World Heart Day 2026 | Cardiology Special | A Conversation with Dr. Josep Brugada: The Present and Future of Cardiovascular Health

Interview by Houda Bakkali

In this new in-depth interview, in celebration of World Heart Day and Heart Month 2026, internationally renowned cardiologist Dr. Josep Brugada reflects on the evolution of some of the key issues that have shaped the conversations I have had the privilege of conducting with him since 2013.

From the profound impact of the discovery of Brugada Syndrome, which he identified together with his brothers, to the transformative potential of artificial intelligence in predictive medicine, Dr. Brugada offers a perspective that bridges decades of medical progress with the challenges now redefining the future of cardiology.

He also revisits several enduring themes, examining both their current significance and what lies ahead: childhood obesity, the crucial challenge of health education, the evolving challenges of sports medicine, and the ethical responsibility surrounding medical communication in the digital age.

I would like to extend my sincere gratitude to Dr. Josep Brugada for his time and his enduring commitment to making medical knowledge more accessible, as well as for his dedication to prevention, education and greater public awareness of the issues that shape our health, well-being and collective happiness.

It is a true honour to learn from his expertise and to witness the evolution of cardiology through thirteen years of collaboration, bringing medical knowledge into a global dialogue where public information intersects with art, humanism, innovation and technology, exploring new possibilities and challenges in medical communication and health education.

«To take care of your heart, first, be happy. Second, take care of your body, everything around you, and everyone you love. Connect with others, live a healthy life, live a pleasant life. Above all, follow all your doctors’ advice.»

«It is very important that we connect with others, avoid loneliness, avoid ostracism, and avoid shutting ourselves away.»

«The problem with communication today is that fake news is invading everything. Nobody knows what is true and what is false.»

«Do not trust anything on the internet; do not follow advice on the internet given by who knows whom, without any kind of oversight.»

«Children should leave school with a very solid, well-substantiated understanding of the basic elements of health (…) and we should prevent social media, precisely, from being what misinforms them.»

«Not all of us have a body that is suited to everything. Not all of us can run marathons.»

«Sport prolongs life, makes it happier, makes it healthier, makes it better. But (…) be careful not to exceed physiological limits, such as running marathons every so often.»

«Artificial intelligence is helping us predict whether someone will develop a particular condition in the years ahead.»

«Basically, all heart diseases that do not have a purely genetic component can be prevented.»

«We can all prevent practically all heart diseases through our lifestyle, the way we behave, our character, and our willingness to take care of our body and our mind.»

«There is a very important part that depends on us, not on technology or treatments, but on our lifestyle, our way of being, and how we behave towards ourselves.»

«Brugada Syndrome still poses challenges in understanding the mechanism of the disease (…) we have two-thirds of patients in whom we have still not been able to identify which genetic mutation lies behind this syndrome, and that is important.»

«Obesity does not simply happen; it results from poor habits, and those habits develop from childhood. Ensuring that our children eat healthily, eat well, exercise, are happy, and play is absolutely fundamental to ensuring that their future adult lives are equally healthy and effective.»

«Within the family, it is essential to create a culture of healthy eating, eating together, sitting around the table and enjoying a family lunch or dinner with healthy food. That is basic and fundamental.»

«We have a hopeful headline every day (…) technology, science, and research have made it possible to radically change how we treat heart disease today.»

«Happiness is everything. If you are happy, then you normally see everything differently.»

Dr. Josep Brugada | Present and Future of Cardiovascular Health

How do you think new technologies and digital media are impacting the dissemination of medical knowledge? What do they contribute, and what challenges do they present?

The ability to reach so many people with truthful information is absolutely wonderful. It is something that allows us to educate the public. Our inability to clearly distinguish false news from reality, the informational contamination of reality, is what is leading us to this enormous challenge.

From a medical perspective, it is very difficult for us to provide truthful information when a patient comes to you and constantly bombards you by saying that they read it on the internet, that it says this or that. It is very difficult to fight against this because you constantly have to tell them that many of the things they are reading have not been verified. They are false stories, biased stories intended to steer citizens in one direction or another.

In 2014, you told me that medicine was moving towards prediction. Is this now routinely applied? What has been achieved, and what remains to be achieved in this field?

Indeed, artificial intelligence is helping us predict whether someone will develop a particular condition in the years ahead, because we can analyse large amounts of data and use them intelligently and ethically to see that there are, indeed, a series of patterns that identify patients who may experience problems in the future. Therefore, if someone fits one of these patterns, we can predict it and tell that individual: be careful, you fit this pattern and it is very likely that you could develop this type of condition; take care of these factors that could further trigger or increase the likelihood of this happening… I believe that this is the great challenge we face as a society in terms of public health.

In 1992, the definitive study on Brugada Syndrome was published in the Journal of the American College of Cardiology, describing it as a new clinical and electrocardiographic syndrome. How was this discovered, and what does this condition involve?

It is a genetic disease that affects the electrical channels of the heart. It causes these electrical channels to function abnormally, and in some cases this can lead to abnormal rhythms, some of them malignant, and even sudden death. This was discovered because the disease, this alteration of the channels, modifies the electrocardiogram. It has a very visible marker on the electrocardiogram that we were able to identify in a series of patients who had suffered sudden death, from which they had been resuscitated, and this allowed us to analyse all these patients in detail. We saw that they did indeed have a particular electrocardiogram, an electrocardiographic pattern that was repeated in all the patients, their families and all those who came afterwards. Ultimately, we were able to describe the disease, investigate and discover its genetic origin and the best therapeutic approach.

This has been a process spanning almost 35 years, during which we have never stopped learning or making progress, beginning with observations made in 1990–91 in a small number of patients, and today it is a disease widely recognised throughout the world.

What challenges remain today in the management of Brugada Syndrome?

Brugada Syndrome still poses challenges in understanding the mechanism of the disease. In approximately 35% of patients, we are able to identify the responsible genetic mutation.

But we have two-thirds of patients in whom we have still not been able to identify which genetic mutation lies behind this syndrome, and that is important. We have seen that in patients with highly malignant forms of the condition, that is, patients who experience several episodes of sudden death and are, of course, resuscitated because they have an implantable defibrillator that treats the malignant arrhythmia and brings them back to life, a whole series of electrical channels can be modified through catheter ablation, and this allows us, in many cases, to normalise the situation.

It will undoubtedly evolve over the coming years. From a technological perspective, we are going to have more tools and more resources to properly treat the majority of these patients.

What advantages and challenges does the digital era present in the field of cardiology?

The digital era offers a number of advantages, such as having access to all this accumulated information and being able to manage it for the benefit of the patient, which is fundamental and has helped us make progress.

But the digital era also presents many challenges regarding data protection, how we safeguard our patients’ privacy, and how all this information is used appropriately. We cannot simply accept information as truthful just because a machine gives it to us. Any recommendations that may emerge from information provided by artificial intelligence, for example, have to be implemented with clinical criteria, a physician’s judgement, and the common sense that a specialist physician brings to the management of all this information.

But it is true that the enormous volume of data we will have available in the coming years could be extraordinarily powerful if it is used in the right way, in the right direction, which is to help the patient.

It could also be devastating if it is used for the benefit of large multinational corporations seeking to exploit all that information to generate greater consumption of any kind. This includes, of course, the consumption of pharmaceuticals, and we must be extremely vigilant to prevent it from being used in this way.

From the perspective of coronary disease, where are we today?

We have known for a long time that when coronary arteries become blocked, we have to unblock them immediately. When a coronary artery becomes blocked, time is gold. Every second, every minute, that passes without that coronary artery being unblocked means cells in the heart are dying.

The Western world has implemented extremely urgent 24-hour care services for what is known as the “heart attack code”. In other words, if you have suspicious pain that could be a heart attack, no time is wasted; you are immediately transferred to a hospital under the “heart attack code” and the interventional cardiologist is immediately alerted to perform the procedure to unblock that coronary artery. Even in doubtful cases, this is what is done.

No time is wasted on intermediate steps; the patient goes directly to the catheterisation laboratory so that we can unblock the coronary artery, if possible within the first 90 or 100 minutes from the onset of pain. And this is what has led to a dramatic reduction in mortality and in long-term consequences as well.

And from a preventive perspective?

From the perspective of preventing coronary disease, there have undoubtedly been major advances in different medications to normalise cholesterol levels, which we know is one of the important factors contributing to atherosclerosis of the coronary arteries and, therefore, to coronary disease.

We are talking, undoubtedly, about the fight against obesity, the fight against sedentary lifestyles and against smoking. All of these are fundamental elements in combating coronary disease.

From a technological perspective, undoubtedly, all the tools used to diagnose coronary disease, the different applications of cardiac imaging, etc., have also represented a tremendous advance in the early diagnosis of incipient coronary disease, allowing preventive measures to be taken so that it does not progress.

And regarding the treatment itself…

All the guideline-based tools, and so on, currently used to treat coronary disease are at an extremely high technological level and make it possible to address practically any type of lesion without difficulty.

What are the main risk factors for heart disease?

We know that diabetes, hypertension and cholesterol are classic and well-known risk factors that must be controlled and treated aggressively, with sufficient intensity and sufficient conviction on the part of both the physician and the patient. The patient needs to understand that these conditions must be treated, that they are a very silent enemy, one that is there, doing its work day after day without us noticing, until the consequences become irreversible.

Therefore, all this information has to reach the patient and has to be conveyed clearly, transparently and truthfully, so that they fully understand what we are doing. We are not making their life worse by restricting certain things; on the contrary, we are promoting a much healthier, much longer life, while also helping them reach older age in good physical condition, so that they can enjoy that stage of life without living as a chronically ill patient.

Obviously, smoking, obesity and sedentary lifestyles are also key factors in managing these patients and helping them understand that their well-being depends greatly on their own behaviour towards themselves.

Which diseases can be prevented and which cannot?

Basically, all heart diseases that do not have a purely genetic component can be prevented, that is, the genetic component is what we have inherited and that is something we cannot change.

It is true that if we are aware that there is heart disease in our family, for example, many myocardial infarctions among all the men in the family and that this pattern keeps recurring, that family probably has a genetic predisposition to the disease and therefore has certain lottery numbers that were given to them at birth, which is genetics.

But what we have to prevent is these people buying extra numbers in this myocardial infarction lottery. In other words, they should take care of themselves, exercise, not smoke, and control their cholesterol, hypertension and diabetes, etc., with much greater intensity than someone with an entirely normal genetic profile, who therefore probably does not need to be extremely concerned because they do not have these extra numbers and can manage their life a little more calmly than someone we know has this genetic predisposition and who must be strongly warned that all the factors they add to the one they were given will be negative.

Therefore, we can all prevent practically all heart diseases through our lifestyle, the way we behave, our character, and our willingness to take care of our body and our mind. All of this will undoubtedly help prevent a great many heart diseases.

To what extent does therapeutic and pharmacological management guarantee a good quality of life?

It depends on each disease. Prevention is always better than treatment, that is clear. But once we have the disease, or once we have been unable to prevent it from occurring, the most appropriate treatment will have to be provided, whether pharmacological or invasive. If we are hypertensive and that hypertension is accompanied by a certain degree of obesity, a sedentary lifestyle and smoking, then by controlling these risk factors, our hypertension will probably be much less severe than we thought.

Preventive treatment will indeed help make pharmacological treatment much less intensive, or it may even mean that it is not required at all because we are able to control the condition through external factors.

How do stress and smoking affect cardiovascular health?

Without a doubt, they are two of the classic factors affecting our state of health, not only cardiac health but our overall health. They cause our body to run at an accelerated pace, at a speed that is not appropriate from the perspective of physiology and the circulation of catecholamines and all those elements that can be very useful at times when we need sudden stress to make an effort or to create a positive dynamic at a particular moment, but which, when repeated and inappropriate, can ultimately cause our body to suffer, with our physiology operating beyond the demands it needs to meet, and this causes the entire body to become stressed.

The heart becomes stressed, our nervous system becomes stressed, and this ultimately causes more anxiety, greater damage to the arteries, more atherosclerosis and more hypertension, and all of this, logically, ultimately affects our body.

Smoking, essentially, because of all the harmful effects of nicotine and all the substances contained in tobacco, which we know cause atherosclerosis, strokes and heart disease, as well as all kinds of disorders affecting both the neurological nervous system and the cardiovascular system.

When we talk about healthy eating, what should we avoid?

There are so many recommendations and so much variation when it comes to diet that I think we should try to avoid saying this is good, this is bad. What is good is clear: having a varied diet, having a healthy diet, having a diet with plenty of fruit, plenty of vegetables, plenty of fish, oily fish, a little meat, and variety. Weight control, controlling the calories we consume, not gaining weight, and exercising to burn off any excess calories we may consume.

Can you drink coffee? Yes. Can you drink tea? Yes. Can you eat chocolate? Yes. Can you drink 25 coffees a day? Certainly not. Can you drink three litres of wine? Certainly not. Can you have a small glass of wine every day with a meal? Well, of course.

And I think all of this makes life more pleasant, more relaxed, allows us to be more relaxed and to have a more active social life. It is very important that we connect with others, avoid loneliness, avoid ostracism and shutting ourselves away.

I believe that all these elements, at least in our Mediterranean society, are very important and allow us to have a much healthier, much more appropriate and much more fulfilling life from an emotional perspective.

Can artificial intelligence help with the early detection of heart failure?

Without a doubt, there are several studies underway on how to use all this information and manage it on a large scale. It allows us to adapt our concepts and the way we view a patient. Artificial intelligence will help us define risk patterns, and it will help us identify elements that may be very subtle but are barely visible to the human eye and which, when analysed through large volumes of data, will allow us to identify certain risk factors that are currently going unnoticed and enable us to prevent or predict which patients may develop heart failure in the future and, therefore, take the appropriate preventive measures to avoid it.

To what extent is childhood obesity a risk factor for the heart?

Without a doubt, it is one of the major risk factors, one of the major issues we need to combat. Obesity does not simply happen; it results from poor habits, and those habits develop from childhood. Ensuring that our children eat healthily, eat well, exercise, are happy and play is absolutely fundamental to ensuring that their future adult lives are equally healthy and effective.

If, from a very young age, our children are already eating junk food, eating processed foods all day long, eating foods with large amounts of calories, fats, etc., because that is the easy option, we give them that and do not have to worry about making sure they eat healthily, sitting down at the table, making sure they eat salad, fish, etc., etc., this ultimately creates a problem that we are paying for now.

There are societies, such as American society, that are further along in this respect, where we have seen that American society was ill because childhood obesity had already progressed into adult obesity, with a large proportion of the population being enormously overweight. And that is because when they were young, very young, nobody took care of addressing or preventing it.

Hopefully, we have learned the lesson and together we will be able to address it. Families are fundamental here. I believe that within the family it is essential to create that culture of healthy eating, eating together, sitting around the table and enjoying a family lunch or dinner with healthy food. That is basic and fundamental.

What are the main functions of sports cardiology?

To determine whether someone who is not a patient, but an individual who is going to practise sport, can do so in a healthy and effective way, that they understand their limits a little, that they understand that their heart cannot do everything. Not all of us have a body that can do everything. Not all of us can run marathons. Therefore, it is important to understand where our limits are, what condition our heart is in, whether we need to be careful with the type and intensity of sport we practise and, above all, to follow up, because we know that for some people, particularly with continuous endurance exercise, there may in some cases be an underlying, probably genetic, predisposition that can cause the heart to begin to suffer when we demand too much from it.

Only sports medicine, through regular check-ups of these people, will allow us to detect early when this is happening. Therefore, we have to use these tools, sports medical check-ups, to detect these cases.

How does sport affect a healthy heart?

Sport prolongs life, makes it happier, makes it healthier, makes it better. But at the same time, as I was saying, be careful not to exceed physiological limits, such as running marathons every so often. It is not physiological, it is not normal; it is something completely abnormal that goes beyond the normal, healthy, regular exercise that the general population should engage in, which is healthy, and it can enter a negative dynamic, as I was saying, in which hearts subjected to continuous intensive exercise begin to show signs that they do not like it, that the heart is being overworked and is beginning to suffer. That is what needs to be carefully monitored.

How do you think communication about cardiovascular health has evolved over the last decade? What challenges arise in this field amid the rapid expansion of artificial intelligence?

A tremendous challenge is combating all the fake news. In other words, the problem with communication today is that fake news is invading everything. Nobody knows what is true and what is false.

Artificial intelligence allows you to reproduce, or make it appear that you are reproducing, major figures in medicine or in any other field of science saying outrageous things, and they appear to be true when they are simply generated by artificial intelligence. People are compulsively consuming this type of information, and we are going to have to put a stop to it. This is going to be something tremendous, something governments will have to address very seriously, very, very, very seriously, to determine how we can stop this enormous amount of false news and informational contamination.

And that will be the great challenge: how we ensure that truthful, serious and verified information is what prevails in the media.

When you see that fake news is even being encouraged by governments, and I want to talk, for example, about Robert Kennedy in the United States as Secretary of the U.S. Department of Health and Human Services, who is anti-vaccine, anti-everything, anti-science and openly proclaims it…, this logically creates a tremendous risk for society that this could end very badly from the perspective of communication with the public.

And regarding cardiovascular health education, what remains to be done?

Classes on health in general, cardiovascular health, a healthy diet, how to take care of the body and how to take care of the mind should be absolutely compulsory.

Children should leave school with a very solid, well-substantiated understanding of the basic elements of health, so that they take care of their bodies, take care of their lives, understand the dangers of not doing so and prevent social media, precisely, from being what misinforms them.

What role does happiness play in health?

Happiness is everything. If someone is happy, then normally they see everything differently; they are no less ill. If they are ill, they see it more positively than someone who is pessimistic, for whom any minor health setback seems like the end of the world.

I believe that this aspect of being human, being positive, being happy, seeing things with determination, moving forward, carrying on and being happy with your family, your people, your neighbourhood, your work, or whatever you have, undoubtedly makes our heart respond positively as well.

A hopeful headline for patients suffering from a heart condition…

We have a hopeful headline every day. We have been able to make such enormous progress in cardiology over the last four or five decades in areas that were once unimaginable, when people died with no remedy or entered into an untreatable chronic disease. Today, we have pharmacological treatments, technological treatments and devices to treat practically every disease, prolong people’s lives and give them a much better quality of life.

Therefore, technology, science and research have made it possible to radically change how we treat heart disease today and, without a doubt, we will continue along this path. Therefore, the hope is that we are making progress. We must not forget something we have discussed throughout this interview: there is a very important part that depends on us, not on technology or treatments, but on our lifestyle, our way of being and how we behave towards ourselves.

And a realistic headline…

A realistic headline, I would say, would be: to take care of your heart, first, be happy. Second, take care of your body and everything around you and everyone you love. Connect with others, live a healthy life, live a pleasant life. Above all, follow all the advice of doctors and all sources that provide verified information. Do not trust anything on the internet; do not follow advice on the internet given by who knows whom, without any kind of oversight.

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Published on August 23, 2026 | Josep Brugada, Brugada Syndrome, Cardiovascular Health, Artificial Intelligence in Cardiology, Heart Disease Prevention, Sports Cardiology

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Interviews Featured in El Nuevo Herald, Miami; James Magazine, Italia; Montecarlo News, Monaco; INES-UNAM, México; Cultura Viva, Colombia; Barna Diario, Barcelona; Onmeda, Spain-Germany; Organization of Ibero-American States for Education, Science and Culture (OEI).

A Conversation with Dr. Josep Brugada: A Cartography of Cardiovascular Health

In this cartography, I curate a selection of my conversations with Dr. Josep Brugada on cardiovascular health, the impact of art and technology, and the importance of health education.