DALLAS — This calculator does much more than add and subtract. Researchers working with the American Heart Association have developed an innovative calculator that estimates an individual’s risk of cardiovascular disease (CVD) over the next 30 years. This game-changing scale incorporates measures of cardiovascular, kidney, and metabolic health for the first time.
The new risk calculator, known as the American Heart Association PREVENT (Predicting Risk of cardiovascular disease EVENTs), assesses the risk of heart attack, stroke, and heart failure. It is designed to address the strong connections among cardiovascular disease, kidney disease, and metabolic disease, collectively referred to as CKM syndrome. CKM syndrome was initially defined in an AHA presidential advisory and scientific statement in October 2023.
According to the AHA’s 2023 Statistical Update, one in three adults in the United States has three or more risk factors contributing to cardiovascular disease, kidney disease, and/or metabolic disorders. As CKM syndrome worsens, the risk of heart attack, stroke, and heart failure also increases.
“A new cardiovascular disease risk calculator was needed, particularly one that includes measures of CKM syndrome, which is highly prevalent in the U.S.,” says Dr. Sadiya S. Khan, chair of the statement writing committee for the AHA, in a media release. “The new PREVENT risk calculator enables clinicians to quantify this risk and may help people receive preventive care or treatment earlier to reduce CVD risk.”
The PREVENT risk calculator is unique in that it assesses CVD risk separately for each biological sex, acknowledging the differences in CVD presentation and risk factors between men and women. It does not include race in its calculation, as race is considered a social factor and not a biological variable. However, there is an option to include social factors in the calculation if available.
The last CVD risk calculator, the Pooled Cohort Equation, was released in 2013. The new PREVENT calculator accounts for advances in treatments for conditions associated with CKM, such as obesity, Type 2 diabetes, and kidney disease.
The PREVENT risk calculator is applicable to adults as young as 30 years-old and estimates both 10-year and 30-year risks of total cardiovascular disease. It provides a broader perspective on risk, considering longer-term estimates to reveal opportunities for intervention and prevention in younger individuals.
The calculator also incorporates measures of kidney function, recognizing the significance of kidney health in cardiovascular well-being. Chronic kidney disease increases cardiovascular risks, and the calculator includes an estimated glomerular filtration rate and allows for the use of urine albumin excretion to individualize risk assessment.
Metabolic health is also considered by the calculator, as abnormal blood sugar levels are associated with CVD risk in individuals with and without Type 2 diabetes. Furthermore, heart failure risk prediction is included in the PREVENT calculator, considering the importance of heart failure in the context of CKM syndrome, especially among those with obesity, Type 2 diabetes, and/or kidney disease.
An essential aspect of the PREVENT calculator is that it avoids race-specific calculations, aligning with a growing consensus in the medical community to eliminate race as a factor in medical algorithms. The calculator has been found to be equally accurate among diverse racial and ethnic groups.
In addition, the calculator provides an option to incorporate the Social Deprivation Index, which factors in adverse social determinants of health such as education, poverty, and unemployment, recognizing that these social factors can influence health outcomes.
The development of the PREVENT equations involved data from over six million U.S. adults with diverse backgrounds. It draws information from both research studies and electronic health records, making it more applicable to the general adult population in the U.S.
While the PREVENT calculator represents a significant advancement, there are knowledge gaps and areas for further research, such as refining risk assessments, collecting more data from diverse populations, improving the understanding of social determinants of health, and expanding risk prediction to earlier in life.
The new risk calculator promises to enhance CVD risk assessment and promote more equitable preventive care by focusing on individual health factors while recognizing the limitations of race as a predictive factor in CVD risk.
The study is published in the journal Circulation.
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