Beyond Heart Attack: A New Lens on Risk

Key Takeaway: The American Heart Association’s new PREVENT equations represent a fundamental shift in cardiovascular risk prediction. These equations move beyond just heart attacks and strokes to focus on predicting heart failure risk, incorporating kidney function and metabolic health into the process. By calculating the expected benefit of treatment in absolute terms, these equations provide a concrete figure for physicians and patients to use as a basis for discussing the decision to start a new medication.

A Long-Awaited Advancement in Risk Calculation

For nearly a decade, the cornerstone of cardiovascular prevention in the United States has been the “Pooled Cohort Equations.” These formulas estimated the ten-year risk for atherosclerotic cardiovascular disease (ASCVD), namely heart attack and stroke. While they transformed clinical practice upon their release in 2013, these equations were a product of a different era^[2]. They were based on data from cohorts established decades ago, did not fully reflect the country’s diversity, and overlooked two of the most powerful drivers of modern cardiovascular problems: chronic kidney disease and metabolic disorders like obesity and type 2 diabetes. Now, a new AHA/ACC Scientific Statement provides a practical roadmap for implementing their successor: the PREVENT equations. These new equations were designed from the ground up for the modern epidemic of intertwined cardiovascular, kidney, and metabolic (CKM) diseases^[1].

Recommendations from the Scientific Statement

This statement is not the result of a single clinical trial. It is an expert consensus document—a detailed, evidence-based roadmap explaining how physicians should use the PREVENT equations in daily practice. The equations themselves were developed using data from more than 6.6 million adults across diverse community cohorts, making them…