New PREVENT Equations Transform Hypertension Treatment with Personalized Cardiovascular Risk Assessment

The American Heart Association's PREVENT equations offer more precise cardiovascular disease risk estimation and support personalized treatment approaches for adults with hypertension, according to a new scientific statement published in Circulation, Hypertension, and JACC. This clinical tool, developed in 2023, represents a significant advancement in cardiovascular risk assessment by incorporating broader health factors and modern data from over 6 million diverse U.S. adults.

The PREVENT calculator utilizes clinical factors including body mass index, blood pressure, diabetes status, and social determinants of health through a zip code-based social deprivation index to estimate 10- and 30-year risk for total cardiovascular disease. This comprehensive approach provides broader applicability than previous risk models, specifically addressing both atherosclerotic cardiovascular disease and heart failure risk in adults aged 30-79 without existing cardiovascular disease.

The 2025 High Blood Pressure Guideline newly recommends using the PREVENT equations to guide treatment decisions, establishing a specific risk threshold that combines blood pressure levels with cardiovascular risk scores. Adults with stage 1 hypertension (systolic blood pressure 130-139 mm Hg or diastolic blood pressure 80-89 mm Hg) and a PREVENT 10-year cardiovascular disease risk score of ≥7.5% are now recommended to begin antihypertensive medication alongside lifestyle modifications.

This updated approach addresses previous concerns about treatment recommendations by demonstrating that the number of people recommended for antihypertensive therapy remains similar to the 2017 guidelines. The enhanced accuracy of the PREVENT equations means healthcare providers can better identify individuals most likely to benefit from treatment while avoiding unnecessary medication in lower-risk patients. More information about PREVENT is available at https://www.heart.org.

According to Dr. Daniel W. Jones, chair of the 2025 high blood pressure guideline writing committee, "The new PREVENT equations are based on more modern, more contemporary datasets, therefore, they are a better tool than the past risk models. They include information about kidney disease and metabolic disease, all of which are linked to blood pressure levels." The equations represent the first risk tool that combines cardiovascular, kidney, and metabolic health measurements to support primary prevention-focused treatment decisions.

Dr. Sadiya S. Khan, chair of the scientific statement writing group, emphasized that "risk from high blood pressure is modifiable, and the goal of using the PREVENT equations is to tailor and personalize preventive care so we can better support our patients to achieve marked improvements that result in longer, healthier lives." The implementation of these equations supports holistic risk assessment and integrated healthcare planning that addresses individual patient needs while optimizing cardiovascular disease prevention strategies.