Cardiovascular disease (CVD) is a significant global health concern and the leading cause of death in many countries. Early detection and diagnosis of CVD can significantly reduce the risk of complications and mortality. Machine learning methods, particularly classification algorithms, have demonstrated their potential to accurately predict the risk of cardiovascular disease (CVD) by analyzing patient data. This study evaluates seven binary classification algorithms, including Random Forests, Logistic Regression, Naive Bayes, K-Nearest Neighbors (kNN), Support Vector Machines, Gradient Boosting, and Artificial Neural Networks, to understand their effectiveness in predicting CVD. Advanced preprocessing techniques, such as SMOTE–ENN for addressing class imbalance and hyperparameter optimization through Grid Search Cross-Validation, were applied to enhance the reliability and performance of these models. Standard evaluation metrics, including accuracy, precision, recall, F1-score, and Area Under the Receiver Operating Characteristic Curve (ROC-AUC), were used to assess predictive capabilities. The results show that kNN achieved the highest accuracy (99%) and AUC (0.99), surpassing traditional models like Logistic Regression and Gradient Boosting. The study examines the challenges encountered when working with datasets related to cardiovascular diseases, such as class imbalance and feature selection. It demonstrates how addressing these issues enhances the reliability and applicability of predictive models. These findings emphasize the potential of kNN as a reliable tool for early CVD prediction, offering significant improvements over previous studies. This research highlights the value of advanced machine learning techniques in healthcare, addressing key challenges and laying a foundation for future studies aimed at improving predictive models for CVD prevention.