PREVENT Tool Enhances 30-Year Cardiovascular Risk Communication, Suggests Research
USA: Researchers have developed age- and sex-specific percentiles for 30-year cardiovascular disease (CVD) risk using the PREVENT risk calculator. Comparing an individual’s risk with peers of the same age and sex can improve communication and understanding of long-term risk.
The new tool may be especially useful for motivating young people to address risk factors earlier in life. Researchers say it can help patients better understand their long-term heart health risks.
Published in JACC, the study—led by Vaishnavi Krishnan and colleagues from the Northwestern University Feinberg School of Medicine—addresses a key gap in current prevention strategies. Although guidelines increasingly emphasize long-term risk assessment in adults under 60, many patients and clinicians find it difficult to interpret absolute 30-year risk numbers in a meaningful way. By presenting risk as a percentile relative to peers, the authors aim to make these estimates more intuitive and actionable.
The research team analyzed data from 8,686 adults aged 30 to 59 years who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) between 2011 and 2020. None of the participants had existing cardiovascular disease. Using the PREVENT equations—which estimate 30-year risk of CVD, atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF)—the investigators calculated risk values and then generated percentile charts for each age and sex.
The sample represents roughly 91 million U.S. adults in this age range. The average age was approximately 45 years for both men and women, and the median 30-year CVD risk across the population was 13.1%. However, the detailed percentile calculations revealed striking differences by age and sex.
For example, at age 45, the median 30-year CVD risk (50th percentile) was 9.9% for women and 16.2% for men. At the 75th percentile, the risk rose to 14.7% for women and 21.2% for men. Similar disparities were seen for ASCVD and HF, with men consistently showing higher estimated long-term risk across the age spectrum. According to the authors, these percentile comparisons may help younger adults grasp whether their risk is unusually high for their demographic—even if the absolute percentage initially seems modest.
To make the tool accessible, the researchers developed an online interface where clinicians and patients can view both absolute and percentile risk estimates generated through PREVENT. This dual-display approach may help translate complex epidemiological data into clearer, personalized information that can support shared decision-making.
The authors note that using percentiles does not replace traditional risk assessment but rather complements it by offering additional context. They emphasize that future prospective studies should evaluate whether this percentile-based method improves patient understanding, motivates lifestyle change, or enhances the adoption of preventive therapies in younger adults.
"Overall, the study provides an innovative framework for reframing long-term CVD risk communication—one that could make prevention discussions more relatable, especially for adults in their 30s and 40s who may underestimate their lifetime cardiovascular risk," the authors concluded.
Reference:
Krishnan, V., Huang, X., Zhang, S., Shah, N. S., Navar, A. M., Coresh, J., Rangaswami, J., Ho, J. E., Khera, A., Blumenthal, R. S., Pencina, M., Lloyd-Jones, D. M., Greenland, P., Ndumele, C. E., & Khan, S. S. (2025). Age and Sex-Specific Percentiles of 30-Year Cardiovascular Disease Risk Based on the PREVENT Equations. JACC, 86(21), 2017-2027. https://doi.org/10.1016/j.jacc.2025.09.1509
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