The American Heart Association's PREVENT equations are revolutionizing cardiovascular disease risk assessment by providing more accurate predictions and supporting personalized treatment for adults with hypertension, according to a new scientific statement published in Circulation, Hypertension, and JACC. This development represents a significant advancement in preventive cardiology, offering clinicians a more comprehensive tool to estimate both 10- and 30-year cardiovascular disease risk.
The PREVENT equations, developed in 2023 and now recommended in the 2025 AHA/ACC High Blood Pressure Guideline, incorporate clinical factors including body mass index, blood pressure, diabetes status, and social determinants of health through a zip code-based social deprivation index. Built on data from over 6 million diverse U.S. adults, the tool offers broader applicability than previous risk models and represents the first risk assessment tool that combines cardiovascular, kidney, and metabolic health measurements.
The scientific statement introduces a crucial new threshold: adults with stage 1 hypertension (systolic blood pressure 130-139 mm Hg or diastolic blood pressure 80-89 mm Hg) and a PREVENT 10-year cardiovascular disease risk score of ≥7.5% should begin antihypertensive medication alongside lifestyle modifications. This precision approach addresses earlier concerns about potential overtreatment by identifying individuals most likely to benefit from medication while avoiding unnecessary treatment in lower-risk patients.
Daniel W. Jones, M.D., FAHA, chair of the 2025 high blood pressure guideline writing committee, emphasized that "the new PREVENT equations are based on more modern, more contemporary datasets, therefore, they are a better tool than the past risk models." The equations' inclusion of kidney disease and metabolic disease markers, both closely linked to blood pressure levels, provides a more comprehensive risk prediction that enables truly personalized care.
Sadiya S. Khan, M.D., M.Sc., FAHA, chair of the scientific statement writing group, noted that "the most important message for clinicians and patients is that risk from high blood pressure is modifiable." The goal of using PREVENT equations is to tailor preventive care to achieve marked improvements that result in longer, healthier lives for patients. The tool's ability to provide practical guidance for integrating holistic risk assessment into clinical practice represents a significant step forward in cardiovascular disease prevention.
Population-level analysis demonstrates that the number of people recommended for antihypertensive therapy under the new guidelines remains similar to the 2017 guidelines, directly addressing concerns that fewer individuals might receive treatment recommendations. The greater accuracy of PREVENT equations means healthcare providers can more effectively identify those who will benefit most from intervention while reducing unnecessary medication use in lower-risk populations.
