AHA PREVENT Risk Calculator
The PREVENT equations (2023) replaced the Pooled Cohort Equations. They are race-free, cover ages 30–79, estimate 10-year and 30-year risk for Total CVD, ASCVD, and Heart Failure separately, and incorporate kidney function and BMI as predictors. Enter your values below to assess your cardiovascular risk profile.
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For validated numerical results, use the official AHA PREVENT Calculator at professional.heart.org — the reference standard endorsed by the American Heart Association.
Demographics
Blood Pressure
Lipids
Kidney Function & Metabolic
Risk Factors
Estimated 10-year risk (AHA PREVENT 2023 base model)
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Total CVD
10-year
10-year
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ASCVD
10-year
10-year
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Heart Failure
10-year
10-year
These are estimates only. For validated PREVENT scores, use the official AHA calculator:
professional.heart.org/en/guidelines-and-statements/prevent-calculator ↗
professional.heart.org/en/guidelines-and-statements/prevent-calculator ↗
What PREVENT measures:
Total CVD = ASCVD (heart attack, stroke) + Heart Failure
ASCVD = Atherosclerotic CV events: fatal/non-fatal MI and stroke
Heart Failure = First hospitalization or fatal HF event
Advantages over old Pooled Cohort Equations: Race-free · Ages 30–79 (vs 45–79) · Includes eGFR + BMI · Predicts HF separately · 30-year risk · More accurate for diverse US populations · Corrects PCE's known ~2× overprediction
Reference: Khan SS et al. "Development and Validation of the American Heart Association's PREVENT Equations." Circulation 2024;149(6):430-449.
Total CVD = ASCVD (heart attack, stroke) + Heart Failure
ASCVD = Atherosclerotic CV events: fatal/non-fatal MI and stroke
Heart Failure = First hospitalization or fatal HF event
Advantages over old Pooled Cohort Equations: Race-free · Ages 30–79 (vs 45–79) · Includes eGFR + BMI · Predicts HF separately · 30-year risk · More accurate for diverse US populations · Corrects PCE's known ~2× overprediction
Reference: Khan SS et al. "Development and Validation of the American Heart Association's PREVENT Equations." Circulation 2024;149(6):430-449.
PREVENT Risk Categories & Treatment Thresholds
| 10-Year Total CVD Risk | Category | Treatment Considerations |
|---|---|---|
| < 5% | Low risk | Lifestyle modification; reassess in 4–6 years. Statin not routinely indicated unless LDL very elevated. |
| 5% – < 7.5% | Borderline risk | Risk-enhancing factors may justify statin initiation. Clinician-patient discussion recommended. |
| 7.5% – < 20% | Intermediate risk | Moderate-intensity statin indicated. Treat BP if >130/80. Consider aspirin only in select cases. |
| ≥ 20% | High risk | High-intensity statin therapy. Aggressive BP control (<130/80). Consider ezetimibe ± PCSK9i if LDL persists. Aspirin 81 mg/day may be appropriate. |
Note: Treatment thresholds are based on 10-year ASCVD risk from ACC/AHA 2019 primary prevention guidelines. Updated thresholds specifically referencing PREVENT-defined risk categories are still being developed. The 2024 U.S. Preventive Services Task Force (USPSTF) statin recommendations also use 10-year CVD risk ≥ 10% as a key threshold.
Risk-enhancing factors that may support therapy at borderline risk: LDL ≥160 mg/dL, triglycerides ≥175 mg/dL, hsCRP ≥2.0 mg/L, Lp(a) ≥50 mg/dL, ABI <0.9, family history of premature ASCVD, metabolic syndrome, CKD.
Risk-enhancing factors that may support therapy at borderline risk: LDL ≥160 mg/dL, triglycerides ≥175 mg/dL, hsCRP ≥2.0 mg/L, Lp(a) ≥50 mg/dL, ABI <0.9, family history of premature ASCVD, metabolic syndrome, CKD.
Why PREVENT Replaced the Pooled Cohort Equations
Key advances in the 2023 AHA PREVENT equations:
| Feature | Pooled Cohort Equations (2013) | AHA PREVENT (2023) |
|---|---|---|
| Age range | 40–79 years | 30–79 years |
| Race variable | White / African American only | Race-free (equally accurate across groups) |
| Outcomes predicted | ASCVD only | Total CVD, ASCVD, Heart Failure separately |
| eGFR / kidney function | Not included | Included (CKD-EPI 2021) |
| BMI | Not included | Included |
| Time horizon | 10-year only | 10-year and 30-year |
| Statin users included? | No | Yes (separate coefficient) |
| Calibration accuracy | ~2× overprediction documented | Well-calibrated in diverse populations |
| Derivation data | Observational cohorts only | Cohorts + EHR data (1992–2022) |
⚕️ Clinical note: The risk estimates shown here use the published AHA PREVENT base model structure (Khan SS et al., Circulation 2024;149:430–449) and are intended as a screening tool and educational reference. For clinical decision-making, use the official AHA PREVENT calculator at professional.heart.org. PREVENT does not apply to individuals with pre-existing ASCVD, HF, or eGFR <15. Risk estimates are for primary prevention only. Always discuss results with your provider in the context of your full medical history.