Background: Prevention of cardiovascular disease at population level has proven to be both possible and successful. The European Heart Health Charter (EHHC) outlines goals for successful cardiovascular (CV) prevention both in individuals and at a national level. The objective of this study was to explore key European health policymakers’ perceptions of their country’s proximity to the EHHC-targets and their views on obstacles to domestic CV health and on the actions needed to improve it.Design: Questionnaire, descriptive.Method: The questionnaire was distributed to health policy leaders (n = 116) within the Ministries of Health, public health institutes, cardiac societies and heart foundations in 32 European countries, assessing previous knowledge, goal fulfilment of the EHHC, perceived obstacles to CV health, actions deemed to be important to improve the CV situation, and measures to promote CV health.Results: The response rate was 68%. The general consensus was that the national CV situations were far f...