Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.1302 Dr. Timothy S. Anderson et al.
Points
- In 2023, the American Heart Association introduced the PREVENT equations to estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk, replacing the 2013 pooled cohort equations (PCEs).
- The study compared national estimates of 10-year ASCVD risk using the PCEs and PREVENT equations and evaluated their impact on recommendations for primary prevention statin therapy.
- The cross-sectional study included 3,785 US adults aged 40 to 75 without known ASCVD, with 20.7% reporting current statin use.
- The mean estimated 10-year ASCVD risk with the PREVENT equations (4.3%) was lower than with the PCEs (8.0%), with pronounced differences for Black adults and those aged 70 to 75.
- Adopting the PREVENT equations could reduce the number of adults eligible for primary prevention statin therapy from 45.4 million to 28.3 million, highlighting the need for accurate risk assessment tools in guiding cardiovascular prevention strategies.
Summary
In 2023, the American Heart Association (AHA) introduced the Predicting Risk of Cardiovascular Disease Events (PREVENT) equations to estimate the 10-year risk of atherosclerotic cardiovascular disease (ASCVD), replacing the 2013 pooled cohort equations (PCEs). The PREVENT equations, derived from contemporary cohorts, incorporated variables for kidney function and statin use while eliminating race as a factor. This study aimed to compare the national estimates of 10-year ASCVD risk using both the PCEs and PREVENT equations and evaluate the implications of these equations on recommendations for primary prevention statin therapy.
The cross-sectional study included 3,785 US adults aged 40 to 75 without known ASCVD, with 20.7% reporting current statin use. The mean estimated 10-year ASCVD risk was notably lower using the PREVENT equations (4.3%) than the PCEs (8.0%). Across various demographic subgroups, the differences in estimated ASCVD risk were particularly pronounced for Black adults and individuals aged 70 to 75 years. Adopting PREVENT equations could reduce the number of adults eligible for primary prevention statin therapy from 45.4 million to 28.3 million, with a significant proportion of individuals no longer meeting the criteria for statin therapy based on the new equations.
The study highlighted that implementing the PREVENT equations decreased the number of US adults eligible for primary prevention statin therapy. Despite this reduction, a substantial portion of individuals meeting the criteria based on the PREVENT equations were not currently using statins. This underscores the importance of accurate risk assessment tools in guiding primary prevention strategies for cardiovascular health.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2819821
References Anderson, T. S., Wilson, L. M., & Sussman, J. B. (2024). Atherosclerotic Cardiovascular Disease Risk Estimates Using the Predicting Risk of Cardiovascular Disease Events Equations. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.1302
