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PREVENT Equations

Primary Prevention Registry • ACC/AHA 2013-2019

Atherosclerotic Prevention Protocol

ASCVD 10-Year Risk (PCE)

Patient Sex

Race Equation

Age (yrs)

Systolic BP (mmHg)

Total Chol (mg/dL)

HDL Chol (mg/dL)

Calculator Ready

Enter age, cholesterol, and blood pressure to generate the estimated 10-year cardiovascular risk report.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary prevention: Estimating 10-year risk for the first "hard" ASCVD event — nonfatal MI, coronary heart disease (CHD) death, or fatal/nonfatal stroke.

Decision support for initiating statin therapy in asymptomatic adults aged 40–79 years.

Guiding blood pressure targets, aspirin use, and lifestyle intervention intensity in primary prevention.

Facilitating clinician-patient risk discussion prior to initiating long-term pharmacotherapy.

Risk reclassification: use alongside coronary artery calcium (CAC) scoring or risk-enhancing factors when the treatment decision is uncertain.

Target Population

PCE validated for adults aged 40–79 years without pre-existing clinical ASCVD (prior MI, stable or unstable angina, arterial revascularization, stroke, TIA, or symptomatic PAD). Equations are sex-specific, with separate validation for White and African American populations. PREVENT equations extend the age range to 30–79, are race-free, and additionally predict heart failure risk.

When NOT to Use

Established ASCVD (prior MI, stroke, PAD, coronary revascularization): These patients are already in the highest-risk category — secondary prevention rules apply, statins are indicated regardless.

LDL-C ≥ 190 mg/dL: High-intensity statin is initiated without risk scoring (familial hypercholesterolaemia protocol).

Adults < 40 or > 79 years: The PCE was not validated in these age ranges; use clinical judgment or SCORE2-OP for older adults.

Pregnancy: Statins are contraindicated in pregnancy; do not score.

Patients with Diabetes Mellitus (DM) aged 40–75 with LDL 70–189 mg/dL: Start at least a moderate-intensity statin regardless of ASCVD score per 2019 ACC/AHA guidelines.

Endorsed By

The 2013 ACC/AHA Guideline on Assessment of Cardiovascular Risk, the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease, and the 2022 AHA/ACC Chest Pain Guideline. Adopted as the cornerstone of US primary cardiovascular prevention strategy. The 2023 AHA PREVENT equations are anticipated to replace the PCE as the new standard.

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Framingham Risk, QRISK3, SCORE2, Friedewald LDL Equation, Martin/Hopkins LDL, IDF Metabolic Syndrome Criteria, Egfr Calc or the HbA1c ↔ eAG Converter to formulate a comprehensive care plan.

Last Comprehensive Review: 2026

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