This new GCOA paper, published alongside the launch of the Aging with Heart Alliance, provides an analysis of cardiovascular disease (CVD) as the leading global cause of death and underscores the urgent need for a prevention-based approach. With the world undergoing an unprecedented aging megatrend, CVD prevention is more critical than ever, as aging populations face higher risks of multimorbidity, chronic disease, and healthcare strain. The paper advocates for a continuum-based prevention strategy—spanning primordial, primary, secondary, and tertiary prevention—to mitigate CVD’s growing burden on individuals, healthcare systems, and economies. By emphasizing innovation, policy-driven solutions, and the integration of community-based care, the paper calls for a global commitment to prioritizing prevention as a sustainable and cost-effective solution to combat CVD and promote healthier aging.