Communicating long-term cardiovascular disease (CVD) risk to younger adults can be challenging, but new research offers a tool to frame risk relative to an individual's peers. Investigators have developed population-based, age- and sex-specific percentiles for 30-year risk of CVD, atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF) using the PREVENT (Predicting Risk of CVD EVENTs) equations.¹
This analysis utilised data from a nationally representative sample of US adults in the National Health and Nutrition Examination Survey (NHANES) from 2011 to March 2020. The study cohort included 8,686 participants aged 30 to 59 years without prevalent CVD, representing approximately 91 million adults in the US population.
Using the PREVENT equations, researchers calculated 30-year absolute risk estimates for each participant.² The primary objective was to derive and evaluate age- and sex-specific percentiles for the 30-year risk of total CVD, ASCVD, and HF.
The median 30-year absolute CVD risk in the overall sample was 13.1%. The derived percentiles demonstrated clear differences based on age and sex. For example, at age 45, the 50th percentile for 30-year CVD risk was 9.9% for women and 16.2% for men. At the same age, the 75th percentile for 30-year CVD risk was 14.7% for women and 21.2% for men.
Similar patterns were observed for ASCVD and HF, with men consistently showing a higher 30-year absolute risk compared with women across the age spectrum studied.
Framing risk in terms of population-based percentiles may improve risk communication by providing context that is easier for patients to conceptualise than absolute risk estimates alone. The study authors concluded that “population-based age- and sex-specific percentiles for 30-year CVD risk with PREVENT may offer a complementary tool for clinicians and patients in addition to communicating absolute CVD risk estimates.”¹ An online tool has also been developed to present these risk percentiles.
The investigators suggest that further research is needed to validate the clinical utility of this approach. They note that “prospective studies should test whether this approach improves risk perception or decision-making in younger adults.”¹
References
1. Krishnan V, Huang X, Zhang S, et al. Age and Sex-Specific Percentiles of 30-Year Cardiovascular Disease Risk Based on the PREVENT Equations. JACC. 2025;86(21):2017-2027. https://doi.org/10.1016/j.jacc.2025.09.1509
2. Khan SS, Matsushita K, Sang Y, et al. Development and validation of the American Heart Association's PREVENT Equations. Circulation. 2024;149(6):430-449. https://doi.org/10.1161/CIRCULATIONAHA.123.067626
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