Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA. https://doi.org/10.1001/jama.2025.2868 Vaishnavi Krishnan et al.
Points
- This study analyzed data from over 9,700 adults aged 30 to 59 and found that 1 in 7 had a high 30-year cardiovascular disease risk despite a low 10-year risk.
- The researchers used the PREVENT equations to assess both short- and long-term risk, revealing that many individuals with low 10-year risk still had elevated long-term risk.
- Participants were categorized into three groups to highlight discrepancies between short—and long-term CVD risk and emphasize the need for dual assessments in clinical settings.
- These findings support ACC and AHA guidelines recommending long-term risk evaluations for adults under 60 to guide early preventive strategies better.
- The study calls for more comprehensive assessments and lifestyle interventions to address long-term cardiovascular risk in younger populations before clinical symptoms appear.
Summary
This study, published in JAMA, aimed to estimate the distribution of 10-year and 30-year cardiovascular disease (CVD) risk among U.S. adults aged 30 to 59. Using the Predicting Risk of CVD EVENTs (PREVENT) equations, the research analyzed data from over 9,700 participants, representing approximately 101 million adults. The study found that while most participants had a low 10-year risk, approximately 1 in 7 adults in this age group had a high 30-year risk for CVD. This highlights the importance of assessing long-term risk, particularly for younger adults, as the 10-year risk assessment may miss individuals with elevated long-term risk.
The study divided participants into three groups based on their 10-year and 30-year risk scores: low short-term risk with low long-term risk, low short-term risk with high long-term risk, and high short-term risk. Despite most individuals having a low 10-year risk, many had a higher 30-year risk, underscoring the value of incorporating both 10- and 30-year assessments in primary care. These findings support the American College of Cardiology/American Heart Association (ACC/AHA) 2019 guideline recommendation to estimate long-term risk in adults under 60, particularly those with low 10-year risk.
The results emphasize the need for more comprehensive CVD risk evaluations in younger adults, which could lead to earlier interventions. The study suggests that patients with high long-term risk, despite low short-term risk, may benefit from preventive measures to reduce future CVD events. Future studies will explore interventions, such as physical activity and dietary changes, to lower long-term CVD risk and improve patient outcomes.
Link to the article: https://jamanetwork.com/journals/jama/article-abstract/2832149
References Krishnan, V., Huang, X., Perak, A. M., Coresh, J., Ndumele, C. E., Greenland, P., Lloyd-Jones, D. M., & Khan, S. S. (2025). Discordance of 10- and 30-year predicted risk for cardiovascular disease in us adults. JAMA. https://doi.org/10.1001/jama.2025.2868
