Interpretation
| Result | Meaning |
|---|---|
| < 3% | Low |
| 3 to < 5% | Borderline: consider statin |
| 5 to < 10% | Intermediate: statin recommended |
| ≥ 10% | High: statin recommended |
Formula
Logistic model: risk = 1 / (1 + e^−x). x is a sex-specific sum of coefficients × centred terms: (age−55)/10; non-HDL-C (mmol/L) − 3.5; (HDL-C − 1.3)/0.3; SBP splines (min(SBP,110)−110)/20 and (max(SBP,110)−130)/20; diabetes; current smoking; eGFR splines (min(eGFR,60)−60)/−15 and (max(eGFR,60)−90)/−15; BP treatment; statin; and interactions (treated × SBP, statin × non-HDL, age × non-HDL, HDL, SBP, diabetes, smoking, low eGFR). Cholesterol mg/dL × 0.02586 = mmol/L.
Clinical pearls
- Valid for ages 30–79 without established ASCVD or heart failure. PREVENT gives lower absolute risks than the Pooled Cohort Equations, so the new thresholds (3%, 5%, 10%) are lower than the old 5%/7.5%/20%.
- This is the base model. The optional HbA1c, urine albumin-creatinine ratio and social deprivation index add-ons, the 30-year horizon and the heart-failure outcome (which needs BMI) are not included here.
- Coronary artery calcium scoring can reclassify borderline or intermediate-risk patients when the statin decision is uncertain.
Examples
prevent risk 50F tc 200 hdl 45 sbp 160 on bp meds diabetic nonsmoker egfr 90 no statinPREVENT 10 year ASCVD risk for a 66 year old man, cholesterol 188, HDL 52, BP 148 untreated, smoker, diabetic, on a statin, eGFR 67aha prevent 45M tc 5.2 mmol/L hdl 1.1 sbp 130 no dm no smoking egfr 95
FAQ
What replaced the pooled cohort equations?
The AHA PREVENT equations (2023), which drop race, add eGFR and statin use, and estimate total CVD including heart failure. The 2026 ACC/AHA dyslipidemia guideline uses PREVENT-ASCVD risk.
What PREVENT risk means a statin is recommended?
Under the 2026 ACC/AHA guideline, a statin is recommended at 10-year PREVENT-ASCVD risk ≥5% and can be considered at 3–<5% after a risk discussion.