Key result
The 2023 PREVENT calculator removes race from cardiovascular risk prediction to address disparities, as Black adults present with CVD 6-7 years earlier and have lower life expectancy (71 vs 76 years).
Why the study?
How does the removal of race from the AHA PREVENT cardiovascular risk calculator impact risk prediction and health equity compared to the Pooled Cohort Equations?
How does the removal of race from the AHA PREVENT cardiovascular risk calculator impact risk prediction and health equity compared to the Pooled Cohort Equations?
Answers are grounded in this paper and cite their sources.
The AHA's new PREVENT calculator removes race from cardiovascular risk prediction to address structural inequities and improve prevention strategies.
In the US, racial disparities in cardiovascular disease (CVD) are substantial, pervasive, and enduring.1 CVD more commonly presents prematurely among Black adults (an average of 6-7 years earlier) compared with White adults, which leads to significantly higher premature mortality.This translates into greater years of potential life lost (1990-2021: >80 million years) and substantially lower life expectancy (2021: 71 years vs. 76 years) for the Black population compared with the White population. 2 The origin of these persistent racial disparities is structural racism with longstanding racial differences in multi-level social determinants of health (SDOH) that impact risk factor development, identification and management, and preventable clinical complications. 3 Enhancing equity in CVD prevention is a fundamental component of strategies to eliminate disparities.Our prevailing approach to CVD prevention involves matching the intensity of preventive therapies to the predicted risk of individuals in order to maximize benefit.Accurate estimations of risk are thus necessary for optimal prevention.To this end, the American Heart Association (AHA) developed the new Predicting Risk of cardiovascular disease EVENTs (PREVENT) calculator in 2023, which predicts total CVD events (atherosclerotic cardiovascular disease [ASCVD] plus heart failure [HF]) over 10-and 30-year time horizons for individuals aged 30-79 years.4 Unlike the prior risk calculator, the Pooled Cohort Equations (PCEs), PREVENT did not include race in the risk model.This shift is best contextualized by examining the evolution of how race has been incorporated in CVD risk prediction models (Figure ) and necessitates an examination of the implications of this decision through an equity lens.
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Ndumele et al. (2025) conducted a review in Cardiovascular disease. PREVENT calculator vs. Pooled Cohort Equations was evaluated. The 2023 PREVENT calculator removes race from cardiovascular risk prediction to address disparities, as Black adults present with CVD 6-7 years earlier and have lower life expectancy (71 vs 76 years).
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