Advances in cardiovascular science have highlighted the heterogeneity of cardiovascular risk, driven by genetic predisposition, comorbidities, lifestyle, and life-stage–related physiological changes. Novel biomarkers and improved imaging techniques now enable more refined risk assessment, allowing clinicians to move beyond a “one-size-fits-all” approach toward more individualized prevention strategies. This session aims to promote earlier risk identification, and support more comprehensive, patient-centered approaches. Furthermore, by examining the US vision in primary prevention and the Italian approach in secondary prevention, the session will offer valuable insights into how healthcare organization and how adherence to guidelines can be integrated to optimize outcomes.