Evidence that cardiovascular disease is contributing to the slowdown in improvements in life expectancy in some OECD countries prompted OECD and The King’s Fund to convene an international workshop to examine this issue. Invitees included members of OECD’s Health Care Quality and Outcomes Working Party and five international experts. This publication describes the workshop proceedings and conclusions about the evidence on trends in cardiovascular disease mortality, their drivers and the policy implications. The report includes contributions by the plenary speakers, Susanne Løgstrup (European Heart Network), Jessica Ho (University of Southern California), Catherine Johnson (Institute of Health Metrics and Evaluation), Anton Kunst (Amsterdam AMC) and Martin O’Flaherty (University of Liverpool). It shows cardiovascular disease is an important contributor to slowing life expectancy improvements in some countries, and flags some measurement problems such as international differences and changes in diagnostic practices and cause of death coding, and the complex linkages between cardiovascular disease and other causes of death. The report calls for improvements in national and international data and monitoring to support more timely and effective policy responses for preventing, managing and treating cardiovascular disease, and for tackling socio-economic and gender inequalities.