Key result
High 30-year predicted risk is linked to over double the 10-year CVD events despite low short-term risk.
Why the study?
Little is known about the characteristics and determinants of incident CVD in adults with low 10-year but high 30-year predicted risk.
Does low 10-year but high 30-year predicted CVD risk increase the 10-year incidence of total CVD compared to low 10-year and low 30-year risk in adults aged 45 to 59 years?
Cohort (n=6,761)
Yes
Does low 10-year but high 30-year predicted CVD risk increase the 10-year incidence of total CVD compared to low 10-year and low 30-year risk in adults aged 45 to 59 years?
Identifying adults with low 10-year but high 30-year predicted CVD risk highlights a subgroup that may benefit from earlier preventive interventions, particularly hypertension management.
Answers are grounded in this paper and cite their sources.
May identify candidates for intensified prevention beyond 10-year estimates; extends AHA equations but leaves optimal strategies open pending trials.
BACKGROUND: The American Heart Association's Predicting Risk of Cardiovascular Disease (CVD) Events equations enable 30-year CVD risk estimation for adults 30 to 59 years of age, facilitating the identification of individuals with low 10-year but high 30-year risk. Little is known about the characteristics and determinants of incident CVD in adults within this predicted risk group. METHODS: We examined participants aged 45 to 59 years without prevalent total CVD from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Participants were categorized into 3 groups based on the Predicting Risk of CVD Events total CVD risk equations: low 10-year/low 30-year predicted risk (<7.5%/<20%), low 10-year/high 30-year predicted risk (<7.5%/≥20%), and high 10-year predicted risk (≥7.5%). All analyses were sex-stratified. Using adjudicated events for total CVD (atherosclerotic CVD or heart failure), we accounted for the competing risk of non-CVD death to calculate the 10-year cumulative incidence of total CVD for the 3 risk groups. Population attributable risk quantified the contribution of risk factors for the low 10-year/high 30-year risk group. RESULTS: Among 6761 participants, 41.9% were categorized as low 10-year/high 30-year risk (mean age [SD], 55.2 [3.4] years; 52.8% female). Over 10 years, the cumulative incidence of total CVD was higher in the low 10-year/high 30-year risk group compared with those with low 10-year/low 30-year risk in both women (4.8% versus 1.8%) and men (6.0% versus 1.5%). Hypertension was the leading contributor to CVD events among participants with low 10-year/high 30-year predicted risk, accounting for 57.8% (95% CI, 45.1%-70.0%) of events in women and 28.9% (95% CI, 14.8%-43.2%) in men. CONCLUSIONS: Using Predicting Risk of CVD Events 30-year predicted total CVD risk identified a subgroup of younger adults with low 10-year and high 30-year risk who may benefit from earlier preventive interventions. Hypertension was the leading contributor to CVD in this risk category.
No takes yet. Share an insight, caveat, or question.
Satish et al. (2026) conducted a cohort in Adults without prevalent total cardiovascular disease (n=6,761). Low 10-year/high 30-year predicted CVD risk vs. Low 10-year/low 30-year predicted CVD risk was evaluated on 10-year cumulative incidence of total CVD in women. Adults with low 10-year but high 30-year predicted CVD risk had higher 10-year CVD incidence than those with low 30-year risk, with hypertension accounting for 57.8% of events in women and 28.9% in men.
Synapse has enriched 8 closely related papers on similar clinical questions. Consider them for comparative context: