Current status of cardiovascular risk factor control: are we meeting the targets?

Control of cardiovascular risk factors remains suboptimal worldwide, despite advances in pharmacologic therapies and evidence-based guidelines. Key modifiable determinants such as hypertension, diabetes, dyslipidemia, and smoking are still poorly managed, with fewer than half of patients achieving recommended targets in most registries, largely due to clinical inertia, limited adherence, and health system barriers. Beyond these classical determinants, non-biological barriers such as therapeutic inertia and limited treatment adherence continue to widen the gap between guideline recommendations and real-world practice. Addressing psychosocial factors is therefore essential for effective cardiovascular prevention. This review synthesizes current evidence, quantifies the treatment gaps across conventional and nonconventional risk factors, and highlights opportunities for integrated, patient-centered strategies to reduce residual cardiovascular risk.