Ethical Governance of Artificial Intelligence in Cardiovascular Disease Management: A Health Policy Perspective

Abstract

Artificial intelligence (AI) is increasingly integrated into cardiovascular disease (CVD) prevention, diagnosis, and risk stratification, offering opportunities to improve early detection and population health outcomes. However, rapid adoption of AI technologies has outpaced the development of ethical, regulatory, and equity-centered governance frameworks, raising concerns about algorithmic bias, transparency, interoperability, and public trust. This editorial examines challenges in the governance of AI for cardiovascular care in the United States and situates them within global digital health policy discussions. While current federal oversight primarily focuses on clinical safety, this editorial advances a policy-oriented framework, formulated by the authors as the Artificial Intelligence Driven Cardiovascular Health Equity and Data Integration Act (AI-CVD Equity Act). This proposed act builds upon the existing Food and Drug Administration (FDA) and Department of Health and Human Services (HHS) initiatives by introducing mandatory, standardized demographic bias audits and regionally coordinated community oversight with critical layers of governance currently absent from federal frameworks to support equitable, transparent, and accountable AI deployment. Strengthening governance, workforce capacity, and community engagement is essential to ensure that AI-driven innovation reduces, rather than exacerbates, cardiovascular health disparities.

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