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AHA PREVENT

AHA Predicting Risk of CVD EVENTs equations

#3
coverage rank
United States202410-year and 30-yearTotal CVD (ASCVD + heart failure)14 inputs

Adults 30-79, general population (no prior CVD)

12
atlas factors covered
10
strongly-evidenced (A/B)
7
of 15 categories
Strengths
  • Sex-specific, race-free (removed race, uses region/SDI instead) reducing race-based miscalibration
  • Adds kidney (eGFR, optional UACR) and metabolic (optional HbA1c) axes absent from PCE
  • Predicts total CVD including heart failure, not just ASCVD
  • Offers 10- and 30-year horizons; derived and validated in large contemporary US cohorts (>6 million)
  • Better calibrated to modern event rates than PCE (which overestimated)
Weaknesses
  • Omits Lp(a), hs-CRP/inflammatory markers, and family history despite strong evidence
  • No coronary artery calcium or other subclinical imaging input
  • Optional UACR/HbA1c/SDI often unavailable in routine primary care, so base model dominates use
  • Still restricted to a small set of traditional factors; most graded A/B atlas factors are unused

Input variables (14)

InputMaps to atlas factorCategoryGradeNote
AgeAgeDemographic & SocialA
SexSexDemographic & SocialC
Total cholesterolTotal cholesterolLipids & LipoproteinsA
HDL cholesterolHDL cholesterolLipids & LipoproteinsA
Systolic blood pressureSystolic blood pressureBlood Pressure & HemodynamicsA
Antihypertensive treatment— derived / not in atlastreatment/medication-use variable; not a factor in atlas
Diabetes mellitusType 2 diabetes mellitusGlycemic & MetabolicA
Current smokingCigarette smokingLifestyle & BehavioralA
eGFR (CKD-EPI 2021)Estimated glomerular filtration rateRenal & ElectrolyteA
BMIBody mass indexAnthropometric & Body CompositionA
Statin use— derived / not in atlastreatment/medication-use variable; not a factor in atlas
UACR (optional, full model)AlbuminuriaRenal & ElectrolyteA
HbA1c (optional, full model)Hemoglobin A1cGlycemic & MetabolicA
Social Deprivation Index (optional)Social deprivationDemographic & SocialC

References