Porter Health
PREVENT Risk Calculator
The American Heart Association's Latest Cardiovascular Risk Prediction Tool
PREVENT (Predicting Risk of cardiovascular disease EVENTs) is the American Heart Association's newest set of equations for estimating cardiovascular disease risk, released in 2024. It replaces the older Pooled Cohort Equations (PCE) with more contemporary data and improved accuracy.
PREVENT was developed using data from over 3 million participants across multiple diverse U.S. cohorts, making it the most comprehensive cardiovascular risk calculator for the American population.
PREVENT provides both 10-year and 30-year risk estimates for multiple cardiovascular outcomes:
Total Cardiovascular Disease (CVD)
Risk of any major cardiovascular event including heart attack, stroke, heart failure, or cardiovascular death
Atherosclerotic CVD (ASCVD)
Risk of atherosclerotic events: fatal or nonfatal myocardial infarction or stroke
Coronary Heart Disease (CHD)
Risk of fatal or nonfatal myocardial infarction, coronary revascularization, or CHD death
Heart Failure
Risk of developing heart failure with hospitalization
Stroke
Risk of fatal or nonfatal ischemic or hemorrhagic stroke
Enhanced Models: When UACR, HbA1c, or SDI data are available, PREVENT uses enhanced prediction models that provide more accurate risk estimates, especially for individuals with diabetes or kidney disease.
PREVENT 10-year total CVD risk is typically categorized as follows:
Low Risk
<5%Focus on maintaining healthy lifestyle behaviors and optimal risk factor control
Borderline Risk
5-7.5%Lifestyle intervention emphasized; may consider additional testing (e.g., CAC score) to guide statin therapy decision
Intermediate Risk
7.5-20%Lifestyle modification plus moderate-to-high intensity statin therapy typically recommended
High Risk
≥20%High-intensity statin therapy and comprehensive risk factor management strongly recommended
PREVENT and QRISK3 are both evidence-based cardiovascular risk calculators, but they were developed for different populations and measure slightly different outcomes:
| Feature | PREVENT (2024) | QRISK3 (2017) |
|---|---|---|
| Geography | US-based | UK-based |
| Population | Multi-ethnic US cohorts (3M+ participants) | UK Biobank (7.89M patients) |
| Primary Outcome | Total CVD (separate predictions for CHD, stroke, HF, ASCVD) | Total CVD (combined CHD + stroke + TIA + PAD) |
| Timeframes | 10-year AND 30-year | 10-year only |
| Age Range | 30-79 years | 25-84 years |
| Kidney Function | eGFR (required) + UACR (enhanced model) | CKD stages (qualitative) |
| Unique Risk Factors | HbA1c, UACR, Social Deprivation Index | Rheumatoid arthritis, SLE, migraine, mental health meds, erectile dysfunction |
Clinical Note: In our analysis of Porter Health alpha testers with complete data, QRISK3 predicted an average 10-year CVD risk of 2.8%, while PREVENT predicted 1.4%—a difference of approximately 42%. This is expected because QRISK3 includes additional cardiovascular outcomes (TIA, PAD) and was calibrated to the UK population, which may have different baseline risk compared to the U.S. population.
You might have a Health Score (LE8) of 80+ but still see a PREVENT 10-year risk of 10-20% or higher. This is common and reflects important differences in what these tools measure.
Health Score (LE8) Measures:
- •Current health status: How well you're managing your cardiovascular risk factors right now
- •Behavior quality: Diet, exercise, sleep, and tobacco avoidance today
- •Medication-controlled values: BP, cholesterol, and glucose can score well when properly treated
PREVENT Risk Incorporates:
- •Age-related risk: Cardiovascular risk increases with age even with optimal current health. A 65-year-old with excellent behaviors has higher risk than a 40-year-old with the same profile
- •Disease history: Past cardiovascular events, established diabetes, or kidney disease carry ongoing risk even when optimally managed
- •Cumulative exposure: Years of exposure to risk factors (even if now controlled) affects future event probability
- •Kidney function: Even mild-to-moderate kidney disease (eGFR 45-59) increases cardiovascular risk independently of other factors
Why Both Matter: A high Health Score means you're doing everything right to minimize future risk—keep it up! Your PREVENT risk score accounts for non-modifiable factors (age) and disease history that persist despite excellent current management. Together, these metrics help us celebrate your healthy behaviors while ensuring appropriate medical interventions (like statin therapy) to lower your absolute risk.
Your Porter Health dashboard uses PREVENT as the primary cardiovascular risk calculator for U.S. patients:
Data Collection: We gather all required PREVENT inputs from your intake questionnaire and lab results
Enhanced Models: When available, we use UACR, HbA1c, and SDI data for more accurate predictions
Multiple Outcomes: We display your 10-year and 30-year risks for total CVD, ASCVD, CHD, heart failure, and stroke
Personalized Recommendations: Your action plan is tailored based on your risk category, with specific interventions to lower your risk
Primary Source
Khan SS, Matsushita K, Sang Y, et al. Development and Validation of the American Heart Association's PREVENT Equations. Circulation. 2024;149(6):430-449.
DOI: 10.1161/CIRCULATIONAHA.123.067626