The AHA PREVENT Risk Equations
The AHA PREVENT Risk Equations.
Source
• Study published: JAMA Cardiology, June 25, 2025
• Summary article: Medscape Medical News, June 27, 2025
The AHA PREVENT (Predicting Risk of Cardiovascular Disease Events) equations are newer tools developed by the American Heart Association to better estimate a patient’s risk of future cardiovascular disease (CVD)—including heart attacks, strokes, and heart failure.
They are designed to improve on older calculators like the Pooled Cohort Equations, especially in diverse populations.
Study Overview (Published in JAMA Cardiology, June 2025)
1. Objective
To test how well the AHA PREVENT risk calculator works in real-world patients of different ethnicities—particularly Asian and Hispanic populations.
2. Study Design
• Retrospective cohort of 361,778 adults (aged 30–79) seen at Sutter Health (California) from 2010 to 2023.
• Patients were free of CVD at baseline and had all required labs:
• Non-HDL cholesterol
• Systolic BP
• BMI
• eGFR
• Diabetes and smoking status
• Follow-up: Average of 8.1 years
Key Findings
• 22,648 CVD events occurred during follow-up.
• The PREVENT equations predicted risk more accurately than older models across all ethnicities.
Among Asian groups:
• Best performance in Asian Indian subgroup (C-statistic: 0.85).
• Filipino subgroup slightly lower but still good (C-statistic: 0.79).
• In general, risk was slightly overestimated for some Asian subgroups.
Among Hispanic groups:
• Consistent accuracy (C-statistics: 0.80–0.82).
• Calibration was strong—meaning predicted risk matched observed events.
Clinical Takeaways
• The PREVENT calculator is a reliable tool for estimating CVD risk in diverse populations, especially in Asian and Hispanic patients.
• It can guide more personalized and equitable preventive care—e.g., statin decisions, blood pressure goals.
• It’s better than previous tools for many ethnic groups.
Expert Perspective
This model is an important step forward for populations that were previously underrepresented in CVD prevention guidelines,” said Dr. Nilay Shah, Northwestern University.
(Timeline & Key Differences: ASCVD vs PREVENT Risk
Calculators):
1. 2013 – ASCVD (Pooled Cohort Equations)
▪ Released by AHA and ACC
▪ Estimates 10-year risk of heart attack and stroke
▪ Race-based (Black/White only)
▪ Limited to age 40–79
2. 2018–2022 – Criticism Grows
▪ Racial bias, poor accuracy in younger and non-White patients
▪ Excludes heart failure or kidney function
▪ Pressure builds for more inclusive models
3. November 2023 – AHA Launches PREVENT
▪ Developed by AHA only (not ACC)
▪ Race-neutral, broader age range (30–79)
▪ Predicts total CVD, not just ASCVD
▪ Includes eGFR, HbA1c, and social determinants
▪ Offers both 10-year and 30-year risk estimates
4. 2025 – PREVENT Validated in Large Diverse Population
▪ Outperforms ASCVD in Asian and Hispanic groups
▪ Stronger calibration, less risk overestimation
▪ Encouraged by AHA as preferred future model
Try the Calculators Yourself
• ASCVD Calculator (2013):
• AHA PREVENT Calculator (2023):