ArticleJournal of the American Heart Association2025
Comparison of Short- and Long-Term Cardiovascular Disease Risk Assessment Tools in US Young Adults.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review and Meta-Analysis of Ethnic Inequalities in Stroke Incidence Patterns and Trends in High-Income Countries (2015-2025).Neuroepidemiology · 2026Pooled it
- Cardiovascular Disease Incidence and Risk Factor Contributions in Adults Aged 45 to 59 Years With Low 10-Year and High 30-Year Risk: Findings From REGARDS.Circulation. Population health and outcomes · 2026Article
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Authors and funding
16 authors.
Funding
Abstract
backgroundIn 2023, the American Heart Association published the Predicting Risk of Cardiovascular Disease Events (PREVENT) equations for estimating atherosclerotic cardiovascular disease (ASCVD) risk in adults aged 30 to 79 years. We compared PREVENT's performance with existing US guideline recommended models-Pooled Cohort Equations for 10-year ASCVD risk and FHS (Framingham Heart Study) equations for 30-year ASCVD risk-among young adults.
methodsWe analyzed adults aged 20 to 39 years without baseline ASCVD from 2 sources: (1) pooled data from 2 large epidemiologic cohorts (CARDIA [Coronary Artery Risk Development in Young Adults] and FHS, n=7763), and (2) electronic health records from Kaiser Permanente Southern California (n=266 378). Incident ASCVD events were defined as nonfatal myocardial infarction, coronary heart disease death, and fatal/nonfatal stroke at 10 and 30 years.
resultsPREVENT improved 10-year risk discrimination over Pooled Cohort Equations in both the epidemiologic cohorts (∆Harrell's C, 0.057 [95% CI, 0.013-0.101]) and Kaiser Permanente Southern California (∆Harrell's C=0.041 [95% CI, 0.034-0.049]). The Pooled Cohort Equations overestimated 10-year risk (mean calibration 3.26 in the epidemiologic cohorts; 1.73 in Kaiser Permanente Southern California), whereas PREVENT was well calibrated in the epidemiologic cohorts (1.10 [95% CI, 0.83-1.73) but underestimated risk in KPSC (0.91 [95% CI, 0.86-0.96]), particularly among Black individuals (0.54 [95% CI, 0.48-0.61]). For 30-year risk, PREVENT and FHS had similar discrimination, but PREVENT underestimated 30-year risk (mean calibration 0.63) whereas FHS had good calibration (mean calibration 0.90 to 0.99]).
conclusionsPREVENT may be a better tool for short-term ASCVD risk assessment in young adults than the PCEs, whereas the FHS equations may be better for long-term risk assessment than PREVENT in this age group.
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