce existing power imbalances by privileging the perspectives of policymakers and health professionals, while social, cultural, and community voices remain marginalized. We need to shift these dynamics by redistributing power toward individuals and communities, particularly those most at risk for CVD, to foster more inclusive and responsive prevention efforts. Emphasizing shared decision-making, participatory frameworks, and the co-production of strategies can enhance both equity and sustainability. This perspective foregrounds agency, empowerment, and collaboration in reimagining prevention to address not only biological risk factors but also the broader social determinants of health. By acknowledging and reconfiguring power relations, we can develop prevention strategies that are just, relevant, and aligned with the lived realities of diverse populations.