New PREVENT Equations Transform Cardiovascular Risk Assessment and Personalize Hypertension Treatment

The Predicting Risk of cardiovascular disease EVENTs (PREVENT™) equations significantly improve risk estimation accuracy and support personalized treatment approaches for adults with hypertension, according to a new scientific statement published in Circulation, Hypertension, and JACC. This companion document to the 2025 AHA/ACC High Blood Pressure Guideline demonstrates how the PREVENT equations, developed using data from over 6 million diverse U.S. adults, offer broader applicability than previous risk models by incorporating clinical factors, kidney disease, metabolic health, and adverse social determinants including a zip code-based social deprivation index.

The scientific statement details the evidence supporting the new PREVENT-CVD threshold established in the 2025 Guideline, which recommends initiating blood pressure medication along with lifestyle changes for individuals with stage 1 hypertension and a 10-year cardiovascular disease risk score of ≥7.5%. This approach addresses earlier concerns about potential reductions in treatment recommendations by demonstrating that the number of people recommended for antihypertensive therapy remains similar to the 2017 guidelines while improving accuracy in identifying those most likely to benefit from intervention.

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 health markers, both closely linked to blood pressure levels, provides more comprehensive risk prediction that enables clinicians to personalize care more effectively. More information about PREVENT is available at https://professional.heart.org/en/guidelines-and-statements.

Sadiya S. Khan, M.D., M.Sc., FAHA, chair of the scientific statement writing group, noted that "the PREVENT equations are the first risk tool that combines cardiovascular, kidney and metabolic health measurements to support primary prevention-focused treatment decisions." The most critical message for clinicians and patients is that cardiovascular risk from high blood pressure is modifiable, and the goal of using these equations is to tailor preventive care to achieve marked improvements leading to longer, healthier lives. The Association's financial information is available at https://www.heart.org/en/about-us/our-financial-information.

The practical guidance provided in the statement helps clinicians integrate PREVENT equations into holistic risk assessment, enabling the development of integrated healthcare plans that meet individual patient needs. By combining traditional clinical factors with social determinants and modern health metrics, the PREVENT equations represent a significant advancement in cardiovascular risk prediction that supports more targeted and effective hypertension management strategies across diverse patient populations.