The American Heart Association's PREVENT equations offer significantly improved accuracy in estimating cardiovascular disease risk for adults with hypertension, according to a new scientific statement published in Circulation, Hypertension, and JACC. The equations, developed in 2023 and now recommended in the 2025 AHA/ACC High Blood Pressure Guideline, represent a major advancement in personalized cardiovascular care by incorporating broader risk factors and modern data from over 6 million diverse U.S. adults. This comprehensive approach provides more accurate risk assessment than previous models, particularly the Pooled Cohort Equations that only estimated atherosclerotic cardiovascular disease risk.
The PREVENT calculator uses clinical factors including body mass index, blood pressure, diabetes status, and social determinants of health through a zip code-based social deprivation index to estimate both 10- and 30-year risk for total cardiovascular disease. The tool's inclusion of kidney disease and metabolic health measurements makes it the first risk assessment tool to combine cardiovascular, kidney, and metabolic health indicators for primary prevention decisions. This holistic approach enables clinicians to develop more targeted healthcare plans based on individual patient profiles.
A key development in the 2025 guidelines is the establishment of a new risk threshold that recommends blood pressure medication initiation for individuals with stage 1 hypertension and a PREVENT 10-year cardiovascular disease risk score of 7.5% or higher. This threshold, combined with lifestyle modifications, helps identify patients most likely to benefit from treatment while avoiding unnecessary medication for lower-risk individuals. Research demonstrates that the number of people recommended for antihypertensive therapy under the new guidelines remains similar to the 2017 guidelines, addressing earlier concerns about potential reductions in treatment recommendations.
The scientific statement provides practical guidance for clinicians on integrating the PREVENT equations into holistic risk assessment and developing personalized healthcare plans. More information about the PREVENT equations and their implementation is available through the American Heart Association's educational resources at https://www.heart.org/en/professional/guidelines-resources. The development represents a significant step toward more precise, evidence-based cardiovascular risk management that can lead to longer, healthier lives for patients with hypertension by ensuring treatment is appropriately targeted to those who will benefit most from intervention.
