The American Heart Association PREVENT^TM Online Calculator

About the PREVENT Equations

Developed by the American Heart Association in 2023, the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations estimate 10-year and 30-year risk for total cardiovascular disease (CVD), including atherosclerotic CVD (ASCVD) and heart failure (HF). It is the first risk tool to combine cardiovascular, kidney, and metabolic health measures to guide primary prevention-focused treatment decisions.

The equations were derived and validated using data from over 6.5 million U.S. adults across multiple datasets, and they are validated for adults ages 30–79 years without known CVD.

The PREVENT calculator, based on the PREVENT equations, uses required clinical information to estimate CVD risk. Three optional predictors, urine albumin-creatinine ratio (UACR), hemoglobin A1c (HbA1c), and social deprivation index (SDI), can further personalize risk estimates.

The PREVENT calculator provide separate 10-year and 30-year estimates for total CVD (PREVENT-CVD), ASCVD (PREVENT-ASCVD), and HF (PREVENT-HF). The default display is PREVENT-CVD, but each outcome can be selected individually. Because ASCVD and HF are modeled independently, their combined risk may exceed the total CVD estimate.

Patient Eligibility for the PREVENT Equations

Use the PREVENT equations for adults* ages 30–79 without known CVD.

Do not use the PREVENT™ equations for adults with known CVD, evidence of severe subclinical CVD (e.g., left ventricular ejection fraction less than 40%, coronary artery calcium ≥300), positive genetic testing for a variant known to be pathogenic or likely pathogenic for an inherited cardiovascular condition.

*Out-of-range values should be managed as clinically indicated. Risk can still be estimated with the closest in-range value but may represent an over- or under- estimate.

How to Use and Interpret PREVENT Equation Results

The PREVENT equations estimate absolute 10-year and 30-year risk for total CVD (PREVENT-CVD), ASCVD (PREVENT-ASCVD) and HF (PREVENT-HF).

New: The 2025 AHA/ACC High Blood Pressure Guideline recommends using the PREVENT-CVD outcome specific equation to estimate 10-year risk of total CVD to inform management decisions for Stage 1 hypertension (systolic blood pressure 130–139 mm Hg or diastolic blood pressure 80–89 mm Hg) among adults without known CVD, diabetes, or chronic kidney disease. Adults at increased CVD risk with the PREVENT-CVD equations, which is defined as a 10-year risk of total CVD ≥7.5%, are recommended to initiate anti-hypertensive therapy for Stage 1 hypertension.

For management decisions about cholesterol and heart failure prevention therapies, the PREVENT-ASCVD and PREVENT-HF equations may help inform clinician-patient discussions. Until updated guidance becomes available with specific risk thresholds, clinicians should continue to use the Pooled Cohort Equations (PCEs) to guide statin initiation and follow current recommendations for HF prevention from the latest HF guideline.

Other co-existing conditions may lead to underestimation of an individual patient’s absolute risk of CVD. These have been defined in the 2019 Primary Prevention Guidelines as “Risk Enhancing Factors” and are listed below.

Risk Enhancing Factors

Table: Risk-Enhancing Factors to Consider for the Primary Prevention of Cardiovascular Disease
Risk-Enhancing Factors to Consider for the Primary Prevention of Cardiovascular Disease
Family history of premature ASCVD (males, age <55 y; females, age <65 y) Primary hypercholesterolemia (LDL-C, 160–189 mg/dL [4.1–4.8 mmol/L]; non–HDL-C 190–219 mg/dL [4.9–5.6 mmol/L]) Chronic kidney disease (eGFR 15–59 mL/min/1.73 m2 with or without albuminuria; not treated with dialysis or kidney transplantation) Chronic inflammatory conditions, such as psoriasis, RA, lupus, or HIV/AIDS History of premature menopause (before age 40 y) or history of adverse pregnancy outcomes Persistently elevated primary hypertriglyceridemia (≥175 mg/dL, non-fasting) Elevated biomarkers, if measured (high-sensitivity C-reactive protein ≥2.0 mg/L, Lp(a) ≥50 mg/dL or ≥125 nmol/L, ApoB≥130 mg/dL, ABI<0.9)

*This tool is intended to support clinician-patient discussions and patients should discuss their risk estimates with their clinician

**For any questions or concerns regarding the use, functionality, or the risks estimated with the PREVENT™ calculator, please email us at [email protected]. For access to the PREVENT code, please agree to our terms and conditions for use.

Please see the PREVENT FAQs (PDF) for answers to the most frequently asked questions about PREVENT.

References

Khan SS, Matsushita K, Sang Y, et al. Development and Validation of the American Heart Association Predicting Risk of Cardiovascular Disease EVENTs (PREVENT™) Equations. Circulation 2023. DOI: 10.1161/CIRCULATIONAHA.123.067626.
Khan SS, Coresh J, Pencina MJ, et al. Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association. Circulation 2023;148(24):1982-2004. DOI: 10.1161/CIR.0000000000001191.